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Chapter 38 Pelvic Organ Prolapse
Lisa Jambusaria, MD
❍ Pus expressed through the urethral meatus on palpation of the urethra may indicate the presence of what defects?
Infected urethral diverticulum or infected Skene glands.
❍ What is the most common compartment for pelvic organ prolapse?
The anterior compartment (commonly known as a cystocele).
❍ What is the most common compartment for prolapse recurrence after surgical repair?
The anterior compartment.
❍ What defect of pelvic support is due to a weakened cul-de-sac of Douglas?
Enterocele.
❍ What standardized measurement system is used to describe pelvic organ prolapse?
Pelvic Organ Prolapse Quantitation System or the POPQ giving measures at different compartments and a stage of
prolapse based on the measure of the leading edge of prolapse.
❍ What point on the Pelvic Organ Prolapse Quantification System (POP-Q) is not measured after a hysterectomy?
Point D at the posterior fornix.
❍ What is the other commonly used system for describing prolapse?
The Baden Walker Scoring System.
❍ How does the Baden Walker Halfway Scoring System describe prolapse?
The Baden Walker Halfway Scoring System describes position of the leading edge of prolapse being halfway to the
hymen, to the hymen, halfway past the hymen or fully everted out of the vault:
- Grade 0: Normal position for all anatomical markers.
- Grade 1: Descent half way to the hymen.
- Grade 2: Descent to the level of the hymen.
- Grade 3: Descent half way past the hymen.
- Grade 4: Maximum possible descent at all markers.