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Causes and prevention of pelvic organ prolapse

What are the causes of Prolapse?

Prolapse is caused by a weakness in the usual supporting tissues and muscles of the pelvis. Factors that predispose to weakening of these tissues include:

  • Pregnancy
  • Childbirth with vaginal delivery
  • Ageing
  • Conditions that cause increased pressure on the pelvic floor such as:
    • Chronic cough
    • Chronic constipation
    • Heavy lifting and straining
    • Obesity
  • Abnormalities of the connective tissues (i.e. genetically determined weakness in the tissue structures).

Prolapse can still occur in women who have never had children and who have few risk factors.

What can I do to prevent further Prolapse?

Anything that places a chronic increased pressure on the pelvic floor can potentially worsen prolapse. The following measures are thought to help prevent worsening of prolapse and recurrence of prolapse after surgical treatment:

  • Maintain a healthy weight
  • Avoid heavy lifting and straining
  • Have chronic cough and constipation investigated and treated
  • Stop smoking
  • Perform regular pelvic floor exercises

Does prolapse worsen with time?

In many women prolapse will gradually worsen with time. This is usually a slow change. In other women, their prolapse can remain stable without progression.

Once present, prolapse does not generally improve without surgical treatment (except for the prolapse that can occur immediately after childbirth which usually improves in the first 6 months). Not all prolapse will inevitably progress to the stage that surgery or other treatment is required.

The presence of symptoms, the effect of the prolapse on a woman’s quality of life and whether a woman wishes to have treatment are the key factors that determine if a prolapse should be treated.