Genital Prolapse: Classification

Traditional graduation of a genital descensus’.

Grade Description
1 Inside the sheath (= small)
2 Up to the introitus/vaginal entrance (= moderate).
3 Distal of the introitus (= large)

Grade classification of a genital descensus by the Baden-Walker halfway system.

Grade Description
0 No prolapse
1 Halfway to the hymnal
2 Until hymn
3 Halfway after the anthem
4 Maximum genital decensus

The International Continence Society has standardized a quantitative classification that has the advantage of allowing comparisons over a time course or between stages.

Assessment of pelvic floor function can also include specific palpation of the puborectalis loop (functionally the most important portion of the pelvic floor) on both sides and can be graduated using the Oxford system

Grade Description
0 No contraction
1 Twitching of individual muscle fibers
2 Low contraction
3 Contraction with significant elevation (lifting)
4 Strong contraction
5 strong contraction against resistance