The POP-Q system provides a standardized method for measuring pelvic organ prolapse in 3 steps: 1) Measuring the genital hiatus and perineal body. 2) Measuring the total vaginal length. 3) Measuring points on the anterior and posterior vaginal walls relative to the hymen. When used by experienced examiners, the POP-Q system takes about 2 minutes on average to perform and provides an interobserver reliable assessment of prolapse.

1. POP-Q ICS prolapse staging system Modified from Messelink EJ : Evaluation Female Pelvic Floor Disorders , EAU 2010

3. Measurements can be obtained in an average of 2.1 minutes per examination by experienced examiners and 3.7 minutes per examination by new examiners . Therefore, practitioners should be able to learn and use this system with minimal effort. Hall, AF, Theofrastous, JP, Cundiff, GW, et al. Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol 1996; 175:1467 .

5. Anatomic landmarks Hymen is the fixed point of reference The plane of hymen is defined as 0 6 points measured in cm proximal or distal

6. POP-Q iuga simplified version gh 3 cm pb 2 cm Tvl 10 cm Ap 3 cm Bp 3 cm Source : Swift S , 2006

7. Instruments measuring device Sims speculum

8. Order of exams Step 1 : Genital Hiatus (gh : 3 cm) Perineal Body (pb: 2cm)

9. Order of exams Step 2 : Vaginal Lenght ( D : 10 cm )

10. Order of exams Step 3: Anterior wall ( Aa:3 cm – Ba:6 cm )

11. Order of exams Step 4: Posterior wall (Ap:3 cm – Bp:6 cm)

12. BARD Interactive Guide

13. Grid Report