Assessment and management of pelvic organ prolapse

Much of the contemporary management of pelvic organ prolapse (POP) is based on knowledge and surgery developed over 100 years ago. There is a clearer picture emerging of the anatomical defects that result in prolapse, and the cause of those defects. The importance of assessing symptomatology is highlighted, with the use of validated prolapse-specific questionnaires. A simplified version of the POP quantification system is described, which should be used by all clinicians dealing with the condition in order to communicate examination findings more accurately. There is a brief discussion of conservative management, and a more detailed review of the current surgical management options for each compartment. The use of graft material in reconstructive procedures is considered, and emerging minimal access techniques are described to illustrate how improved anatomical understanding has led to site-specific procedures to address those defects.