Evolution of the female pelvis and relationships to pelvic organ prolapse.

The female pelvis provides support for the lower limbs as well as for the gastrointestinal tract, the bladder, and the reproductive organs. It must also serve as a passageway for defecation, urination, and, possibly, delivery of an infant. The bones, ligaments, and muscles of the human female pelvis have evolved from our early ancestors. Pelvic organ prolapse may occur because of the limitations involved with adapting the pelvic bones, muscles, and ligaments previously used for other purposes into a supportive role. Here we review these changing roles and functions of nonhuman primate and human female anatomy.