damage to the pelvic floor not only contributes to urinary incontinence but can lead to pelvic organ prolapse. pelvic organ prolapse occurs in women when pelvic organs (e.g. the vagina, bladder, rectum, or uterus) protrude into or outside of the vagina. the causes of pelvic organ prolapse are not unlike those that also contribute to urinary incontinence. 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 pelvic organ prolapse. the vagina is suspended by attachments to the perineum, pelvic side wall and sacrum via attachments that include collagen, elastin, and smooth muscle. surgery can be performed to repair pelvic floor muscles. the pelvic floor muscles can be strengthened with kegel exercises.