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Julian Classification Method for Vaginal Vault Prolapse

Grade Description
Grade I Vault descends to the level of the ischial spine
Grade II Vault descends beyond the ischial spine but does not reach the vaginal introitus
Grade III Vault descends to the vaginal introitus
Grade IV Vault descends beyond the vaginal introitus

Explanation

Currently, there are no definitive staging standards in China. In 1998, Professor Julian from the University of Wisconsin, USA, classified vaginal vault prolapse into four degrees based on the relative distance of the vault to the vaginal introitus. The maximum extent of the prolapse is determined during the Valsalva maneuver.

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