Pelvic organ prolapse occurs when pelvic floor muscles weaken and bulge downward, or prolapse. Any pelvic organ--intestine, bladder, rectum or uterus--can prolapse. Prolapse, especially of the bladder, leads to stress incontinence, involuntary urine loss under increased abdominal pressure such as coughing, sneezing or laughing. Around one in 11 women has surgery at some point for pelvic organ prolapse. Cystocele, prolapse of the bladder, most often causes stress incontinence. Pelvic organ prolapse, which occurs only in women and increases with age, has a number of causes.
Childbirth
Around 50 percent of all women develop pelvic prolapse after childbirth, Dr. M. Murphy reports on OBGYN.net. Pregnancy and vaginal delivery weakens the pelvic floor muscles, and the risk increases with each pregnancy, the Merck Manual Home Edition states. As many as 300,000 women each year suffer damage to the pelvic floor that leads to stress incontinence, according to the University of Michigan's Women's Health Resource. Damage can affect the muscles, ligaments and nerves that enable the pelvic organs to stay in place. However, having only Cesarean deliveries doesn't prevent all pelvic floor prolapse, since almost 20 percent of women who have never given birth also have some degree of prolapse, lead author Anne Weber, M.D. reports in the September 2005 issue of "Obstetrics and Gynecology."
Aging
As a woman ages, the risk of pelvic organ prolapse increases. This occurs because of the neurological changes related to aging and the increased laxity of ligaments and muscles due to lowered estrogen levels. Connective tissues also lose their elasticity and become lax, allowing organs to prolapse. Between 15 to 40 percent of women over age 60 report incontinence, Dr. Murphy states.
Increaed Abdominal Pressure
Increased abdominal pressure due to obesity, constipation, pulmonary diseases that lead to chronic cough and abdominal fluid retention called ascites can all contribute to development of stress incontinence, particularly when pelvic floor muscles are already weakened. An increased body mass index, or BMI, of 30 or higher raises the risk of developing organ prolapse by 40 to 75 percent, according to Weber.
Pelvic Trauma
Pelvic trauma that damages the pelvic structures can occur during childbirth or during other surgeries. Pelvic organ prolapse also occurs more frequently in women who have had hysterectomies, Dr. Weber states.
