23rd December 2021

A 63-year-old woman presents to her GP with a 4-month history of vaginal discomfort

A 63-year-old woman presents to her GP with a 4-month history of vaginal discomfort. She describes a non-painful lump she has seen emerging from her vagina, and a feeling of fullness in that area. It is not painful, and not associated with any vaginal bleeding. She is currently in her menopause and takes no medication to aid her menopause. She is taking calcium and vitamin D supplements for osteoporosis, and a statin.

On further questioning, she has no problems with bowel frequency, but does report urinary frequency, and ‘little accidents’ that happen often.

On examination there is a clear vaginal prolapse that has not passed the introitus. It protrudes further when standing and coughing. There is no ulceration and no urinary or faecal leakage. Which of the following investigations should be requested?

Select the SINGLE most appropriate option from the list below. Select ONE option only.