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Prevalence of symptomatic pelvic organ prolapse and associated factors in Southern Nations, Nationalities, People’s Region referral hospitals, Ethiopia

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Introduction and hypothesis

Pelvic organ prolapse is one of the major causes of morbidity among women that affect their quality of life. Despite the severity of the problem, there is limited information in Ethiopia. Therefore, this study was aimed at assessing the prevalence of symptomatic POP and its associated factors.


An institution-based cross-sectional study was carried out in the referral hospitals of Southern Nations, Nationalities, People’s Region, Ethiopia. Women were initially interviewed about their prolapse symptoms using validated questionnaires, and if they answered yes to one or more of the questions, they were examined by gynecologists using simplified POP quantification. Pelvic examination results and patient-reported symptoms were used to determine symptomatic POP. A multivariate logistic regression analysis model was used to identify factors associated with symptomatic prolapse.


A total of 1,196 respondents were included in this study. The prevalence of symptomatic POP was found to be 20.1%. Age of women ≥55 years (AOR=8.39; 95% CI 3.41–20.62), carrying heavy objects for ≥ 5 h (AOR= 5.18; 95% CI 2.51–10.69), parity ≥4 times (AOR=2.98; 95% CI 1.60–5.53), history of home delivery (AOR= 2.90; 95% CI 1.50–5.61), giving birth through assisted vaginal delivery (AOR=5.01; 95% CI 1.73–14.53), history of chronic constipation (AOR=2.66; 95% CI 1.38–5.15), and a history of a chronic cough (AOR=9.18; 95% CI 4.52–18.61) were associated with symptomatic POP.


In this study the prevalence of symptomatic POP is high. Older age, long hours of carrying heavy objects, a high parity, last birth through assisted vaginal delivery, a history of home delivery, a history of chronic constipation, and a history of a chronic cough were found to be associated with symptomatic POP.

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Fig. 1

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Adjusted odds ratio


Assisted vaginal delivery


Body mass index


Confidence interval


Cesarean section


Nigist Eleni Memorial


Outpatient department


Odds ratio


Pelvic organ prolapse


Standard deviation


Spontaneous vaginal delivery


Southern Nations, Nationalities, and People’s Region


Statistical Package of Social Sciences


Vaginal delivery


  1. Haylen BT, Maher CF, Barber MD, 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(2):165–94.

    Article  Google Scholar 

  2. Adegoke BO, Anyakudo RO, Odole AC. Spinal deformities among professional load porters in a Nigerian urban market. J Environ Occupational Health. 2014;3(2):109–13.

    Google Scholar 

  3. Chanda A, Unnikrishnan V, Roy S, Richter HE. Computational modeling of the female pelvic support structures and organs to understand the mechanism of pelvic organ prolapse: a review. Appl Mech Rev. 2015.

    Article  Google Scholar 

  4. Whitcomb EL, Rortveit G, Brown JS, et al. Racial differences in pelvic organ prolapse. Obstet Gynecol. 2009;114(6):1271.

    Article  Google Scholar 

  5. Haylen BT, De Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.

    Article  Google Scholar 

  6. Walker GJ, Gunasekera P. Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J. 2011;22(2):127–35.

    Article  Google Scholar 

  7. Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163–96.

    Article  Google Scholar 

  8. Assefa Y, Van Damme W, Williams OD, Hill PS. Successes and challenges of the millennium development goals in Ethiopia: lessons for the sustainable development goals. BMJ Global Health. 2017, 2(2):e000318.

    Article  Google Scholar 

  9. Walker GJ, Gunasekera P. Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J. 2011;2(2):127–35.

    Article  Google Scholar 

  10. Adefris M, Abebe SM, Terefe K, et al. Reasons for delay in decision making and reaching health facility among obstetric fistula and pelvic organ prolapse patients in Gondar University hospital, Northwest Ethiopia. BMC Womens Health. 2017;17(1):1–7.

    Article  Google Scholar 

  11. Gjerde JL, Rortveit G, Muleta M, Adefris M, Blystad A. Living with pelvic organ prolapse: voices of women from Amhara region, Ethiopia. Int Urogynecol J. 2017;28(3):361–6.

    Article  Google Scholar 

  12. Asresie A, Admassu E, Setegn T. Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: a case–control study. Int J Womens Health. 2016;8:713.

    Article  Google Scholar 

  13. Gedefaw G, Demis A. Burden of pelvic organ prolapse in Ethiopia: a systematic review and meta-analysis. BMC Womens Health. 2020;20(1):1–9.

    Article  Google Scholar 

  14. Ethiopia National Reproductive Health Strategy 2016–2020.

  15. Wan M, Colfer CJ, Powell B. Forests, women and health: opportunities and challenges for conservation. Int For Rev. 2011;13(3):369–87.

    Google Scholar 

  16. Central Statistical Agency (CSA). Population projections for Ethiopia 2007–2037.

  17. Henok A. Prevalence and factors associated with pelvic organ prolapse among pedestrian back-loading women in bench Maji Zone. Ethiop J Health Sci. 2017;27(3):263–72.

    Article  Google Scholar 

  18. Belayneh T, Gebeyehu A, Adefris M, Rortveit G, Awoke T. Pelvic organ prolapse in Northwest Ethiopia: a population-based study. Int Urogynecol J. 2020:31(9):1873–81.

    Article  Google Scholar 

  19. Li Z, Xu T, Li Z, Gong J, Liu Q, Zhu L. An epidemiologic study of pelvic organ prolapse in rural Chinese women: a population-based sample in China. Int Urogynecol J. 2019;30(11):1925–32.

