Pelvic Organ Prolapse Quantification System (POP-Q) - a new era in pelvic prolapse staging

C Persu, C R Chapple, V Cauni, S Gutue, P Geavlete, C Persu, C R Chapple, V Cauni, S Gutue, P Geavlete

Abstract

The prolapse of one or several pelvic organs is a condition that has been known by medicine since its early days, and different therapeutic approaches have been proposed and accepted. But one of the main problems concerning the prolapse of pelvic organs is the need for a universal, clear and reliable staging method.Because the prolapse has been known and recognized as a disease for more than one hundred years, so are different systems proposed for its staging. But none has proved itself to respond to all the requirements of the medical community, so the vast majority were seen coming and going, failing to become the single most useful system for staging in pelvic organ prolapse (POP).The latest addition to the group of staging systems is the POP-Q system, which is becoming increasingly popular with specialists all over the world, because, although is not very simple as a concept, it helps defining the features of a prolapse at a level of completeness not reached by any other system to date. In this vision, the POP-Q system may reach the importance and recognition of the TNM system use in oncology.This paper briefly describes the POP-Q system, by comparison with other staging systems, analyzing its main features and the concept behind it.

Keywords: POP–Q; cystocele; prolapse; rectocele; staging.

Figures

Figure 1
Figure 1
Pelvic organ prolapse map
Figure 2
Figure 2
Baden–Walker half way system [6]. It consists of four grades: grade 0 – no prolapse, grade 1–halfway to hymen, grade 2 – to hymen, grade 3 – halfway past hymen, grade 4 –maximum descent.
Figure 3
Figure 3
Points and landmarks for POP–Q system examination. Aa, point A anterior, Ap, point A posterior, Ba, point B anterior; Bp, point B posterior; C, cervix or vaginal cuff; D, posterior fornix (if cervix is present); gh, genital hiatus; pb, perineal body; tvl, total vaginal length
Figure 4
Figure 4
An example of measurements using the POP–Q system.

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