Editing Functional: Pelvic Organ Prolapse (section)

== Normal Pelvic Support Mechanisms ==

* '''3 levels'''
** Level I: suspends the uterus and upper vagina to the sacrum and lateral pelvic sidewall.
*** '''[Loss of level I support contributes to apical prolapse]'''
** Level II: includes the paravaginal attachments of the middle third of the vagina laterally to the superior fascia of the levator ani muscle and the arcus tendineus fascia pelvis.
*** '''Loss of level II support contributes to anterior vaginal wall prolapse/cystocele'''
** Level III: includes the vagina’s lower third attachments with the perineal membrane, levator ani muscles (superficial and deep perineal muscles), and perineal body.
*** '''Loss of level III support anteriorly contributes to urethral mobility'''
*** '''Loss of level III support posteriorly results in a distal rectocele or perineal descent'''