The Baden-Walker halfway system for grading pelvic organ prolapse grades cystocele as Grade 3 when:

• A The leading edge of the bladder is at the hymen
• B The bladder protrudes beyond the introitus by half the potential total descent ✓
• C The bladder descends to halfway between the normal position and the introitus
• D The bladder is completely outside the introitus

Explanation

In the Baden-Walker halfway system: Grade 0 = normal position; Grade 1 = descent halfway to hymen; Grade 2 = descent to hymen; Grade 3 = descent halfway past the hymen (halfway between hymen and maximum protrusion); Grade 4 = maximum possible descent. Therefore Grade 3 represents protrusion halfway between the hymen and the maximum possible protrusion beyond the introitus. The POP-Q system is now more standardized, but Baden-Walker remains a classical examination question.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.