醫學六：80題 ( 包括麻醉科,眼科,耳鼻喉科,婦產科,復健科等科目及其及相關臨床實例與醫學倫理 )題庫下載題庫

POPQ measurements — Each point is located by measuring along the vaginal wall or identifying the most dependent point of a prolapsed structure. The measurement is then taken of the distance from the point to the hymenal plane. The anatomic location of each point is (figure 1) [20,21]:

●Anterior vaginal wall points:

•Point Aa is located in the midline of the anterior vaginal wall, 3 cm proximal to the external urethral meatus, corresponding approximately to the urethrovesical junction. The quantitative value of point Aa is anywhere from –3 to +3 cm from the hymenal plane, depending up...

POPQ measurements — Each point is located by measuring along the vaginal wall or identifying the most dependent point of a prolapsed structure. The measurement is then taken of the distance from the point to the hymenal plane. The anatomic location of each point is (figure 1) [20,21]:

●Anterior vaginal wall points:

•Point Aa is located in the midline of the anterior vaginal wall, 3 cm proximal to the external urethral meatus, corresponding approximately to the urethrovesical junction. The quantitative value of point Aa is anywhere from –3 to +3 cm from the hymenal plane, depending upon the extent of anterior wall prolapse.

•Point Ba is the most distal (ie, most dependent) position of any part of the anterior vaginal wall between point Aa and the vaginal cuff or anterior vaginal fornix. If there is no prolapse, point Ba is –3 cm by definition. In a woman with total posthysterectomy vault prolapse, Ba has a positive value equal to the distance between the vaginal apex and hymenal plane (so the quantitative value of point Ba can range from the most supported measurement [-3], to the most prolapse portion beyond the hymenal ring [this may exceed +3 cm]).

●Superior vagina points:

•Point C is the most distal (ie, most dependent) edge of the cervix or the leading edge of the vaginal cuff (posthysterectomy).

•Point D is measured only in women with a cervix. It is the deepest point of the posterior fornix, corresponding approximately to where the uterosacral ligaments attach to the posterior cervix. Measuring this point distinguishes between suspensory failure of the uterosacral-cardinal ligament complex and cervical elongation: if point C is significantly more positive than point D (>4 cm), the cervix is elongated.

●Posterior vaginal wall points (these are analogous to the two points on the anterior wall):

•Point Ap is located in the midline of the posterior vaginal wall, 3 cm proximal to the posterior hymen. The quantitative value of point Ap is anywhere from –3 to +3 cm from the hymenal plane, depending upon the extent of posterior wall prolapse.

•Point Bp is the most distal (ie, most dependent) position of any part of the upper posterior vaginal wall between point Ap and the vaginal cuff or posterior vaginal fornix. If there is no prolapse, point Bp is –3 cm by definition. In a woman with total posthysterectomy vaginal prolapse, Bp has a positive value equal to the distance between the vaginal apex and hymenal plane (so the quantitative value of point Bp can range from the most supported measurement [-3], to the most prolapse portion beyond the hymenal ring [this may exceed +3 cm]).