Anatomical aspects

The bottom of the abdominal cavity is closed by the pelvic floor. The pelvic floor consists of a system of muscles and connective tissue and ensures that the urine, stool and a fetus cannot just leave the body. In addition, organs such as the bladder, rectum and uterus remain in place. The anatomical support of the organs of the small pelvis is provided by the musculus levator ani complex as well as by the connective tissue complex in the small pelvis. For example, the uterus is held in place by several ligaments of which the sacro-uterine ligament (from cervix to sacrum) is an important pillar. The position of the vagina (the direction of the vaginal axis) also plays a role in the anatomical support: an almost horizontal position of the vagina acts as a valve when the abdominal pressure is increased. Proper nerve provision is necessary for a properly functioning pelvic floor. Dysruption or dysfunction of one or more components of this pelvic floor complex leads to reduction of support and ultimately to prolapse of pelvic organs.¹

Symptoms

Women who seek helpbecause of POP can have a range of complaints.² The most specific complaint is seeing or feeling a bulge. In addition, complaints can occur with regard to the bladder function: incontinence for urine, frequent micturition, incomplete urination, inability to urinate, position change necessaryto urinate. Complaints with regard to bowel function are: incontinence for flatus, fluid or faeces; pain, digital help needed for evacuation of urine or faeces. Sexual dysfunction can also be a consequence of a POP.