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Pelvic organ prolapse: prevalence and risk factors in a Brazilian population

International Urogynecology Journal volume 28, pages 1165–1170 (2017)Cite this article

Abstract

Introduction and hypothesis

Although pelvic organ prolapse (POP) is a prevalent condition among Brazilians, population-based epidemiological studies of POP are scarce. We studied POP in a population of women undergoing routine examination to determine its prevalence, distribution and relationship to risk factors.

Methods

This quantitative descriptive study surveyed 432 women, based on prolapse prevalence, who sought routine care and were assessed for prolapse staging using the Pelvic Organ Prolapse Quantification system (POP-Q). Demographics, health history, socioeconomic data, symptoms and risk factors for prolapse were self-reported by the participants.

Results

A total of 226 (52.3%) of the examined women had POP. The prevalences of POP in relation to stage were as follows: stage 1 (27.8%), stage 2 (23.1%), and stage 3 (1.4%). Regarding risk factors, a history of vaginal delivery (odds ratio, OR, 6.678, 95% confidence interval, CI, 4.16–10.73), delivery of a newborn heavier than 4 kg (OR 2.056, 95% CI 1.19–3.56) and menopausal status (OR 2.793, 95% CI 1.66–4.70) were all associated with a higher risk of prolapse.

Conclusions

We found that a majority of the population sample exhibited some degree of prolapse, suggesting that POP deserves substantial clinical attention. The risk factors identified suggest that eventual prolapse may be unavoidable in some women. Public policies should be implemented with respect to modifiable risk factors and antenatal care.

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References

  1. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24(11):1783–1790.

    Article  PubMed  Google Scholar 

  2. Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet. 2007;369:1027–1038.

    Article  PubMed  Google Scholar 

  3. Smith FJ, Holman CD, Moorin RE, Tsokos N. Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol. 2010;116(5):1096–1100.

    Article  PubMed  Google Scholar 

  4. Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. women: 2010 to 2050. Obstet Gynecol. 2009;114(6):1278–1283.

  5. Boyles SH, Weber AM, Meyn L. Procedures for pelvic organ prolapse in the United States, 1979–1997. Am J Obstet Gynecol. 2003;188:108–115.

    Article  PubMed  Google Scholar 

  6. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016;27(4):655–684.

    Article  PubMed  Google Scholar 

  7. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1013–1021.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wu JM, Kawasaki A, Hundley AF, Dieter AA, Myers ER, Sung VW. Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Am J Obstet Gynecol. 2011;205(3):230.e1–230.e5.

    Article  Google Scholar 

  9. de Araujo MP, Cristina Takano C, Girão MJ, Sartori MG. Pelvic floor disorders among indigenous women living in Xingu Indian Park, Brazil. Int Urogynecol J. 2009;20(9):1079–1084..

    Article  Google Scholar 

  10. Rodrigues AM, de Oliveira LM, Martins K de F, Del Roy CA, Sartori MG, Girão MJ, et al. Fatores de risco para o prolapso genital em uma população brasileira. Rev Bras Ginecol Obstet. 2009;31(1):2–6.

    Article  Google Scholar 

  11. Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG. 2013;120(2):152–160.

  12. Arouca MA, Duarte TB, Lott DA, Magnani PS, Nogueira AA, Rosa-e-Silva JC, et al. Validation and cultural translation for Brazilian Portuguese version of the Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Floor Distress Inventory (PFDI-20). Int Urogynecol J. 2016;27(7):1097–1106.

    Article  PubMed  Google Scholar 

  13. DeLancey JO. The hidden epidemic of pelvic floor dysfunction: achievable goals for improved prevention and treatment. Am J Obstet Gynecol. 2005;192(5):1488–1495.

    Article  PubMed  Google Scholar 

  14. Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D, et al. Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192(3):795–806.

    Article  PubMed  Google Scholar 

  15. Swift SE. The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol. 2000;183:277–85.

    CAS  Article  PubMed  Google Scholar 

  16. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, Steegers-Theunissen RP, Burger CW, Vierhout ME. Symptomatic pelvic organ prolapse and possible risk factors in a general population. Am J Obstet Gynecol. 2009;200(2):184.e1–184.e7.

    Article  Google Scholar 

  17. Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynaecol. 1997;104(5):579–585.

    CAS  Article  PubMed  Google Scholar 

  18. Ismail SI, Bain C, Hagen S. Oestrogens for treatment or prevention of pelvic organ prolapse in postmenopausal women. Cochrane Database Syst Rev. 2010, CD007063.

  19. Shah AD, Kohli N, Rajan SS, Hoyte L. Racial characteristics of women undergoing surgery for pelvic organ prolapse in the United States. Am J Obstet Gynecol. 2007;197(1):70.e1–70.e8.

    Article  Google Scholar 

  20. Dietz HP, Mann KP. What is clinically relevant prolapse? An attempt at defining cutoffs for the clinical assessment of pelvic organ descent. Int Urogynecol J. 2014;25(4):451–455.

    CAS  Article  PubMed  Google Scholar 

  21. Toozs-Hobson P, Swift S. POP-Q stage I prolapse: is it time to alter our terminology? Int Urogynecol J. 2014;25(4):445–446.

    Article  PubMed  Google Scholar 

  22. Wiegersma M, Panman CMCR, Lisman-Van Leeuwen Y, Dekker JH. More research is needed before we regard POP-Q stage 1 prolapse as normal. Int Urogynecol J. 2014;25(9):1291.

    Article  PubMed  Google Scholar 

  23. Digesu GA, Chaliha C, Salvatore S, Hutchings A, Khullar V. The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG. 2005;112(7):971–976.

    Article  PubMed  Google Scholar 

  24. Barber MD, Neubauer NL, Klein-Olarte V. Can we screen for pelvic organ prolapse without a physical examination in epidemiologic studies? Am J Obstet Gynecol. 2006;195(4):942–948.

    Article  PubMed  Google Scholar 

  25. Martins K de F, de Jármy-Di Bella ZI, da Fonseca AM, Castro RA, da Silva ID, Girão MJ, et al. Evaluation of demographic, clinical characteristics, and genetic polymorphism as risk factors for pelvic organ prolapse in Brazilian women. Neurourol Urodyn. 2011;30(7):1325–1328.

    Google Scholar 

  26. Giarenis I, Robinson D. Prevention and management of pelvic organ prolapse. F1000Prime Rep. 2014;6:77.

    Article  PubMed  PubMed Central  Google Scholar 

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Affiliations

  1. Postgraduation program in Health and Environment, University of the Region of Joinville (Univille), Joinville, Brazil

    Wagner Horst, Juliana Barros do Valle, Jean Carl Silva & Carmem Luíza Lucht Gascho

  2. Rua Barão do Rio Branco, 207 sala 7, Jaraguá do Sul, Brazil, 89251-400

    Wagner Horst

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  1. Wagner Horst
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  2. Juliana Barros do Valle
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  3. Jean Carl Silva
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  4. Carmem Luíza Lucht Gascho
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Correspondence to Wagner Horst.

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Horst, W., do Valle, J.B., Silva, J.C. et al. Pelvic organ prolapse: prevalence and risk factors in a Brazilian population. Int Urogynecol J 28, 1165–1170 (2017). https://doi.org/10.1007/s00192-016-3238-7

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  • DOI: https://doi.org/10.1007/s00192-016-3238-7

Keywords

  • Epidemiology
  • Pelvic organ prolapse
  • POP-Q
  • Prevalence
  • Risk factors