Patient selection: woman with pelvic organ prolapsed
Reference point for distance measurements: hymen
A negative distance indicates an internal measurement.
A positive measurements indicated external projection.
Measurements:
(1) Aa: distance from hymen to point Aa on anterior aspect in cm
(2) Ba: distance from hymen to point Ba on anterior aspect in cm
(3) C: distance from hymen to cervix or cervical scar in cm
(4) gh (genital hiatus): length of the genital hiatus in cm
(5) pb (perineal body): length from posterior aspect of genital opening to anus
(6) tvl (total vaginal length): length of vagina from hiatus to posterior fornix
(7) Ap: distance from hymen to point Ap on posterior aspect in cm
(8) Bp: distance from hymen to point Bp on posterior aspect in cm
(9) D: distance from hymen to posterior fornix in cm (blank if post-hysterectomy)
These can be displayed in a 3 x 3 grid with the first row items 1 to 3, the second row 4 to 6, and the third row 7 to 9.
Features of Stage 0 (normal):
(1) distances Aa, Ap, Ba, and Bp all <= -3 cm
(2) distances C and D both <= - (tvl – 2) cm
|
Stage
|
Distances for Aa, Ab, Ba, Bp, C and D
|
|
1
|
All < -1 cm AND not Stage 0
|
|
2
|
Most distal from -1 to 1 cm
|
|
3
|
Most distal > 1 and < (tvl-2) cm
|
|
4
|
Most distal >= (tvl-2) cm
|
