POP Flashcards

1
Q

What is a physical exam quantification for pelvic organ prolapse? What is reference point?

A

POP Q

Hymen

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2
Q

List the elements of POP Q? Aa, Ap, C, TVL?

A

Aa: anterior vaginal wall, 3 cm proximal to hymen, Range -3 to +3

Ba: most distal position of upper anterior vaginal wall

Ap: posterior vaginal wall, 3 cm proximal to hymen, Range -3 to +3

Bp: most distal position of upper anterior vaginal wall

C: most distal edge of cervix or vaginal cuff (8)

TVL: total vaginal length

D: posterior fornix (cannot measure with hysterectomy)

pb: perineal body (10)

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3
Q

What physical exam is important for leakage after sacrocolpopexy?

A

Fluid in vaginal vault
Defects at vaginal apex
Leak per meatus (strain/cough)
PVR
Presence/absence of prolapse
Urethral hypermobility

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4
Q

Patient s/p sacrocolpopexy with new onset leakage, what is ddx?

A

Vesicovaginal fistula
Ureterovaginal fistula
SUI
UUI

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5
Q

How do you evaluate for vesicovaginal fistula? ureterovaginal fistula?

A

Vesicovaginal → cystogram

Ureterovaginal → imaging of upper tracts (CTU/RGP)

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