Advertisement

International Urogynecology Journal

, Volume 17, Issue 4, pp 340–345 | Cite as

Prevalence of severe pelvic organ prolapse in relation to job description and socioeconomic status: a multicenter cross-sectional study

  • Patrick J. WoodmanEmail author
  • Steven E. Swift
  • Amy L. O’Boyle
  • Michael T. Valley
  • Deirdre R. Bland
  • Margie A. Kahn
  • Joseph I. Schaffer
Original Article

Abstract

The aim of this study was to determine if certain occupations or socioeconomic levels are associated with pelvic organ prolapse. Investigators at six American sites performed pelvic organ prolapse quantification examinations on women presenting for routine gynecologic care. Between September 1999 and March 2002, 1,004 patients were examined. Severe pelvic organ prolapse was defined as the leading edge being 1 cm or more beyond the hymeneal ring. The data was analyzed with the Kruskal–Wallis analysis of variance, Bonferroni test, multiple logistic regression, and descriptive statistics. The prevalence of severe pelvic organ prolapse in our group was 4.3%. Women who were laborers/factory workers had significantly more severe prolapse than the other job categories (p<0.001). Women with annual income of $10,000 or less had significantly more severe pelvic organ prolapse than other income groups (p<0.001). These differences persisted even when controlling for age, race, number of deliveries, body mass index >30, and smoking status (all p<0.001). Laborers/factory worker jobs and an annual household income of $10,000 or less are associated with severe pelvic organ prolapse.

Keywords

Pelvic organ prolapse POP-Q Income Socioeconomic status Occupation 

Notes

Acknowledgements

The authors would like to thank Dierdre McCullough, MD, at the San Antonio University of Health Sciences Educational Center, San Antonio, TX, and John A. Ward, PhD, at Brooke Army Medical Center, Department of Clinical Investigation for their assistance in the statistical analysis of this manuscript.

An unrestricted grant for statistical support was received from the General Clinical Research Center (GCRC) at the Medical University of South Carolina.

