Obstetrics & Gynaecology · Prolapse, Urinary Incontinence and Fistulas

The POP-Q (Pelvic Organ Prolapse Quantification) system uses the hymenal ring as the reference landmark (point 0). In staging Stage II prolapse, the leading edge of the prolapse is located:

  • A More than 1 cm above the hymen (≤−1 cm)
  • B Between 1 cm above and 1 cm below the hymen (−1 cm to +1 cm)
  • C More than 1 cm beyond the hymen (+1 cm or more)
  • D At total eversion of the vagina
Correct answer: B. Between 1 cm above and 1 cm below the hymen (−1 cm to +1 cm)

Explanation

The POP-Q staging: Stage I = leading edge >1 cm above hymen (more negative than −1); Stage II = leading edge between −1 cm and +1 cm (within 1 cm of hymen in either direction); Stage III = leading edge >1 cm beyond hymen but not total eversion; Stage IV = complete eversion. Point 0 is the hymen. Points measured include Aa/Ap (anterior/posterior vaginal wall 3 cm from hymen), Ba/Bp (most prolapsed part of anterior/posterior wall), C (cervix/vaginal cuff), D (posterior fornix), gh (genital hiatus), pb (perineal body), tvl (total vaginal length). Stage II is the most commonly symptomatic threshold, though symptom threshold varies between patients.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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