OBJECTIVETo test the null hypothesis that there is no association between pelvic organ prolapse and pelvic or low back pain.METHODSA total of 152 consecutive patients with pelvic organ prolapse completed a visual faces scale to quantify the amount of pelvic or low back pain present. Pelvic organ prolapse severity was graded by three techniques: 1) pelvic organ prolapse quantification staging; 2) descent of the leading edge of prolapse; and 3) dynamic cystoproctography. Linear and nonlinear associations of pelvic organ prolapse quantification staging, descent of the leading edge of prolapse, and dynamic cystoproctography findings with pelvic or low back pain were assessed. We also characterized the nature of any significant nonlinear associations.RESULTSDescent of the leading edge of prolapse was linearly associated with low back pain. Patients with greater descent of the leading edge of their prolapse reported less low back pain (r= −0.176,P= .034). Bladder descent during dynamic cystoproctography was nonlinearly associated with low back pain (P= .037). Neither of these associations was statistically significant after controlling for patient age and prior prolapse surgery. There were no linear or nonlinear associations between pelvic organ prolapse and pelvic pain.CONCLUSIONBased on the data, pelvic organ prolapse is not a cause of pelvic or low back pain.