Genital hiatus measurements predict cuff prolapse risk in prolapse surgery

Background/Aim: Recognition and assessment of apical vaginal support defects remains a significant challenge in the evaluation management prolapse because there are no consensus or guidelines address degree loss at which an procedure should routinely be performed. The aim this study was to evaluate whether preoperative genital hiatus (GH), perineal body (PB), total length (TVL) associated with recurrence after surgery. Methods: Our cohort included 98 patients who underwent hysterectomy suspension due uterovaginal grade 2 higher according Pelvic Organ Prolapse Quantification (POP-Q) staging between 2020 2021. Patients history gynecologic malignancy, those could not tolerate surgery anesthesia, had previously undergone pelvic organ surgery, concomitant stress urinary incontinence, abnormal cervical smear results were excluded. followed for years intervals 3 months first year last POP-Q performed 24 surgical intervention. Surgical failure defined as descent greater than one third length, anterior posterior wall past hymen, subsequent bothersome bulge. given Symptom Score (POP-SS) questionnaire before 6 postoperatively, severity symptoms compared groups without postoperative recurrence. Logistic regression (LR) analysis determine factors affecting Areas under ROC curve calculated differential diagnosis presence recurrence, predictive value (cut-off) variables determined using sensitivity, specificity, positive value, negative LR (+) values. Results: While successful 80 patients, relapse seen 18 patients. mean 3.05 (0.28) cm, GH 3.9 (0.39) TVL 8.54 (1.33) cm. group significantly (P=0.004). POP-SS score 15.14 (1.86), 4.01 (3.74). (P<0.001). For hiatus, cut-off >4 cm sensitivity 61.11%, specificity 76.25%, 36.70%, 89.70%, 2.57. Preop-Postop Change %, <60 94.44%, 98.75%, 94.40%, 98.80%, 75.56. Conclusion: Apical is highly size. In particular, all definitions, Prolapse-Quantification measurement strong predictor loss. This simple can used screen further planning