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Overview of Pelvic Organ Prolapse (POP)

By

Charlie C. Kilpatrick

, MD, MEd, Baylor College of Medicine

Last full review/revision Jan 2021| Content last modified Jan 2021
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Pelvic organ prolapse results from laxities (similar to hernias) in the ligaments, fascia, and muscles supporting the pelvic organs (pelvic floor—see figure Pelvic organ prolapse). The prevalence of pelvic organ prolapse is difficult to ascertain, and treatment is based on symptoms.

Common contributing factors include

  • Childbirth (particularly vaginal delivery)

  • Obesity

  • Aging

  • Injury (eg, due to pelvic surgery)

  • Chronic straining

Less common factors include congenital malformations, increased abdominal pressure (eg, due to ascites, abdominal tumors, or chronic respiratory disorders), sacral nerve disorders, and connective tissue disorders.

Pelvic organ prolapse affects various sites and includes

  • Anterior vaginal wall prolapse

  • Posterior vaginal wall prolapse

  • Apical prolapse (vaginal vault prolapse)

  • Uterine prolapse

Prolapse of the vaginal wall allows surrounding organs to protrude into the vaginal space; commonly used terms include cystoceles, urethroceles, enteroceles, and rectoceles, depending on the site. Procidentia is collapse of the anterior and posterior vaginal walls and apical prolapse. Usually, prolapse occurs in multiple sites.

Pelvic organ prolapse

Pelvic organ prolapse
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Operative Vaginal Delivery
In order to facilitate delivery, operative vaginal delivery involves application of forceps or a vacuum extractor to the fetal head to assist during the 2nd stage of labor. Which of the following is NOT considered an indication for operative vaginal delivery?
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