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An epidemiologic study of pelvic organ prolapse in rural Chinese women: a population-based sample in China

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Introduction and hypothesis

We aimed to investigate the prevalence and risk factors of symptomatic pelvic organ prolapse (POP) in rural China.


A cross-sectional study of POP was conducted in rural China from February 2014 to March 2016. In total, 25,864 rural women were recruited. All were asked to complete a questionnaire that included questions about their age, job, parity, diseases, and so on. Symptomatic POP was assessed using Pelvic Organ Prolapse Quantification (POP-Q) system staging and validation questionnaires. Multivariate logistic regression was used to assess the factors associated with symptomatic POP.


The prevalence of symptomatic POP was 9.10%. There was a consistent trend toward an increasing prevalence of POP with increasing age, ranging from 2.53 to 13.40% (P < 0.0001). Women aged 50–59 years [adjusted odds ratio (AOR) 1.86, 95% confidence interval (CI) 1.46–2.37] were more likely to have POP than women aged 20–29 years. POP was positively associated with giving birth to more than three children (AOR 2.18, 95% CI 1.88–2.43). Cesarean section was a significant protective factor (AOR = 0.34, 95% CI 0.33-0.49) compared with vaginal delivery. Multivariate logistic regression analysis showed that obesity, constipation, smoking, coughing, gynecological diseases, and other physical diseases were also associated with POP.


Symptomatic POP affects a substantial proportion of women in rural China. Older age, multiparity, vaginal delivery, obesity, and many chronic conditions significantly increased the odds of developing symptomatic POP. Additional healthcare campaigns are needed to educate women in rural areas about POP.

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Fig. 1

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Pelvic organ prolapse


Pelvic Organ Prolapse Quantification


Adjusted odds ratio


Confidence intervals


Body mass index


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This study obtained ethical approval from clinical and (number: ChiCTR-OCH-14004675). Written consent was obtained from all eligible participants. All eligible patients were invited to participate in the study, and those who agreed were provided with a written informed consent form to sign. Ethical approval for the research was sought and obtained from the Research Ethical Committee at the Peking Union Medical College Hospital in 2014.


This study was funded by the CAMS Initiative for Innovative Medicine (CAMS-I2 M; 2017-I2 M-1-002).

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Correspondence to Lan Zhu.

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Li, Z., Xu, T., Li, Z. et al. An epidemiologic study of pelvic organ prolapse in rural Chinese women: a population-based sample in China. Int Urogynecol J 30, 1925–1932 (2019).

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