Current opinion on the classification and definition of genital tract prolapse

There are few issues in obstetrics and gynecology that seem so readily apparent but are in actuality replete with confusion than the diagnosis of genital tract prolapse. This stems from the difficulties in defining genital tract prolapse and from the long history of turmoil regarding how to classify and describe it. In the past 5-10 years our specialty has begun to make inroads into these issues. Finally, there is an accepted classification system and because of this we are beginning to recognize what represents normal vaginal support versus genital tract prolapse.

In 1993 the confusion regarding the classification of genital tract prolapse was documented by a very thorough review of the literature; in response, the Pelvic Organ Prolapse Quantification system was developed. Subsequent to this, several articles have begun to define the epidemiology of genital tract prolapse and this is providing a glimpse of what differentiates pathologic genital tract prolapse from normal support.

We can now reliably classify and describe genital tract relaxation and imply what is normal support versus pathological genital tract prolapse. However, we still have not defined genital tract prolapse, determined its prevalence or provided the clinician with a simple and reliable means of testing for its presence or absence.