Int Urogynecol J (2009) 20:1013–1021 DOI 10.1007/s00192-009-0903-0 ORIGINAL ARTICLE Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population Marijke C. Ph Slieker-ten Hove & Annelies L. Pool-Goudzwaard & Marinus J. C. Eijkemans & Regine P. M. Steegers-Theunissen & Curt W. Burger & Mark E. Vierhout Received: 30 December 2008 / Accepted: 22 April 2009 / Published online: 15 May 2009 # The Author(s) 2009. This article is published with open access at Springerlink.com Abstract Introduction and hypothesis Estimation on prevalence and distribution of pelvic organ prolapse (POP) signs in a general female population is difficult. We therefore devel- oped and validated a prediction model and prognostic instrument. Methods Questionnaires were sent to a general female population (45–85 years). A random sample underwent vaginal examination for POP (POPQ). A prediction model was developed using multivariate analysis and validated in a subgroup of participants. Results Positive questionnaire-response rate was 46.8% (1,397 of 2,979). From the questionnaire group, 649 M. C. Ph. Slieker-ten Hove : R. P. M. Steegers-Theunissen Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands M. C. Ph. Slieker-ten Hove : A. L. Pool-Goudzwaard Cobra Research Institute, Amersfoort, The Netherlands A. L. Pool-Goudzwaard Department of Neuroscience, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands M. J. C. Eijkemans Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands R. P. M. Steegers-Theunissen Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands women were vaginally examined (46.5%). Prevalence of clinically relevant POP was 21%. Multivariate analysis demonstrated significantly higher odds ratios on the report of vaginal bulging, parity ≥2 and a mother with POP. The receiver operating characteristic curve showed areas under the curve of 0.672 and 0.640. Conclusions The prevalence of POP at or beyond the hymen could be estimated in a general female population using our prediction model with 17 questions and our POP score chart with eight questions. Keywords Pelvic organ prolapse . POPQ . Prediction model . Prevalence . Vaginal bulging R. P. M. Steegers-Theunissen Department Paediatrics/Paediatric Cardiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands R. P. M. Steegers-Theunissen Department Clinical Genetics, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands C. W. Burger Department of Obstetrics and Gynaecology/ Division of Gynaecologic Oncology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands M. E. Vierhout Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands M. C. Ph. Slieker-ten Hove (*) Softwareweg 5, 3821 BN, Amersfoort, The Netherlands e-mail: m.slieker@somt.nl