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Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study

International Urogynecology Journal volume 24, pages 1135–1143 (2013)Cite this article

Abstract

Introduction and hypothesis

Pelvic floor disorders affect many women in high-income countries. Since little is known about such disorders in Africa, this study aimed at assessing the prevalence and risk factors in an Ethiopian community. We also assessed the validity of a prolapse questionnaire.

Methods

A community-based cross-sectional study was conducted among 395 women, recruited by a systematic random sampling technique. Women were interviewed about symptoms of urinary incontinence, faecal incontinence and pelvic organ prolapse by female nurses. Additionally, pelvic examinations were performed in 294 (74.2 %) participants to assess anatomical prolapse using the simplified Pelvic Organ Prolapse Quantification staging system. Descriptive statistics and logistic regression analyses were employed.

Results

The median age of participants was 35.0 years. Thirty-one women reported urinary incontinence (7.8 %), 25 (6.3 %) symptomatic pelvic organ prolapse and 2 (0.5 %) faecal incontinence. Anatomical pelvic organ prolapse stage II–IV was detected in 162 (55.1 %) of women who underwent pelvic examination. The questionnaire for prolapse assessment had poor validity (38.3 % sensitivity and 95.4 % specificity) even in cases of clinically relevant prolapse (stage III or IV). After adjustment, carrying heavy objects for 5 or more hours a day, history of prolonged labour and highland rural residence were associated with anatomical pelvic organ prolapse.

Conclusions

Self-reported incontinence seems low in northwest Ethiopia. The prevalence of symptomatic prolapse was low despite a high prevalence of prolapse signs. Notably, heavy carrying and prolonged labour increased the risk of anatomical prolapse stage II–IV. The methods of assessing pelvic floor disorders in a low-income context need further development.

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Acknowledgments

We appreciate the Swift group for providing us a DVD for demonstration of the S-POPQ pelvic examination. We also extend our heartfelt thanks to study participants and data collectors. This study was funded by the Western Norway Regional Health Authority and the Nordic Urogynecological Association.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia

    Berihun Megabiaw, Getu Degu & Yigzaw Kebede

  2. Department of Gynecology and Obstetrics, School of Medicine, University of Gondar, Gondar, Ethiopia

    Mulatu Adefris & Mulu Muleta

  3. Research Group for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway

    Guri Rortveit

  4. Research Unit for General Practice, Uni Health, Uni Research, Bergen, Norway

    Guri Rortveit

  5. The Research Group ‘Global Health: Ethics, Economics and Culture’, Department of Public Health and Primary Health Care and Centre for International Health, University of Bergen, Bergen, Norway

    Astrid Blystad

  6. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Torvid Kiserud

  7. National Centre for Gynecological Fistulae, Department of Obstetrics & Gynecology, Haukeland University Hospital, Bergen, Norway

    Torvid Kiserud

  8. Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia

    Tesfahun Melese

Authors
  1. Berihun Megabiaw
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  2. Mulatu Adefris
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  3. Guri Rortveit
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  4. Getu Degu
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  5. Mulu Muleta
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  6. Astrid Blystad
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  7. Torvid Kiserud
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  8. Tesfahun Melese
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  9. Yigzaw Kebede
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Corresponding author

Correspondence to Berihun Megabiaw.

Additional information

The study was conducted in Gondar, Ethiopia.

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Megabiaw, B., Adefris, M., Rortveit, G. et al. Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study. Int Urogynecol J 24, 1135–1143 (2013). https://doi.org/10.1007/s00192-012-1981-y

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  • DOI: https://doi.org/10.1007/s00192-012-1981-y

Keywords

  • Pelvic floor disorder
  • Prevalence
  • Urinary incontinence
  • Faecal incontinence
  • Pelvic organ prolapse
  • Ethiopia