Obstetrics & Gynaecology · Prolapse, Urinary Incontinence and Fistulas

A 58-year-old woman presents with a bulge at the vaginal introitus. On examination, the cervix is 3 cm beyond the hymenal ring. No cystocele or rectocele is seen. Using POP-Q (Pelvic Organ Prolapse Quantification) system, where the hymenal ring is 0 and points are: point C (cervix) = +3, total vaginal length = 9 cm, Aa = -2, Ba = -2, Ap = -3, Bp = -3. What is the POP-Q stage?

  • A Stage II
  • B Stage III
  • C Stage IV
  • D Stage I
Correct answer: B. Stage III

Explanation

POP-Q staging: Stage I = most distal point > 1 cm above hymen; Stage II = most distal point between -1 cm and +1 cm from hymen; Stage III = most distal point > 1 cm below hymen but < TVL-2; Stage IV = eversion ≥ TVL-2 cm (complete prolapse). The most dependent point is the cervix at +3 cm (3 cm below hymen). Since +3 > +1 and is not ≥ TVL-2 (TVL-2 = 7 cm), this is Stage III prolapse.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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