Received: 10 April 2018 | Accepted: 9 July 2018 DOI: 10.1002/nau.23798 ORIGINAL CLINICAL ARTICLE Comparability between adult female anogenital distance and perineal measurements standardized by POP-Q system (GH and PB) María L. Sánchez-Ferrer 1 | María T. Prieto-Sánchez 1 | Luis C. Moya-Jiménez 2 | Evdochia Adoamnei 3,4 | Jaime Mendiola 3,4 | Alberto M. Torres-Cantero 3,4 1 Departmentof Obstetrics and Gynecology, “Virgen de la Arrixaca” University Clinical Hospital and Institute for Biomedical Research of Murcia, El Palmar, Murcia, Spain 2 Department of Obstetrics and Gynecology, University General Hospital Santa Lucía, Cartagena, Murcia, Spain 3 Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, Espinardo, Murcia, Spain 4 Institute for Biomedical Research of Murcia, El Palmar, Murcia, Spain Correspondence María T. Prieto-Sánchez, Department of Obstetrics and Gynecology, “Virgen de la Arrixaca” University Clinical Hospital, 30120 El Palmar, Murcia, IMIB-Arrixaca, Spain. Email: mt.prieto@um.es Funding information Ministry of Economy and Competitiveness, ISCIII (AES), Grant number: PI13/01237; Seneca Foundation, Murcia Regional Agency of Science and Technology, Grant number: 19443/PI/14 Aims: Anogenital distance (AGD) has been proposed as a marker of the prenatal hormonal milieu and potential environmental insults. The measures of the Pelvic Organ Prolapse-Questionnaire (POP-Q) system is being widely used in the evaluation of the perineum in women with POP pathologies. Genital hiatus (GH) and perineal body (PB) lengths have been related to both prolapse incidence and recurrence and for pessary treatment failure. The use of AGD in female human studies is now emerging and its comparability with other anthropometric measurements could be relevant. The aim of the study was to compare AGD and POP-Q system in adult females. Methods: The study included 155 pregnant women in the first stage of labor. Perineal measurements were performed on women in the lithotomy position: AGD from the anus to the clitoris (AGD AC ); AGD from the anus to the fourchette (AGD AF ); GH from the external urethral meatus to the posterior midline hymen, and length of the PB from the posterior midline hymen to the mid-anal opening. Coefficients of variations (CV) were calculated. Intraclass correlation coefficients (ICC) and Bland-Altman graphs were used to compare both set of measurements. Results: CV were below 15% for AGD AC and GH + PB, though higher for AGD AF and PB (20% and 17%, respectively). ICCs for each pair of measurements were above 80%, (excellent agreement between methods). Concordance between measurements was confirmed by Bland-Altman graphs. Conclusions: Comparable measurements were obtained using AGDs and POP-Q system. Further studies are needed to explore clinical and epidemiological implications of these findings. KEYWORDS anogenital distance, perineal measurements, POP-Q 1 | INTRODUCTION The distance from the anus to the genitals (AGD) is a sexually dimorphic characteristic in placental mammals. 1–4 Experimental studies on animals have shown that AGD is set prenatally and persists during adulthood. 5 Anogenital distance (AGD) is considered a marker of prenatal androgen exposure. 6 Higher intrauterine androgen exposure induces longer, more masculine, Jan-Paul Roovers led the peer-review process as the Associate Editor responsible for the paper. Neurourology and Urodynamics. 2018;1–7. wileyonlinelibrary.com/journal/nau © 2018 Wiley Periodicals, Inc. | 1