The POP-Q (Pelvic Organ Prolapse Quantification) system uses the hymenal remnant as the fixed reference point (0 cm). A woman has Aa = +1, Ba = +3, C = +4, gh = 5, pb = 3, tvl = 9, Ap = −1, Bp = −1, D = +2. What POP-Q stage is her anterior compartment prolapse?

• A Stage II — leading point between 1 cm above and 1 cm below hymen
• B Stage IV — total vaginal eversion
• C Stage III — leading point >1 cm beyond hymen but not total eversion ✓
• D Stage I — leading point above hymen

Explanation

POP-Q staging is based on the LEADING POINT of the most prolapsed segment. Here, the anterior points: Aa = +1 cm (at hymen = Stage II boundary), Ba = +3 cm (3 cm beyond hymen). The leading anterior compartment point is Ba = +3 cm, which is >1 cm beyond the hymenal plane but less than total vaginal eversion (Stage IV, defined as leading point ≥ tvl−2 cm = ≥+7 cm). Therefore, anterior compartment is Stage III. Stage II requires leading point between −1 and +1 cm; Stage III is >+1 cm but not complete eversion.

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

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