Symptomatic Pelvic Organ Prolapse: Prevalence and Risk Factors in a Population-Based, Racially Diverse Cohort

Rortveit, G., Brown, J.S., Thom, D.H., Van Den Eeden, S.K., Creasman, J.M., Subak, L.L.

This study analysed the prevelence of symptomatic pelvic organ prolapse, the risk factors for developing the condition and the associated level of distress in a racially diverse cohort of women over 40 years of age.  Symptomatic prolapse was determined by the patient's self-reporting of a feeling of bulge, pressure or protrusion or a visible bulge from the vagina.  Risk factors were also assessed by self report, interview, physical examination and record review which were identified as independent risk factors by multivariate logistic regression.  Distress was assessed by self report.

Symptomatic prolapse was reported in 118 (6%) of women who were studied (n=2001; randomly selected population-based study).  Almost 50% of these women reported moderate or great distress, with 35% reporting that the symptoms were severe enough to affect at least one physical, social or sexual activity.  The risk of prolapse was significantly increased in women with one, two and three or more vaginal deliveries compared with nulliparous women.  Irritable bowel syndrome, constipation and self reported fair or poor health status were strongly associated with prolapse.  African-American women were significantly less likely to report symptomatic prolapse compared with white women.

This study identified that symptomatic prolapse is less common amongst African-American women and more common among women with prior vaginal delivery, poor health status, constipation or irritable bowel syndrome.  Nearly half of women with symptomatic prolapse are significantly bothered by their symptoms.

Obstetrics & Gynecology, 2007, 109, 1396-1403

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