Pelvic organ prolapse (POP) is the dropping of the pelvic organs caused by the loss of normal support of the vagina.
POP occurs when there is weakness or damage to the normal support of the pelvic floor. The pelvic floor holds up the pelvic organs, including the vagina, cervix, uterus, bladder, urethra, intestines and rectum. If the supportive tissue of the pelvic floor (including muscles and connective tissue) become weakened, stretched, or are torn, the pelvic organs may drop down. Women may feel or see a bulge coming out beyond the opening of their vagina.
- Watch a video interview with Drs. Victoria Handa and Gunhilde Buchsbaum about pelvic organ prolapse.
Am I at Risk?
Pelvic organ prolapse is common in women. The incidence increases after childbearing and as women increase in age.
Childbirth (vaginal or operative vaginal delivery) can cause injury to the muscles or fascia of the pelvic floor. The increased pressure of childbirth on the internal organs in the abdomen can lead to POP. Operative vaginal deliveries (forceps or vacuum deliveries) may also increase the risk of pelvic floor injury and increase a woman’s risk of developing prolapse.
Risk factors, which predispose, cause, promote, or worsen pelvic organ prolapse, include:
Genetics
- POP is a hereditary disorder, meaning that it runs in families. Our genes influence the strength of our bones, muscles and connective tissue. Some women are born with weaker tissues and are a higher risk for prolapse.
Lifestyle
- Smoking increases your risk of developing POP.
Pelvic Floor Injury
- Injury to any part of the pelvic floor can occur during vaginal delivery, surgery, pelvic radiation, or fractures to the back and pelvis caused by falls or motor vehicle accidents.
Other Health Conditions
- Chronic constipation and chronic straining.
- Chronic coughing.
- Obesity—obese women have a 40 to 75% increased risk of pelvic organ prolapse.
- Menopause
- Nerve and muscle diseases, which contribute to the deterioration of pelvic floor strength.