Point Aa of the POP-Q system as a predictive value of urethral mobility in women

Abstract

This study was conducted to evaluate the relationship between the point Aa of the pelvic organ prolapse quantification (POP-Q) system and the Q-tip straining angle and to determine if Q-tip testing is required to assess urethral mobility. A total of 250 women presenting with urinary incontinence were prospectively examined. Spearman's correlation coefficient was used to assess the degree of correlation between the POP-Q point Aa position and Q-tip values. Urethral hypermobility was noted in 61% of stage I, 89% of stage II, and 100% of stages III and IV. A substantial negative correlation was found between the point Aa position and the straining Q-tip angle (r=0.683, p<0.0001). A substantial correlation was found between descent at point Aa and the straining Q-tip angle. The point Aa of the POP-Q system is highly predictive of the abnormal straining urethral angle in women with stage I or greater anterior vaginal wall prolapse.