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Assessment of pelvic organ prolapse

Clinical assessment of Pelvic Organ Prolapse

Most of the assessment of a woman’s prolapse is clinical – in other words it is based on a combination of the history of symptoms and the physical examination (particularly the pelvic or vaginal examination).

The physical examination includes an abdominal examination and a pelvic (also known as internal or vaginal examination). Examination is performed with the patient lying down and sometimes while standing. Additional manoeuvres such as coughing or straining are used to help better demonstrate the prolapse. A vaginal speculum (similar to the speculum used when performing a pap smear) is used to help determine which type of prolapse is present (i.e. which area is prolapsing) as well as the severity of the prolapse.

Assessment of pelvic organ prolapse has many features in common with the assessment of urinary incontinence.

Other tests used in the assessment of Pelvic Organ Prolapse

Depending on the presence of urinary symptoms as well as the type and severity of the prolapse, further tests may be needed including:

  • Urinary ultrasound – to check the kidneys and assess bladder emptying
  • Urodynamic study – to check for blockage related to the prolapse, bladder function and the presence and severity of stress urinary incontinence.
  • Trial of a vaginal pessary – to see if symptoms thought to be due to the prolapse improve when the prolapse is corrected and to see if urinary incontinence is “unmasked” by correction of the prolapse.