What is pelvic organ prolapse and how might it contribute to urinary incontinence?

• A. Downward descent of pelvic organs; can worsen SUI by changing urethral support or cause overflow if obstruction occurs
• B. Increase in bladder capacity
• C. Decreased risk of infection
• D. Never affect urinary symptoms

Answer: (A)

Pelvic organ prolapse is the downward descent of pelvic organs—most commonly the bladder, uterus, or vaginal walls—through the vaginal opening due to weakened pelvic floor support. This positional change alters how the bladder and urethra are supported. When the urethra loses stable support, increases in abdominal pressure during activities like coughing or lifting can overcome the urethral closure and promote leakage, contributing to stress urinary incontinence. In more pronounced prolapse, the prolapsed tissue can kink or compress the bladder outlet, causing obstruction to urine flow and incomplete emptying, which can lead to overflow incontinence. So the condition can influence urinary continence by both diminishing urethral support (raising the risk of leakage with effort) and, in some cases, causing obstruction with retention and overflow. It’s not about a simple change in bladder capacity, and urinary symptoms can indeed be affected by prolapse, rather than never being affected.