Advanced anterior vaginal wall prolapse is highly correlated with apical prolapse

Objective The purpose of this study was to determine the relationship between the most prolapsed portion of the anterior and posterior vaginal walls and the apex. Study design After obtaining institutional review board approval, demographic data and pelvic organ prolapse quantification findings from consecutive new patients who were seen at our urogynecologic practice between January 2004 and February 2005 were reviewed. Results Three hundred twenty-five women were included in this cohort. The support of the vaginal apex (pelvic organ prolapse quantification point C) correlated strongly with the most prolapsed portion of the anterior vaginal wall, Ba (Spearmanʹs ρ = 0.835; P< .001) and correlated moderately with the most prolapsed portion of the posterior vaginal wall, Bp (Spearmanʹs ρ = 0.556; P< .001). A strong linear relationship was found between C and Ba, which is best modeled by the following regression equation: C = Ba(1.4) − 4.4 (r = .869). Conclusion Anterior vaginal wall prolapse is associated strongly with apical prolapse. Anterior vaginal wall defects that are surgically repaired usually require a concomitant repair of the apex.