Review of the POP-Q Pelvic Organ Prolapse assessment app

Post image for Review of the POP-Q Pelvic Organ Prolapse assessment app

Purpose of App Review

  • to review the utility of the app for routine pelvic organ prolapse assessment
  • to evaluate the diversity of the app for POP-Q grid guidance and for visual guidance

Introduction

Muscles and soft tissue eventually give out.

For some women this occurs in their 30s or 40s, for others in the 60s and 70s; other women never experience the symptoms of pelvic organ prolapse (POP).

When women present with symptoms, meticulous attention to the pelvic floor support is required to diagnose and plan treatment strategies.

The Pelvic Organ Prolapse Quantification (POP-Q) system is a validated physical exam tool to assess POP (Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull B, Smith ARB, Am J Obstet Gynecol, 175(1):1956-1962, 1996).

The POP-Q Pelvic Organ Prolapse Interactive Assessment Tool medical app seeks to provide a visual grid and pelvic anatomy guide and teaching tool for healthcare providers of women with POP.

User Interface

On first use, the app requires you to register (for free) with BARD. After your register, you can then use all the app’s features. The home screen gives you several options: Make an Assessment, Choose an Example, and Stress Urinary Incontinence (SUI).

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The Make an Assessment section provides the POP-Q grid, as well as an image of the female hemipelvis. As you select the various points on the grid, the image changes to indicate which POP-Q component you are looking at and gives a brief descripton.

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You can select to have the image with or without a uterus.

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You can also send an email with the grid assessment in longitudinal format and an image with the exam results. Links for professionals and patients are given at the bottom to BARD medical.

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The Prolapse Examples section provides repair examples and prolapse examples. The prolapse examples include anterior, uterine, vaginal vault, and posterior examples of all four stages, including without uterus pictures.

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Each prolapse image gives example POP-Q findings, as well as the ability to look at normal anatomy.

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The repair examples include anterior and posterior grafts with and without a uterus, as well as a vaginal vault graft.

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The Stress Urinary Incontinence (SUI) portion of the app provides four videos about SUI, including: normal anatomy, SUI, treatment of SUI with a sling, and treatment with bulking agents.

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Evidence to support use

  • The app utilizes the POP-Q system appropriately, but does not mention or reference the original study (Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull B, Smith ARB, Am J Obstet Gynecol, 175(1):1956-1962, 1996)  or subsequent validation studies in order to support their use of the POP-Q system in the app.
  • The POP-Q system was first developed and studied in the 1990s with the original paper published in 1996. It has been adopted by the International Continence Society and is an accepted staging system for pelvic organ prolapse.

Price

  • Free

Likes

  • multiple prolapse examples that can be used to show patients or trainees
  • ability to email exam results
  • guidance for POP-Q grid components
  • ability to have with and without uterus images

Dislikes

  • inability to write on the images
  • no reference to original paper on POP-Q
  • no references to other helpful sights about POP except BARD

Healthcare providers that would benefit from the app

  • Healthcare providers and trainees taking care of women with pelvic organ prolapse, especially if the POP-Q exam is not something you do on a routine basis. Probably not helpful for a pelvic floor medicine and reconstructive surgeon or a urologist who performs POP-Q exams daily

Patients that may benefit from app

  • Patients with POP who would like to know more about what each stage looks like

Conclusions

  • The POP-Q Pelvic Organ Prolapse Interactive Assessment Tool medical app provides a useful assessment tool reminder for healthcare providers using the POP-Q to assess for pelvic organ prolapse. It is most useful to providers who do not use the exam on a daily basis, but provides useful images that could be used on a daily basis.
  • This is tool I would love to have my trainees use along with me as I do the exam in order to record the results of the exam and provide some useful learning for them and the patient. It does have some proprietary caveats (such as a reference to BARDs mesh, while ignoring the use of pessaries) that potentially detract, but they are placed in such a way that they are not obtrusive.
  • As of publish, the app is not available on the Android platform.

iTunes Link

Rating: 4/5
1. User Interface – 4.  Occasional difficulty in getting back to the homescreen, but otherwise very easy to navigate
2. Multimedia usage – 4.  Utilizes split-screen display, smooth transitions, and video.  Only detractor is inability to write on the images.
3. Price – 5. Free!
4. Real world applicability – 3.  Moderate usage for the general gynecologist

App version: 1.2
Compatibility: Compatible with iPhone, iPad, and iPod touch
Requires: Requires iOS 4.0 or later
Tested on: iPhone 4S with iOS 7

Disclaimer:
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your healthcare provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or healthcare provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your healthcare provider.

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