Clinical assessment

A physical examination is the cornerstone for diagnosing POP and for assessing the type and severity of anatomical abnormalities. The examination is usually done in a lithotomy position; both the abdomen and the pelvis are examined externally and internally. The examination is done at rest and at maximum press (Valsalva); all 3 compartments (anterior, middle and posterior) are assessed separately. Also, the overall muscle strength and coordination of the pelvic floor muscles are assessed.

Examination in standing position can be useful if there is a discrepancy between the complaints of the woman and the findings in the research in lithotomy position.2

The place of urodynamic testing is under debate; so far there is no evidence that preoperative urodynamic investigation improves the outcome of prolapse surgery.