Pelvic Organ Prolapse Workup

Updated: Jun 20, 2016
  • Author: George Lazarou, MD, FACOG, FACS; Chief Editor: Kris Strohbehn, MD  more...
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Workup

Laboratory Studies

See the list below:

  • Urine sample, clean midstream to rule out infection in patients with incontinence and prolapse
  • BUN, creatinine, glucose, and calcium recommended in patients with compromised renal function, or if polyuria is present
  • Urine cytology in patients with microscopic hematuria to exclude bladder neoplasm
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Imaging Studies

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  • If the uterus is to be preserved, ultrasonographic imaging is strongly recommended.
  • Some surgeons have used MRI, contrast radiology, and ultrasonography to describe the nature of the support defects. Patients with defecatory dysfunction may benefit from defecating proctography and proctosigmoidoscopy. Colonic transit studies are indicated in patients with motility disorders. Dynamic MRI defecography can be used to provide defecatory and high-quality soft tissue imaging; however, this expensive test has not been shown to change clinical decision making.
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Diagnostic Procedures

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  • In patients who are planning to undergo LeFort colpocleisis (see Surgical Management of Apical Vaginal Prolapse and Uterine Prolapse section), cervical cytology and either pelvic ultrasonography or endometrial biopsy is recommended to rule out endometrial pathology.
  • Urodynamic testing can be considered to evaluate urinary incontinence and to rule out potential incontinence.
  • Cystoscopy is recommended for patients with symptoms of bladder pain, hematuria, or urinary urgency/frequency who are not responding to medications.
  • Cervical cytology should be considered if cervical screening is not current. (See Cervical Cancer.)
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