Contributing factors

The development of a prolapse has been determined to be multi-factorial. The factors that contribute to the development of a prolapse can be divided into established risk factors and potential risk factors.

Vaginal childbirth is the factor most frequently associated with prolapse and also advancing age and obesity are established risk factors.2 Childbirth can lead to muscular and neurological damage. Poor levator muscle function might be the first step in a process that ultimately causes failure of the connective tissue supports of the pelvic organs.1,11 In a substantial minority of women delivering vaginally, the puborectalis muscle is shorn off the pelvic side wall. This avulsion risk is strongly associated with age at first delivery and vaginal operative delivery.3

Potential risk factors for developing a POP are: pregnancy, prolonged second stage of labour, high birthweight child, shape of pelvis, hysterectomy,13 family history positive for POP14, race or ethnic origin, connective tissue disorders and chronic predisposing factors like heavy lifting, constipation and coughing.25