2026 Urogynecology for the Advanced Practice Provider-POP 101: Elevating Your Pelvic Prolapse Skills

Video Transcription

Video Summary

Dr. Amanda Artson, an assistant professor in urogynecology, presents a practical overview of pelvic organ prolapse (POP), covering anatomy, symptoms, risk factors, evaluation, and counseling. She explains that prolapse is very common after vaginal birth and often underreported, with many women not seeking care despite symptoms like vaginal bulge, pressure, or difficulty emptying the bladder. She emphasizes that POP can affect quality of life, sexual activity, social functioning, and body image.<br /><br />Artson reviews how prolapse develops from changes in connective tissue, muscle, and support structures, influenced by childbirth, aging, menopause, obesity, hysterectomy, constipation, and genetic factors. She highlights the importance of examining all three vaginal support levels and using the POP-Q system to stage prolapse accurately. She stresses that physical exam, especially standing exam when needed, is often more useful than imaging for treatment planning.<br /><br />She discusses management options including observation, constipation treatment, pelvic floor physical therapy, pessaries, and surgery. She also addresses occult stress incontinence testing, explaining how prolapse reduction testing can help predict postoperative leakage and guide decisions about adding a sling. Throughout, she encourages individualized counseling based on symptoms, activity goals, bladder emptying, and patient preferences.

Asset Subtitle

This session provides APPs with a practical, hands-on introduction to pelvic organ prolapse, emphasizing foundational anatomy, symptom recognition, and clinical evaluation. Participants will learn how to perform and document a standardized POP-Q exam with confidence, interpret findings, and integrate them into patient-centered care plans as well as how to counsel patients on and initiate conservative management—including pelvic floor muscle training, pessary fitting and follow-up, and lifestyle modifications. This talk equips APPs with the essential skills to assess prolapse severity, optimize conservative therapy, and support shared decision-making across diverse patient presentations.

By the end of this session, participants will be able to:

Describe the anatomy and pathophysiology underlying pelvic organ prolapse, including support defects of the anterior, apical, and posterior compartments.
Identify common symptoms, risk factors, and natural history of POP across the lifespan.
Document and Interpret POP-Q findings to classify prolapse severity and compartment involvement.
Select appropriate adjunctive tests (e.g., post-void residual, urinalysis, cough stress testing) based on patient presentation.
Counsel patients on evidence-based conservative treatment options—including pelvic floor muscle training, pessary use, and bowel/bladder optimization.

Speaker: Amanda Artsen, MD

Keywords

pelvic organ prolapse

urogynecology

POP-Q staging

vaginal birth

pessary

pelvic floor physical therapy

occult stress incontinence

prolapse counseling

bladder emptying