On the role of the constitution and the angle of inclination of the pelvis in the etiology of prolapse of the female genital organs

If all authors agree that the direct cause of prolapse of the genitals in a woman is increased intra-abdominal pressure, then regarding the anatomical moments contributing to the occurrence of this anomaly, the opinions of the authors differ sharply: some attribute here an important role to innate moments, which may be - spina bifida lumbo -sacralis, in which there is a paralysis of the sacral nerves innervating the pelvic floor, then — congenital hypoplasia of the pelvic floor muscles, excessive depth of the posterior Doug-Jas'ova pocket, observed in infantilism and accompanied by a very low position of the levator'a ani, etc .; others see the main reason for prolapse in acquired relaxations and violations of the integrity of the musculo-fascial base of the pelvic floor, especially the levator'a ani and the urogenital diaphragm; still others, considering the prolapse as a hernia, see the main predisposing reason for its development in the excessive width of the hiatus genitalis; fourth, on the basis of the fact that prolapse of the uterus, especially complete, is observed mainly in old women, in the first place among the etiological moments leading to prolapse, put climacteric changes in the ligamentous apparatus of the uterus, walls of the genital canal, etc.; fifths put forward retroflection of the uterus as an important etiological moment of prolapse, sixth - insufficiency of parametric, paravaginal and especially paravesical tissue, which failure is sometimes the result of poor nutrition, hard work, etc., moments that cause the disappearance of adipose tissue, altering the elasticity of the muscle-fascial septum pelvic floor, etc.