{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T23:42:29Z","timestamp":1769557349045,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The POP-Q system is conventionally used to evaluate pelvic organ prolapse (POP). Nevertheless, differences between clinical examination and intraoperative findings can hinder appropriate surgical planning. We aimed to assess the accuracy of a sequential protocol involving clinical POP-Q assessment and, in cases of uncertain diagnosis, transperineal ultrasound. Methods: We conducted a prospective observational study with 314 women scheduled for POP surgery from January 2021 to December 2024. A pelvic floor specialist assessed all patients using the POP-Q system. Transperineal ultrasound was carried out only when the clinical diagnosis remained uncertain. We compared the accuracy of this sequential approach (POP-Q \u00b1 ultrasound) versus POP-Q alone, using intraoperative findings as the gold standard. Sensitivity and specificity were determined for each type of prolapse. Results: Of the 314 patients, 181 (57.6%) had a definitive diagnosis with POP-Q alone, whereas 133 (42.4%) required additional ultrasound. In these uncertain cases, the addition of ultrasound significantly increased sensitivity for cystocele (by 0.5\u201311.3%), uterine prolapse (45.5\u201363.7%), cervical elongation (5.2\u201321.4%), rectocele (5.7\u201316.4%), and enterocele (58.7\u201374.7%) (all p &lt; 0.05). Specificity also improved for uterine prolapse, cervical elongation, and rectocele. The sequential protocol\u2019s performance in uncertain cases was comparable to clinical examination in straightforward cases. Conclusions: Applying a sequential protocol that adds transperineal ultrasound for unclear cases significantly increases diagnostic precision for surgical POP, potentially optimizing surgical planning.<\/jats:p>","DOI":"10.3390\/jcm15030979","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:21:40Z","timestamp":1769505700000},"page":"979","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improving Diagnostic Accuracy for Surgical Pelvic Organ Prolapse: A Sequential Protocol Combining POP-Q Examination and Transperineal Ultrasound"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3079-5583","authenticated-orcid":false,"given":"Jos\u00e9 Antonio","family":"Garc\u00eda-Mejido","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Seville, 41014 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Hurtado-Guijosa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Seville, 41014 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5823-5705","authenticated-orcid":false,"given":"Ana","family":"Fern\u00e1ndez-Palac\u00edn","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, 41014 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3525-2924","authenticated-orcid":false,"given":"Fernando","family":"Fern\u00e1ndez-Palac\u00edn","sequence":"additional","affiliation":[{"name":"Department of Statistics and Operational Research, University of C\u00e1diz, 11003 C\u00e1diz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9367-6541","authenticated-orcid":false,"given":"Fernando","family":"Bugatto","sequence":"additional","affiliation":[{"name":"Department of Child and Mother Health and Radiology, School of Medicine, University of C\u00e1diz, 11009 C\u00e1diz, Spain"},{"name":"Division of Maternal-Fetal Medicine, Obstetrics and Gynecology Department, Puerta Del Mar University Hospital, Biomedical Research and Innovation Institute of C\u00e1diz (INiBICA), 11009 C\u00e1diz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9571-3219","authenticated-orcid":false,"given":"Jos\u00e9 Antonio","family":"Sainz-Bueno","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Seville, 41014 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/S0029-7844(97)00058-6","article-title":"Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence","volume":"89","author":"Olsen","year":"1997","journal-title":"Obstet. 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