References

  1. 1.
    DeLancey J (1992) Anatomical aspects of vaginal eversion after hysterectomy. Am J Obstet Gynecol 166:1717–1728PubMedGoogle Scholar
  2. 2.
    Allen RE, Hosker GL, Smith ARB, Warrell DW (1990) Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol 97:770–779PubMedGoogle Scholar
  3. 3.
    Snooks SJ, Swash M, Henry MM, Setchell M (1986) Risk factors in childbirth causing damage to the pelvic floor innervation. Int J Colorectal Dis 1:20–24CrossRefPubMedGoogle Scholar
  4. 4.
    Smith ARB, Hosker GL, Warrell DW (1989) The role of partial denervation of the pelvic floor in the aetiology of genital prolapse and stress incontinence of urine. A neurophysiological approach. Br J Obstet Gynaecol 96:24–28PubMedGoogle Scholar
  5. 5.
    Jorgensen S, Hein HO, Gyntelberg F (1994) Heavy lifting at work and risk of genital prolapse and herniated lumbar disc in assistant nurses. Occup Med 44:47–49CrossRefGoogle Scholar
  6. 6.
    Spence-Jones C, Kamm MA, Henry MM, Hudson CN (1994) Bowel dysfunction: a pathogenic factor in uterovaginal prolapse and urinary stress incontinence. Br J Obstet Gynaecol 101:147–152PubMedGoogle Scholar
  7. 7.
    Mant J, Painter R, Vessey M (1997) Epidemiology of genital prolapse: observations from the Oxford Family Planning Association study. Br J Obstet Gynaecol 104:579–585PubMedGoogle Scholar
  8. 8.
    American College of Obstetricians and Gynecologists (1995) Pelvic organ prolapse. ACOG technical bulletin 214. ACOG, Washington, DCGoogle Scholar
  9. 9.
    Bump RC (1993) Racial comparisons and contrasts in urinary incontinence and pelvic organ prolapse. Obstet Gynecol 81:421–425PubMedGoogle Scholar
  10. 10.
    Dwyer PL, Lee ET, Hay DM (1988) Obesity and urinary incontinence in women. Am J Obstet Gynecol 95:91–96Google Scholar
  11. 11.
    Baden WF, Walker TA, Lindsey JH (1968) The vaginal profile. Tex Med 64:56–58PubMedGoogle Scholar
  12. 12.
    Beecham CT (1980) Classification of vaginal relaxation. Am J Obstet Gynecol 136:957–958PubMedGoogle Scholar
  13. 13.
    Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JOL, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic organ dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRefGoogle Scholar
  14. 14.
    Hall AF, Theofrastous JP, Cundiff GC, Harris RL, Hamilton LF, Swift SE et al (1996) Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and the American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol 175:1467–1469PubMedCrossRefGoogle Scholar
  15. 15.
    Swift SE, Herring MD (1998) Comparison of pelvic organ prolapse in the dorsal lithotomy position versus standing position. Obstet Gynecol 91:961–964CrossRefPubMedGoogle Scholar
  16. 16.
    Swift S (2002) Current opinion on the classification and definition of genital tract prolapse. Curr Opin Obstet Gynecol 14:503–507CrossRefPubMedGoogle Scholar
  17. 17.
    Swift SE, Pound T, Dias JE (2001) Case-control study on the etiology of severe pelvic organ prolapse. Int Urogynecol J 12:187–190CrossRefGoogle Scholar
  18. 18.
    Swift SE, Tate SB, Nichols J (2003) Correlation of symptomotology with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol 189:372–379CrossRefPubMedGoogle Scholar
  19. 19.
    Swift SE, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D et al (2005) Pelvic Organ Support STudy (POSST): the distribution, clinical definition and epidemiology of pelvic organ support defects. Am J Obstet Gynecol 192:795–806CrossRefPubMedGoogle Scholar
  20. 20.
    Swift SE (2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic care. Am J Obstet Gynecol 183:277–285CrossRefPubMedGoogle Scholar
  21. 21.
    Muir TW, Barber MD (2003) Adoption of the pelvic organ prolapse quantification system (POPQ) in peer reviewed literature. Am J Obstet Gynecol 189:1632–1636CrossRefPubMedGoogle Scholar
  22. 22.
    Materia E, Rossi L, Spadea T, Cacciani L, Baglio G, Cesaroni G et al (2002) Hysterecto my and socioeconomic position in Rome, Italy. J Epidemiol Community Health 56:461–465CrossRefPubMedGoogle Scholar
  23. 23.
    Otto L, Urankar R, Clark A (1998) Correlation of symptoms of pelvic organ prolapse in ambulatory women. Abstract presented at the 20th annual scientific meeting of the American Urogynecologic Society, San Diego, 14–16 October 1998Google Scholar
  24. 24.
    Chiaffarino F, Chatenoud L, Dindelli M, Meschia M, Buonaguidi A, Amicarelli A et al (1999) Reproductive factors, family history, occupation and risk of urogenital prolapse. Eur J Obstet Gynecol Reprod Biol 82:63–67CrossRefPubMedGoogle Scholar
  25. 25.
    U.S. Census Bureau (2004) Census 2000 Special EEO Tabulation. Available from http://www.census.gov/cgi-bin/broker
  26. 26.
    U.S. Census Bureau (2003) Census 2000 Briefs and Special Reports. Available from http://www.census.gov/population/www/cen2000.html
  27. 27.
    Thompson B, Coronado GD, Solomon CC, McClerran DF, Neuhouser ML, Feng Z (2002) Cancer prevention behaviors and socioeconomic status among Hispanics and non-Hispanic whites in a rural population in the United States. Cancer Causes Control 13:719–728CrossRefPubMedGoogle Scholar
  28. 28.
    Toklu C, Ozen H, Sahin A, Rastadoskouee M, Erdem E (1999) Factors involved in diagnostic delay of testicular cancer. Int Urol Nephrol 31:383–388CrossRefPubMedGoogle Scholar

Copyright information

© International Urogynecology Journal 2005

Authors and Affiliations

  • Patrick J. Woodman
    • 1
    • 8
    Email author
  • Steven E. Swift
    • 2
  • Amy L. O’Boyle
    • 3
  • Michael T. Valley
    • 4
  • Deirdre R. Bland
    • 5
  • Margie A. Kahn
    • 6
  • Joseph I. Schaffer
    • 7
  1. 1.Department of Obstetrics & Gynecology, Division of Urogynecology and Pelvic Reconstructive SurgeryMadigan Army Medical CenterTacomaUSA
  2. 2.Department of Obstetrics & Gynecology, Division of Benign GynecologyMedical University of South CarolinaCharlestonUSA
  3. 3.Department of Obstetrics & GynecologyNaval Medical Center PortsmouthPortsmouthUSA
  4. 4.Department of Obstetrics & GynecologyHealth System MinnesotaShakopeeUSA
  5. 5.Blue Ridge Medical AssociatesWinston-SalemUSA
  6. 6.Departments of Obstetrics & Gynecology and Urology, Division of UrologyUniversity of Texas Medical Branch–GalvestonGalvestonUSA
  7. 7.Department of Obstetrics & Gynecology, Division of Urogynecology and Reconstructive Pelvic SurgeryUniversity of Texas Southwestern Medical CenterDallasUSA
  8. 8.Urogynecology Associates Methodist HospitalIndiana University/Clarian HealthIndianapolisUSA

Personalised recommendations