Pelvic Organ Prolapse Involving Multiple Compartments

Understanding Multi-Compartment Prolapse

The American College of Radiology recognizes that pelvic organ prolapse may involve various compartments of the pelvic floor simultaneously, including the anterior compartment, apical compartment, and posterior compartment 1
Patients usually present with pelvic pressure or bulge and often have other associated pelvic floor dysfunction affecting multiple compartments 1

Initial evaluation is clinical and begins with physical examination to determine which vaginal compartments and to what degree prolapse exists 1
Imaging is reserved for cases where clinical evaluation is difficult or inadequate, or when patients present with persistent or recurrent prolapse symptoms after treatment 1
Goals of imaging include evaluating for occult pelvic floor disorders in compartments other than those apparent on physical examination 1, 2

Assessment of prolapse (anterior, posterior, apical) as determined by preoperative pelvic examination should be recorded for all patients being considered for surgical treatment 3
The presence of multi-compartment prolapse influences surgical planning, as surgical procedures for stress urinary incontinence and prolapse may be safely performed concomitantly in appropriately selected women 3