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International urogynecology consultation chapter 1 committee 2: Epidemiology of pelvic organ prolapse: prevalence, incidence, natural history, and service needs

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Abstract

Introduction and hypothesis

This narrative review describes the existing epidemiologic literature and identifies gaps regarding pelvic organ prolapse (POP) prevalence, incidence, natural history, and current and future service needs.

Materials and Methods

A PubMed search identified relevant citations published in 2000 or later. Pre-specified criteria were used to screen titles, abstracts, and manuscripts, including reference sections. Study findings were summarized to define what is known, identify gaps in current knowledge, and suggest priority areas for future research.

Results

The reported prevalence of POP varies widely (1–65%) based on whether its presence is ascertained by symptoms (1–31%), pelvic examination (10–50%), or both (20–65%). Most existing population-based surveys do not include physical examination data. White women from higher income countries are overrepresented in the existing literature. Incidence and natural history data are limited and consist mainly of cohorts that follow women after pregnancy or menopause. Given global increases in aging populations in well-resourced countries, the need for POP treatment is anticipated to increase in the coming decades. In lower and middle income countries (LMICs) where demographic trends are different, there is a dearth of information about anticipated POP service needs.

Conclusion

Future POP incidence, prevalence, and natural history studies should include non-white women from LMICs and should combine pelvic examination data with validated patient-reported outcome measures when feasible. Anticipated future service needs differ globally, with a greater demand for POP treatment services in well-resourced settings where aging populations are prevalent.

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Acknowledgements

The authors sincerely thank Robert Koehler, Chief Librarian at UnityPoint Health-Meriter, Madison, WI, USA, and Madeline Moureau, Research Specialist at the University of Wisconsin School of Medicine and Public Health, Madison, WI, USA, for their contributions to this manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 1010 Mound Street, 4th floor, Madison, WI, 53715, USA

    Heidi W. Brown & Narmin Mukhtarova

  2. Tata Center for Urogynecology and Pelvic Health, Cama Hospital, Grant Government Medical College, Mumbai, India

    Aparna Hegde

  3. Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Germany, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Markus Huebner

  4. Faculty of Medicine and Health Sciences, MOVANT, Antwerp University Hospital, Gynaecology and Urology, Belgium, University of Antwerp, Belgium, Antwerp, Belgium

    Hedwig Neels

  5. Department of Obstetrics/Gynecology and Urology, Loyola University Chicago Stritch School of Medicine and Loyola University Medical Center, Maywood, IL, USA

    Hayley C. Barnes

  6. Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Gisele Vissoci Marquini

  7. Department of Epidemiology and Biostatistics, Mbeya College of Health and Allied Sciences UDSM-MCHAS, University of Dar es Salaam, Mbeya, Tanzania

    Bernard Mbwele

  8. Department of Urogynaecology, Imperial College Healthcare, London, UK

    Visha Tailor

  9. Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Ervin Kocjancic

  10. Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville, VA, USA

    Elisa Trowbridge

  11. Department of Urogynecology, Middlemore Hospital, Auckland, New Zealand

    Lynsey Hayward

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  1. Heidi W. Brown
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  2. Aparna Hegde
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  7. Narmin Mukhtarova
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Contributions

HW Brown: project development, data collection, data analysis, manuscript writing, manuscript revision

A Hegde: project development, data collection, data analysis, manuscript writing, manuscript revision

M Huebner: project development, data collection, data analysis, manuscript writing, manuscript revision

H Neels: project development, data collection, data analysis, manuscript writing, manuscript revision

HC Barnes: data collection, data analysis, manuscript writing

G Vissoci Marquini: project development, data collection, data analysis, manuscript writing, manuscript revision

N Mukhtarova: data collection, data analysis, manuscript writing, manuscript revision

B Mbwele: project development, data collection, data analysis

V Tailor: project development, data collection, data analysis, manuscript writing, manuscript revision

E Kocjancic: project development, data collection, data analysis, manuscript writing

E Trowbridge: project development, data collection, data analysis, manuscript writing

L Hayward: project development, data collection, data analysis

Corresponding author

Correspondence to Heidi W. Brown.

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Conflict of interest

HW Brown: receives funding from NIDDK, royalties from Wolters-Kluwer, Inc. for authoring Up-To-Date, Inc. article, honorarium from Elsevier for editing issue of OB/GYN Clinics of North America; royalties from Springer for editing text book Challenges in Older Women’s Health; and is an expert consultant for Grand Rounds, Inc.

A Hegde: None

M Huebner: PROMEDON GmbH Consultant

H Neels: None

HC Barnes: None

G Vissoci Marquini: None

N Mukhtarova: None

B Mbwele: None

V Tailor: None

E Kocjancic: None

E Trowbridge: None

L Hayward: None

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Brown, H.W., Hegde, A., Huebner, M. et al. International urogynecology consultation chapter 1 committee 2: Epidemiology of pelvic organ prolapse: prevalence, incidence, natural history, and service needs. Int Urogynecol J 33, 173–187 (2022). https://doi.org/10.1007/s00192-021-05018-z

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