Post-Hysterectomy Vaginal Vault Prolapse GTG 2015 Flashcards
What proportion of hysterectomies have vault prolapse?
11% Hysterectomy for prolapse
1.8% hysterectomy for other bengin causes
How many points are measured in POP-Q in relation to the Hymen?
6 points
When are the points measured
All except TVL are measured in maximum valsalva
Describe point Aa and Ap
Aa Anterior vaginal wall 3cm proximal to hymen
Ap posterior vaginal wall 3cm proximal to hymen
-3cm to +3cm
Describe point Ba and Bp
Ba Most distal portion of remaining anterior vaginal wall
Bp Most distal portion of remaining posterior vaginal wall
-3cm to +tvl
How to measure total vaginal length?
Depth of vagina when point D or C is reduced to normal position
Describe point C
Most distal edge of cervix or vaginal cuff scar
Describe point D
Posterior fornix (N/A if post hysterectomy)
What is the genital hiatus (gH)
Middle of external urethral meatus to posterior nudkube hymen
What is the perineal body
Measure from posterior margin of gH to middle of anal opening
POP-Q staging Stage 0
Stage 0 No descent
(Aa, Ap, Ba, Bp -3cm
C or D < TVL-2cm)
POP-Q staging 1
Stage 0 not met, leading edge > 1cm above hymnal ring
POP-Q staging 2
Leading edge from 1cm above to 1cm below hymnal ring
POP-Q Staging 3
Leading edge more than 1 cm but less than (TVL-2cm)
ie not complete eversion
POP-Q staging 4
Leading edge over TVL-2cm
Complete eversion