Clinical Eval of POP

Question 1

Baden-Walker

Answer 1

Grade 0: Normal position for each site
Grade 1: Descent halfway to hymen
Grade 2: Descent to hymen
Grade 3: Descent halfway past hymen
Grade 4: Maximum descent for each site

Question 2

POP-Q points

Answer 2

6 Defined points:
 2 on anterior vagina (Aa, Ba)
 2 in superior vagina (C, D)
 2 on posterior vagina (Ap, Bp)
 Above hymen is negative (-) cm
 Below hymen is positive (+) cm; + means prolapse

patient needs to confirm maximum point of prolapse

Question 3

Using POP-Q for staging

Answer 3

 Stage 0
 No prolapse
 Aa, Ba, Ap and Bp all -3
 Point D (if with uterus) or C (if without uterus) equal
-TVL to -[TVL-2] cm

 Stage 1
 Criteria for stage 0 not met
 Most advanced aspect of prolapse is less then -1

 Stage 2
 Most advanced aspect of prolapse is between -1 and +1

 Stage 3
 Most advanced aspect of prolapse is greater than +1 but
less than +[TVL-2]

 Stage 4
 Eversion of total length of vagina
 Most advanced aspect of prolapse is at least +[TVL-2]