The visual analog scale of UDI-6 and IIQ-7 has been shown to be reliable and reproducible compared to the Likert-type supporting its use in urogynecologic research.[34] Many studies have emerged over the past decade that have incorporated QOL questionnaires to determine their relationship to symptoms, to evaluate and compare efficacy of different treatment modalities and to investigate their potential use in predicting the presence of physical objective findings. The nearly universal acceptance of the POP-Q system of staging of prolapse combined with the consistent use

of standardized and validated QOL questionnaires has facilitated the evaluation of findings across study designs thereby increasing their potential to influence clinical practice. Several studies have investigated the relationship between check details scores on QOL questionnaires, subjective symptoms and findings on physical examination. Symptoms that women with POP experience have been commonly thought to be related to specific compartments (i.e. UI) (and other voiding dysfunction) and bowel dysfunction were due to anterior and posterior

compartment prolapse, respectively. However, earlier studies reported few correlations between symptoms of pelvic floor dysfunction and the presence of POP.[35-37] These findings are similar to results from a more recent prospective cross-sectional OSI-906 solubility dmso study evaluating the relationship between bowel complaints and the severity of prolapse. Three hundred and twenty-two mostly Caucasian women with stage I through IV prolapse by POP-Q were asked

to complete the Colorectal-Anal Distress Inventory and Colorectal-Anal Impact Questionnaire.[38] Although almost one-third of women answered “yes” to the question “Do you usually have to push on the vagina or around the rectum to have or complete a bowel Etofibrate movement?”, a prevalence consistent with other studies,[39, 40] there was no association between a more advanced stage of prolapse and increased questionnaire scores or bowel symptoms. These results may in part be due to the fact that the “severity of prolapse” may be too broad a category and more specific physical findings should be targeted. In support of this, Saks et al. found that using the short form PFDI-20 to screen 260 women with POP, those with posterior vaginal wall prolapse were more likely to report straining on defecation, incomplete emptying and splinting with defecation.[41] Thus, in the absence of posterior compartment prolapse, symptoms of bowel dysfunction may not be an associated feature of advanced POP. Barber et al. investigated whether a single question could screen for the presence of POP without a physical examination.