Damage to the pelvic floor not only contributes to SUI but can lead to pelvic organ prolapse. Pelvic organ prolapse occurs in women when pelvic organs (e.g. the vagina, urinary bladder, rectum, or uterus) protrude into or outside of the vagina. The causes of POP are not unlike those that also contribute to UI. These include inappropriate (asymmetrical, excessive, insufficient) muscle tone and asymmetries caused by trauma to the pelvis. Age, pregnancy, family history, and hormonal status all contribute to the development of POP. The vagina is suspended by attachments to the perineum, pelvic side wall and sacrum via attachments that include collagen, elastin, and smooth muscle.(23,36,40)
