Box 2.

Causes and contributing factors

Congenital

Bladder exstrophy

Collagen defects (for example, type IV Ehlers-Danlos  syndrome, Marfan syndrome)

Race (white people, for example, have a higher risk)

Anatomy (for example, congenitally short vagina)

Childbirth

Trauma

Denervation

Raised intra-abdominal pressure

Chronic obstructive airway disease

Straining, constipation, heavy lifting

Menopause

Oestrogen deficiency

Iatrogenic

Pelvic surgery (for example, hysterectomy, colposuspension, sacrospinous fixation)