A simple teaching tool for training the pelvic organ prolapse quantification system

Abstract

The pelvic organ prolapse quantification (POPQ) system is currently the most common and specific system describing different prolapse stages. Nevertheless, its use is not yet accepted worldwide in routine care. Our aim was to develop a simple teaching tool for the POPQ system capable of simulating different stages of uterovaginal prolapse for use in medical education with hands on training. We constructed a moveable and flexible tool with an inverted Santa Claus' cap, which simulated the vaginal cuff and the tassel at the end representing the cervix. A wooden embroidery frame fixed the cap and served as the hymen, the reference point for all measurements. Inside the cap, we sewed buttons to define the anatomic landmark points Aa and Ap located 3 cm distal from the frame. After explaining the device to the students, we used the three-by-three grid for recording the quantitative description of the pelvic organ support. First, each student had to demonstrate a specific prolapse with his cap device. Then, a prolapse was simulated on the cap, and the student had to take the relevant measurements and record them in the POPQ grid. The main training effect to understand the POPQ system seems to be the possibility for each trainee to simulate a three-dimensional prolapse with this flexible vagina model.

Improvements in overactive bladder syndrome after polypropylene mesh surgery for cystocele

“…Of the women who visited our clinic between April 2005 and June 2007, patients with grades 2–4 of pelvic organ prolapse and OABS were studied. These grades were assigned according to the Pelvic Organ Prolapse Quantitative (POP‐Q) system 15 . Twenty‐four women underwent transobturator polypropylene mesh AP that was performed by using Gynecare Prolift*.…”

How to use the Pelvic Organ Prolapse Quantification (POP‐Q) system?

“…It has been criticized as being too complicated, difficult to use, teach, and communicate . Various approaches and tools have been used to teach POP‐Q and have all been shown to be effective …”

“…12 Various approaches and tools have been used to teach POP-Q and have all been shown to be effective. 13,14 Women with POP generally present with several complaints of bladder, bowel, and pelvic dysfunction; however, the symptom of a vaginal bulge is considered specific to prolapse and correlates well with the severity for the prolapse. 15,16 POP is generally considered to be symptomatic when the leading edge of the prolapse is at or beyond the level of the hymen (>stage 2 POP-Q).…”

Examen clinique et classification du prolapsus génital

“…Mais, cette classification est toutefois reproductible [17,18] et des améliorations sont possibles : classification simplifiée [19], apprentissage adapté [20]... Malgré tout, la diffusion du POP-Q, sa reproductibilité, son profil pédagogique, son application en recherche clinique, sa constance quels que soient le mode d'examen clinique et surtout la nécessité de son emploi en vue d'une publication internationale la rendent indispensable. Il devra cependant être accompagné de scores de symptômes pour une évaluation complète rigoureuse... puisque jusqu'à présent, on opère surtout une gêne fonctionnelle et non un trouble du POP-Q.…”