aetiology

Last reviewed 01/2018

Aetiology of pelvic organ prolapse is multifactorial. It may be due to:

• weakness of the support structures - caused by a defect in the  complex interaction between the levator ani, the vagina, and the connective tissue
• neuropathic injury  - caused by stretching of the pudendal nerves that may occur during child birth

The following risk factors are associated with POP:

• established risk factors
• higher parity
• increasing vaginal parity was the strongest risk factor for POP in women < 60 years
• vaginal childbirth
• advancing age
• prevalence of POP increases by 40% with each decade of life
• obesity
• previous hysterectomy
• potential risk factors
• forceps delivery
• other obstetric factors
• high infant birth weight >4500 g
• prolonged second stage of labour
• age <25 years at first delivery
• family history of pelvic organ prolapse
• risk of prolapse is higher if mother or sister has prolapse
• shape and orientation of bony pelvis
• occupations which requires heavy lifting
• constipation
• connective tissue disorders
• an association between POP and a variation of collagen type 1 gene has been reported (1,2)

Reference:

• (1) Kuncharapu I, Majeroni BA, Johnson DW. Pelvic organ prolapse. Am Fam Physician. 2010;81(9):1111-7
• (2) Barber MD. Pelvic organ prolapse. BMJ. 2016;354:i3853