A 55-year-old multiparous woman presents with feeling of a lump per vaginum. POP-Q examination shows: Aa +1, Ba +2, C 0, D -4, Ap -2, Bp -1, GH 4, PB 2, TVL 9. What is the MOST accurate POP-Q staging?

• A Stage II prolapse (most distal point between -1 and +1 cm of hymen)
• B Stage IV prolapse (complete eversion)
• C Stage III prolapse (most distal point >+1 cm but <+(TVL-2) cm) ✓
• D Stage I prolapse (most distal point > -1 cm but entirely above hymen)

Explanation

POP-Q staging is based on the most distal prolapsing point. In this case, Ba = +2 cm is the most distal point (anterior compartment). Stage II is defined as the most distal point between -1 and +1 cm. Stage III is >+1 cm but less than +(TVL-2) cm; with TVL 9, Stage IV would require a point >7 cm. Ba of +2 exceeds +1 cm but is <7 cm, confirming Stage III. The anterior wall (cystocele) predominates here.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.