Laboratory Studies

The following laboratory studies may be needed:

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

Imaging Studies

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.

Diagnostic Procedures

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.)

Treatment & Management

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Media Gallery

Abdominal approach.
Sacrospinous ligament suspension procedure for apical vaginal prolapse.

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Author

George Lazarou, MD, FACOG, FACS Chief of Gynecology, Director of Urogynecology and Reconstructive Pelvic Surgery, Winthrop University Hospital; Associate Professor, Department of Obstetrics, Gynecology, and Women's Health, Stony Brook University Hospital

George Lazarou, MD, FACOG, FACS is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Urogynecologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Bogdan A Grigorescu, MD Attending Physician, Urogynecology Division, Department of Obstetrics and Gynecology, Maine Medical Center; Assistant Professor, Department of Obstetrics and Gynecology, Tufts University School of Medicine

Bogdan A Grigorescu, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Medical Association, International Continence Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Nicole W Karjane, MD Associate Professor, Department of Obstetrics and Gynecology, Virginia Commonwealth University Medical Center

Nicole W Karjane, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, Association of Professors of Gynecology and Obstetrics, North American Society for Pediatric and Adolescent Gynecology

Disclosure: Received income in an amount equal to or greater than $250 from: Merck<br/>Served as Nexplanon trainer for: Merck.

Chief Editor

Kris Strohbehn, MD Professor and Vice Chair of Gynecology, Geisel School of Medicine at Dartmouth; Director, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center

Kris Strohbehn, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American College of Surgeons, American Urogynecologic Society, Society of Gynecologic Surgeons

Disclosure: Nothing to disclose.

Additional Contributors

Suzanne R Trupin, MD, FACOG Clinical Professor, Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Urbana-Champaign; CEO and Owner, Women's Health Practice; CEO and Owner, Hada Cosmetic Medicine and Midwest Surgical Center

Suzanne R Trupin, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, International Society for Clinical Densitometry, AAGL, North American Menopause Society, American Medical Association, Association of Reproductive Health Professionals

Disclosure: Nothing to disclose.

Pelvic Organ Prolapse Workup

Laboratory Studies

Imaging Studies

Diagnostic Procedures

References

Tables

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