Validation of the pelvic organ prolapse quantification (POP-Q) system in left lateral position

Introduction and hypothesis  The purpose of this study is to examine the inter-observer reliability of the pelvic organ prolapse quantification (POP-Q) system in left lateral position. Methods  Women attending urogynaecology outpatient clinics were examined in the left lateral position using a digital examination and POP-Q. This was repeated separately by a second blinded clinician. The inter-observer agreement was calculated using the Cohen’s kappa coefficient. The POP-Q examination was then performed with a woman lying in dorsal lithotomy position. The POP-Q findings in the two positions were compared. Results  Two hundred and eighteen women were recruited. The digital examination had a moderate inter-observer reliability with a kappa value of 0.54. The POP-Q showed a high degree of reliability (0.88). There was a high degree of correlation between the POP-Q findings in left lateral and lithotomy position (rho > 0.95, p < 0.001). Conclusion  The POP-Q in the left lateral position is reliable, easy to perform, acceptable for patients, and is not a time-consuming examination.