POP-Q Flashcards

POP-Q Flashcards Overview

• POP-Q (Pelvic Organ Prolapse Quantification) assesses prolapse using 6 key points measured from the hymen.
• Points above the hymen are given negative values, while those below receive positive values, facilitating clear assessment.

Key Measurement Points

• Aa: Anterior vaginal wall measured at 3cm proximal to the hymen, with a range from -3cm to +3cm.
• Ba: Most distal position of the upper anterior vaginal wall, measured from -3cm to total vaginal length (TVL).
• C: Refers to the most distal edge of the cervix or vaginal cuff scar.
• D: Corresponds to the posterior fornix, not applicable post-hysterectomy.
• Ap: Posterior vaginal wall at 3cm proximal to the hymen, also ranging from -3cm to +3cm.
• Bp: Most distal position of the upper posterior vaginal wall, similar measurement range as Ba.
• Genital Hiatus (gh): Measured from the middle of the external urethral meatus to the posterior midline hymen.
• Perineal Body (pb): Distance from the posterior margin of gh to the middle of the anal opening.
• Total Vaginal Length (tvl): Depth of vagina determined when point D or C is returned to its normal position.

Staging and Grading of Pelvic Organ Prolapse

• Stage 0: All points (Aa, Ap, Ba, Bp) at 3cm; C or D less than or equal to - (tvl - 2) cm.
• Stage I: Criteria for Stage 0 not met; leading edge between -1cm and +1cm, within two centimeters of tcl.

Grading of Pelvic Organ Prolapse

• Grading based on descriptors by Beecham and Baden & Walker.
• Grade 0: No prolapse.
• Grade 1: Descent halfway to hymen.
• Grade 2: Descent to hymen.
• Grade 3: Descent halfway past hymen.
• Grade 4: Maximum possible descent.

Staging of Pelvic Organ Prolapse

• Based on POP-Q values measured in centimeters.
• Stage 0: No prolapse.
• Stage 1: Prolapse >1cm above hymen.
• Stage 2: Prolapse within 1cm above or below hymen.
• Stage 3: Prolapse > 1cm below hymen, but less than TVL - 2cm.
• Distinctions important for clinical assessment, as a Grade 3 rectocele might be classified under Stage 2 if the leading edge aligns accordingly.