Pelvic floor disorders: Working together with other specialties

Pelvic Organ Prolapse is the descent of one or more of the pelvic organs (bladder, bowel, vagina, uterus) caused by weakness or injury of the ligaments, connective tissue, and muscles of the pelvis. The aetiology is complex and multi-factorial. Risk factors include pregnancy, childbirth, congenital or acquired connective tissue abnormalities, denervation or weakness of the pelvic floor, ageing, hysterectomy, menopause, factors associated with chronically raised intra-abdominal pressure. Surgical procedures for prolapse are numerous, and include vaginal, abdominal, laparoscopic procedures or a combination of these. The main aim of prolapse surgery is to correct the vaginal and rectal protrusion and any associated pelvic floor dysfunction. However, the anatomical correction is not likely to be always related to an improvement of bladder, bowel and sexual function. Moreover, the strong association between rectal and genital prolapse surgery should prompt a multidisciplinary pelvic floor assessment.