    Article  Google Scholar 

  20. Lembo A, Camilleri M. Chronic constipation. N Engl J Med. 2003;349(14):1360–8.

    Article  CAS  Google Scholar 

  21. Ashwell M, Hsieh SD. Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity. Int J Food Sci Nutr. 2005;56(5):303–7.

    Article  Google Scholar 

  22. Lema Z, Yemane Berhane M. Determinants of pelvic organ prolapse among gynecological cases in Wolaita Sodo University Referral Teaching Hospital. Southern Ethiopia: a case control study. J Biol Agric Health Sci. 2015;5(21):1–10.

    Google Scholar 

  23. Masenga GG, Shayo BC, Rasch V. Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: a population based study in Tanzanian rural community. PLoS One. 2018;13(4):e0195910.

    Article  Google Scholar 

  24. Belayneh T, Gebeyehu A, Adefris M, Rortveit G, Genet T. Validation of the Amharic version of the pelvic organ prolapse symptom score (POP-SS). Int Urogynecol J. 2019;30(1):149–56.

    Article  Google Scholar 

  25. Wusu-Ansah OK, Opare-Addo HS. Pelvic organ prolapse in rural Ghana. Int J Gynecol Obstet. 2008;103(2):121–4.

    Article  Google Scholar 

  26. Akter F, Gartoulla P, Oldroyd J, Islam RM. Prevalence of, and risk factors for, symptomatic pelvic organ prolapse in Rural Bangladesh: a cross-sectional survey study. Int Urogynecol J. 2016;27(11):1753–9.

    Article  Google Scholar 

  27. Aytan H, Ertunç D, Tok EC, Yaşa O, Nazik H. Prevalence of pelvic organ prolapse and related factors in a general female population. Turkish J Obstet Gynecol. 2014;11(3):176.

    Article  Google Scholar 

  28. Scherf C, Morison L, Fiander A, Ekpo G, Walraven G. Epidemiology of pelvic organ prolapse in rural Gambia, West Africa. BJOG. 2002;109(4):431–6.

    Article  Google Scholar 

  29. Akmel M, Segni H. Pelvic organ prolapse in Jimma University specialized hospital, Southwest Ethiopia. Ethiop J Health Sci. 2012;22(2):85–92.

    Google Scholar 

  30. Hollick RJ, Reid DM. Role of bisphosphonates in the management of postmenopausal osteoporosis: an update on recent safety anxieties. Menopause Int. 2011;17(2):66–72.

    Article  Google Scholar 

  31. Tinelli A, Malvasi A, Rahimi S, et al. Age-related pelvic floor modifications and prolapse risk factors in postmenopausal women. Menopause. 2010;17(1):204–12.

    Article  Google Scholar 

  32. Brito LGO, Pereira GMV, Moalli P, Shynlova O, Manonai J, Weintraub AY, Deprest J, Bortolini MAT. Age and/or postmenopausal status as risk factors for pelvic organ prolapse development: systematic review with meta-analysis. Int Urogynecol J. 2022;33(1):15–29.

  33. Megabiaw B, Adefris M, Rortveit G, et al. Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study. Int Urogynecol J. 2013;24(7):1135–43.

    Article  Google Scholar 

  34. Jokhio AH, Rizvi RM, MacArthur C. Prevalence of pelvic organ prolapse in women, associated factors and impact on quality of life in rural Pakistan: population-based study. BMC Womens Health. 2020;20:1–7.

    Article  Google Scholar 

  35. Cattani L, Decoene J, Page A-S, Weeg N, Deprest J, Dietz HP. Pregnancy, labour and delivery as risk factors for pelvic organ prolapse: a systematic review. Int Urogynecol J. 2021;32(7):1623–31.

    Article  Google Scholar 

  36. Riesco MLG, Caroci ASC, de Oliveira SMJV, Lopes MHBM. Perineal muscle strength during pregnancy and postpartum: the correlation between perineometry and digital vaginal palpation. Rev Lat Am Enfermagem. 2010;18(6):1138–44.

    Article  Google Scholar 

  37. Blomquist JL, Muñoz A, Carroll M, Handa VL. Association of delivery mode with pelvic floor disorders after childbirth. JAMA. 2018;320(23):2438–47.

    Article  Google Scholar 

  38. Rahmanou P, Caudwell-Hall J, Atan IK, Dietz HP. The association between maternal age at first delivery and risk of obstetric trauma. Am J Obstet Gynecol. 2016;215(4):451.e1–7.

    Article  Google Scholar 

  39. Mawajdeh SM, Al-Qutob RJ, Farag AM. Prevalence and risk factors of genital prolapse. A multicenter study. Saudi Med J. 2003;24(2):161–5.

    Google Scholar 

  40. Elbiss HM, Osman N, Hammad FT. Prevalence, risk factors and severity of symptoms of pelvic organ prolapse among Emirati women. BMC Urol. 2015;15(1):1–5.

    Article  Google Scholar 

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The authors would like to express their gratitude to the study participants for devoting their time to providing us with genuine information and to the University of Gondar for the financial support for the data collection.


University of Gondar sponsored this study but the university has no role in manuscript preparation and publication.

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Authors and Affiliations



E.S. Shewarega conceived the idea, developed the proposal, participated in designing, acquisition of data, data management and analysis, interpretation, and manuscript write-up. Both A.B. Geremew and E.A. Fentie participated equally in designing, data management and analysis interpretation, and manuscript write-up. All authors read and approved the final manuscript, and agreed to submit it for publication.

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Correspondence to Ever Siyoum Shewarega.

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The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Shewarega, E.S., Geremew, A.B. & Fentie, E.A. Prevalence of symptomatic pelvic organ prolapse and associated factors in Southern Nations, Nationalities, People’s Region referral hospitals, Ethiopia. Int Urogynecol J 34, 125–134 (2023).

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