Fig. 1.

Schematic representation of pelvic organ prolapse theoretical disease model based on Chen et al. (2009). a With normal levator function, the hiatus is closed and anterior and posterior pressures are balanced. Levator damage results in a hiatal opening and b the vagina becomes exposed to a pressure differential that creates a tension force (red arrow) on the cardinal (CL) and uterosacral (USL) ligaments. (Modified from DeLancey© [26])