Stages are based on the maximal extent of prolapse relative to the hymen: |
Stage 0: |
No prolapse; anterior and posterior points are all – 3 cm. |
Stage I: |
The criteria for stage 0 are not met, and the most distal prolapse is more than 1 cm above the level of the hymen |
Stage II: |
The most distal prolapse is between 1 cm above and 1 cm below the hymen |
Stage III: |
The most distal prolapse is more than 1cm below the hymen but no further than 2 cm less than TVL |
Stage IV: |
Represents complete vault eversion |
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Six vaginal sites used in staging prolapse: |
Points Aa and Ba anteriorly |
Points Ap and Bp posteriorly |
Point C for the cervix or vaginal apex |
Point D for the posterior fornix (not measured after hysterectomy) |
GH – genital hiatus |
PB – perineal body |
TVL – total vaginal length |