Welcome to the Integrated 3D Pelvic Organ Prolapse Quantification Teaching Model for Beginning and Advanced Learners presented by the Female Pelvic Medicine and Reconstructive Surgery Division at LSU Health in New Orleans. The Pelvic Organ Prolapse Quantification System is a standardized tool used to assess and stage pelvic organ prolapse in females. The quantification system is comprised of six defined points and three other landmarks. For years, there have been many systems used to stage prolapse. To date, the POPQ creates a standardized context to quantify this prolapse. Given the many measurements and necessity for familiarity of pelvic structures, this exam can be challenging to learn. Historically, this exam has been illustrated through PowerPoints, lectures, and 2D models. For a learner, translating from two dimensions to three dimensions can be difficult without a physical model or example. The objective of this video is to, number one, provide instructions on how to create a basic POPQ teaching model and thus allow one to demonstrate with this model how to teach the POPQ examination. Listed below are the supplies you will need to build the pelvic model. Number one, you will need a life-size empty female pelvis. Number two, you will need a nude or sheer knee-high stocking. Number three, you will need paddle wire. Number four, a wire cutter. Number five, 22mm small foam balls. Number six, a package of multicolored pipe cleaners. Number seven, lettered stickers or small labels. And number eight, POPQ sticks or marked long Q-tips. Examples of each of the previously mentioned supplies necessary for this model are listed here on this slide. We will now start with the assembly of the pelvic model. Listed below are the supplies that we used for the assembly of our model. For the construction of the vagina, you will need the nude or opaque knee-high stocking, POPQ stick, small foam ball, paddle wire, and suture if you decide to use that in lieu of the metal wire. You will first start to measure approximately 10cm from the opening of the stocking to the inside. You then will insert the foam ball and feed it to the 10cm mark. Again, recheck your placement with the POPQ stick to ensure that your foam ball is in the correct location. Take your paddle wire and feed it through the foam ball to secure it in the stocking. Then take the paddle wire and wrap it around the foam to secure it in location. If you opt to use suture material, take the suture and feed it through the foam ball and secure it with a knot. Now that the vagina has been constructed, it is time to attach it to the pelvis. You will need the empty pelvis, the vagina, and four pieces of paddle wire, each cut to approximately 3-4 inches. If you opt to use needle and thread or suture material, you will need to prepare it at this time. The opening of the stocking was elevated and the areas of 2 o'clock, 5 o'clock, 7 o'clock, and 10 o'clock were identified and paddle wire was fed through these areas. The stocking was then lined up with the opening of the pelvis. The areas at 2 o'clock and 10 o'clock were then secured to the inferior pubic rami of the pelvic model. The areas of 5 o'clock and 7 o'clock were attached to the ischial tuberosity. If for this step you opt to use suture material or needle and thread, you will secure the stocking in a similar fashion. The stocking, acting as our vagina, is now secured to the pelvis. It's important to remember not to cut the end of the stocking, as it will be used in later steps to secure the vagina. You will now need to take two pipe cleaners of different colors and cut them both. The first will be cut in approximately a 6-inch segment, will be folded in half like so, and placed just inside the opening of the stocking. This ring will act as the hymenal remnant and will be an important landmark when teaching the POPQ examination. The second pipe cleaner will be cut in approximately 1-inch, folded in half, and placed at the 12 o'clock position on the stocking. This will act as the urethra. The foam ball acting as the cervix is gently pulled to the top of the sacral promontory. The remainder of the stocking is pulled down around the sacrum down to the tail of the coccyx and wrapped around in an X fashion. This allows us to secure the vagina to the pelvic model, but also allow for some mobility. Ensure that the foam ball acting as the cervix is not tethered too tight and can be easily moved to simulate different stages of prolapse. POPQ points C, D, AA, BA, AP, and BP will be measured. As demonstrated here, the GH can be measured, but will not be labeled. You will now take your POPQ stick and label out the remaining portions of the POPQ examination. For example, for point AA, you will measure 3 cm proximal to the urethra in the anterior midline of the vagina, and then take the small stickers to mark the point. After measuring out the remainder of your POPQ points, they each should be labeled with the small letters like so, both anteriorly and posteriorly, making it easy for the learner to visualize the location of each one. Total assembly time, approximately 20 minutes. Total cost, approximately $65.45. We summarize that the model is inexpensive and easy to replicate, and may be used with both advanced and beginning learners. Importantly, the 3D model and translucent material may translate to better conceptualization for those learning the POPQ examinations.

3D teaching model

POPQ examination

assembling the model

female pelvis

measurement points