The correlation of urethral mobility and point Aa of the pelvic organ prolapse quantification system before and after surgery

Objective The purpose of the study was to determine the effects of pelvic floor surgery on Q-tip angle and point Aa of the pelvic organ prolapse quantification system. Study design A clinical database was used for this retrospective review of Q-tip and prolapse measurements before and after pelvic floor surgery. Subanalyses of isolated bladder neck and prolapse surgeries were also performed. Correlations between Q-tip and point Aa were assessed with Pearson and Spearman coefficients and the Z statistic. Results Correlations between Q-tip and point Aa for all 350 women were not significantly different before and after the operation (r = 0.45 vs 0.49; P = .50). Subanalysis of the bladder neck–only group demonstrated similarly fair correlations (r = 0.26 vs 0.31; P = .71; n = 94). The prolapse-only group demonstrated better overall correlation without significant differences before and after the operation (r = 0.78 vs 0.51; P = .10; n = 26). Conclusion Point Aa does not reflect bladder neck mobility accurately as measured by the Q-tip angle after surgical restoration of the pelvic anatomy.