 General data

o Type of delivery and the conditions of the babies given birth to

 Since if we consider an anatomic defect of the abdominal

wall and pelvic floor particularly Pelvic Organ Prolapse,
vaginal childbirth–and if with related injury (neurologic or
muscular or both) have been associated with pelvic
support structure defects

 A single vaginal childbirth is associated with up to 10-fold

higher odds of POP (Quiroz, 2010), and the risk of
surgery for POP may increase with each additional
vaginal delivery (Larsson, 2009). And in relation to the
case, the patient had already given 3 births, that make a
higher possibility for pelvic organ prolapse

 Higher weight of the largest infant delivered vaginally is

also a risk factor associated in the development of POP
o Racial origin

 White and Latina women have four to five times higher

risk of symptomatic POP compared with African-American
women, and white women have the highest risk of having
POP at or beyond the hymen (Whitcomb, 2009).
o Weight
 Since obesity is a noted risk factor of POP
 HPI
o Presence, severity, duration and bother of any urinary and
bowel or prolapse symptoms.
 Identifying symptoms in the related organ systems is
critical to effective treatment planning.
 PMHx
o Hysterectomy, when this was performed, and what was the
indication, to know if the patient has any other underlying GU
conditions
o Previous conservative, medical and surgical treatment

 Such as prior pelvic surgery, hysterectomy and

episiotomy,
  as they affect the genitourinary tract and lower bowel.

 And also, ask for the outcome of thise procedures, the

effectiveness and side effects of treatments should be
noted.

o Coexisting diseases may have a profound effect on

incontinence and prolapse sufferers, for example
 Diabetes
 Genetic conditions/connective tissue disorders
 Irritable bowel syndrome and constipation
 Also important to note that Chronic cough and respiratory
diseases such as with asthmatic patients may suffer
significantly during attacks.
o Medications 

 it is always important to review every patient’s medication

and to make an assessment as to whether current
treatment may be contributing to the patient’s condition.
o Obstetric and menstrual history
 PSHx
o Environmental issues

 We would also like to ask if there are other socio-cultural

and environmental issues that we have to consider which
may also affect the management of the patient
o Lifestyle

 including exercise, Exercise

 Heavy lifting, smoking and the amount and type of

food/fluid intake..also the patient’s occupation. Lobo and
colleagues said that Lower education is an associated
risk factor in the development of POP