A review of the pelvic organ prolapse quantification system in China

Introduction and hypothesis: Unified staging systems for pelvic organ prolapse (POP) have been established. We examined the application of the POP quantification (POP-Q) system in China by examining its use in scientific journal articles. Methods: Relevant articles were identified by searching the Sinomed database using the terms: uterus prolapse, cystocele, proctocele, prolapse, and pelvic floor; limited to Chinese core journals in obstetrics and gynecology, from January 2004 to December 2014. We analyzed systems for grading POP severity and the adoption of POP-Q in different article categories and hospitals of different levels. For the last decade, with two 5-year groups (2005–2009; 2010–2014), the χ2 test was used to evaluate inter-group differences. Results: In a total of 429 articles, 331 included a staging system, 70.7% of which used POP-Q. The POP-Q system first appeared in 2004 in China, was reported in 50% of articles in 2007, and its highest use occurred in 2012 (89.5%). In 234 POP-Q system-utilizing reports, operative treatment and basic research accounted for 73.1% and 14.0% respectively. POP-Q usage increased from 2005–2009 to 2010–2014 in surgery-related articles (54.2% vs 85.2%; P = 0.000). The proportion of reports using POP-Q in level I, II, and III hospitals was 20.0%, 35.4%, and 77.8% respectively. Conclusions: The POP-Q system, first used in 2004 in China, is now the most commonly used grading system, with surgery reports and level III hospitals accounting for the largest proportion of POP-Q applications.