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CHAPTER 24: Pelvic Organ Prolapse

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    AMA Citation
    Pelvic Organ Prolapse. In: Werner CL, Richardson DL, Chang SY, Griffith WF, Hamid CA, Rahn DD, Moschos E, Hoffman BL. Werner C.L., Richardson D.L., Chang S.Y., Griffith W.F., Hamid C.A., Rahn D.D., Moschos E, Hoffman B.L. Eds. Claudia L. Werner, et al.eds. Williams Gynecology Study Guide, 3e New York, NY: McGraw-Hill; . http://obgyn.mhmedical.com/content.aspx?bookid=1813&sectionid=126260183. Accessed October 19, 2018.
    MLA Citation
    . "Pelvic Organ Prolapse." Williams Gynecology Study Guide, 3e Werner CL, Richardson DL, Chang SY, Griffith WF, Hamid CA, Rahn DD, Moschos E, Hoffman BL. Werner C.L., Richardson D.L., Chang S.Y., Griffith W.F., Hamid C.A., Rahn D.D., Moschos E, Hoffman B.L. Eds. Claudia L. Werner, et al. New York, NY: McGraw-Hill, , http://obgyn.mhmedical.com/content.aspx?bookid=1813&sectionid=126260183.

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Pelvic Organ Prolapse

What is the cumulative lifetime risk of a woman undergoing surgery for pelvic organ prolapse?

a. 0.1 to 0.15 percent

b. 1 to 5 percent

c. 10 to 15 percent

d. >30 percent

c Epidemiology

Based on physical examination, what percentage of adult women presenting for routine gynecologic care demonstrate prolapse coming to within 1 cm of the plane of the hymen?

a. 0.1 percent

b. 1 percent

c. 10 percent

d. ≥30 percent

d Epidemiology

Compared with selective use, elective episiotomy at the second stage of labor has been associated with all of the following EXCEPT:

a. Periurethral tears

b. Anal sphincter laceration

c. Increased postpartum pain

d. Postpartum anal incontinence

a Obstetric-Related Risks

Risk factors for the development of pelvic organ prolapse include which of the following?

a. Black race

b. Elective cesarean delivery

c. Increased ratio of collagen types III and IV to type I

d. All of the above

c Connective Tissue Disease

Which statement is correct regarding measurements taken for the Pelvic Organ Prolapse Quantification (POP-Q) examination?

a. All are taken at rest, except for total vaginal length, which is obtained during Valsalva.

b. Point D is omitted in the absence of a cervix.

c. GH is measured from the midline of the posterior hymeneal ring to the midanal opening.

d. Point Aa corresponds to the most distal portion of any part of the upper/proximal anterior vaginal wall.

b Apical Vaginal Points

Which POP-Q point represents the level of uterosacral ligament attachment to the proximal posterior cervix?

a. Point Ap

b. Point Bp

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