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Vaginal prolapse — DRCOG MCQ

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HardUrogynaecologyVaginal prolapseDRCOG

A 63-year-old woman has vaginal heaviness, a bulge worse by evening and mild urinary symptoms. What is the most appropriate management?

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Correct answer: BOffer pelvic floor muscle training and lifestyle advice

The best answer is “Offer pelvic floor muscle training and lifestyle advice”. Offer pelvic floor muscle training and lifestyle advice is the best answer because the vignette is testing Vaginal prolapse and the recommended approach is consistent with NICE NG123. The other Specifically, Start combined hormonal contraception, Start topical oestrogen treatment, Arrange routine GP review after the next period, Offer reassurance without further assessment would be suboptimal in this scenario. In DRCOG-style primary care questions, the safest answer is usually the step that matches the acuity and gestation rather than symptomatic treatment alone. Antenatal decisions combine gestation, maternal stability, fetal risk and whether care can safely remain in the community. Screening, diagnostic testing and urgent assessment are not interchangeable. The UK pathway should be followed with clear safety-netting whenever symptoms may evolve before the next routine appointment.

Reference: NICE NG201: Antenatal care: https://www.nice.org.uk/guidance/ng201/chapter/recommendations