Obstetrics & Gynaecology
Pelvic Organ Prolapse
Pelvic Organ Prolapse clinical pathway.
Source: NICE; RCOG; ICS — NICE NG123 (updated 2025)
Step 1 of ~3
info
Assessment & Classification
Symptoms:
• Vaginal bulge/lump
• Pressure/heaviness
• Urinary symptoms
• Bowel symptoms
• Sexual dysfunction
Assessment:
• History including obstetric
• Pelvic examination (supine and standing)
• Assess pelvic floor function
• Exclude other pathology
Red Flags:
• Urinary retention
• Recurrent UTIs
• Hydronephrosis
• Ulceration
Staging:
• POP-Q system: anterior, posterior, apical, uterine vault
• Stage 0 (no prolapse) to Stage IV (complete eversion)
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Methylene Blue · Guanylate Cyclase / Nitric Oxide Pathway Inhibitor
- Sodium phenylbutyrate · Ammonia scavenger (alternative pathway)
- Marstacimab · Anti-tissue factor pathway inhibitor (TFPI) monoclonal antibody
- Glasdegib (Specialist drug) · Hedgehog pathway inhibitor
- Vismodegib (Specialist drug) · Hedgehog pathway (SMO) inhibitor
- Amitriptyline · TCA — Interstitial Cystitis / Chronic Pelvic Pain
Decision support only. Always apply local guidelines and clinical judgement.