Pressure measurement
IAP was measured by a single experienced investigator preoperatively
before the pelvic organ prolapse reconstruction procedure or D&C.
Before the induction of any general or spinal anesthesia, a Foley
catheter was placed, as is our current standard of care.
IAP measurements were obtained with the patient in the fully supine
position without head of bed elevation and at the end of expiration,
according to the recommendations by the World Society of the Abdominal
Compartment Syndrome (WSACS).7 The mid-axillary line
at the level of the iliac crest was used as the zero reference point.
The Foley catheter was clamped 2 centimeters distal to the port. The
pressure transducer system was connected to the pressure monitoring
cable tubing was then connected to the Foley catheter via a 16-gauge
needle through the port on the catheter tubing. A 50 mL syringe was
attached to the distal stopcock and filled with saline, and the stopcock
was turned off toward the patient. Then, 50 cc of sterile saline was
instilled into the bladder and the measurement of IAP was performed for
30-60 seconds, after pressure stabilization and the end of respiratory
expiration were ensured.10 The second measurement was performed 6 months
after prolapse surgery with the same protocol.