According to the POP-Q (Pelvic Organ Prolapse Quantification) system, a woman has point C (cervix) at +2 cm (2 cm beyond the hymen), total vaginal length 8 cm, and Aa point at +3 cm. In the POP-Q staging, what is the Stage?

• A Stage III — leading edge > +1 cm beyond hymen but not complete eversion ✓
• B Stage I — leading edge ≥ 1 cm above hymen
• C Stage II — leading edge between -1 and +1 cm of hymen
• D Stage IV — complete vault eversion (leading edge within 2 cm of TVL)

Explanation

POP-Q staging is based on the most distal (lowest) point of prolapse relative to the hymen: Stage I = leading edge ≥ -1 cm (1 cm or more above hymen); Stage II = between -1 and +1 cm; Stage III = > +1 cm beyond hymen but everted length ≤ total vaginal length minus 2 cm; Stage IV = complete eversion (prolapsed length ≥ TVL - 2 cm). Aa point = +3 cm (which is the most distal) and C = +2 cm. The most distal point is +3 cm, which is > +1 cm but TVL-2 = 8-2 = 6 cm, so +3 < 6, making this Stage III.

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

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Written and medically reviewed by the StethoPrep medical team.