Abstract
Introduction and hypothesis
To define the prevalence and incidence of pelvic/low back pain in patients with pelvic organ prolapse (POP).
Methods
Patients presenting for POP to three urogynecology centers in the US, UK, and Chile were enrolled in an IRB-approved cross-sectional study assessing pain, GU, GI and sexual function symptoms. For prevalence, symptoms were noted as present if the participant recorded the symptom and reported the degree of bother as “somewhat,” “a moderate amount,” or “a lot.” For incidence, participants were queried if the symptom’s onset concurred with the POP. We also queried if they perceived the symptom was worsened by their POP.
Results
Two hundred five participants were recruited: 100 from the US, 46 from the UK, and 59 from Chile. One US participant was excluded due a missing examination. The prevalence of pelvic pain was 42%. Seventy-three percent of these participants reported the onset of pelvic pain coinciding with prolapse onset, and 81% endorsed worsening pelvic pain with POP. The prevalence of low back pain was 46%, with 30% reporting the onset coincided with the onset of POP and 44% responded that prolapse worsened their pain.
Conclusion
A higher proportion of participants than expected endorsed pelvic/low back pain. Among patients with pelvic pain, the majority experienced symptom onset with POP onset and a worsening of pain with POP. While roughly half of participants reported low back pain; a minority correlated this to their POP. These findings highlight a high incidence of pelvic pain, challenging the perception of POP as a painless condition.
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Data Availability
The data that support the findings of this study are available from the corresponding author, [KD], upon reasonable request.
References
Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311–6. https://doi.org/10.1001/jama.300.11.1311.
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. https://doi.org/10.1002/nau.20798.
Harvey M-A, Chih HJ, Geoffrion R, et al. International Urogynecology Consultation Chapter 1 Committee 5: relationship of pelvic organ prolapse to associated pelvic floor dysfunction symptoms: lower urinary tract, bowel, sexual dysfunction and abdominopelvic pain. Int Urogynecol J. 2021;32 Suppl 10:2575–2594. https://doi.org/10.1007/s00192-021-04941-5.
Lukacz ES, Lawrence JM, Buckwalter JG, Burchette RJ, Nager CW, Luber KM. Epidemiology of prolapse and incontinence questionnaire: validation of a new epidemiologic survey. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16 Suppl 4:272–84. https://doi.org/10.1007/s00192-005-1314-5.
Peterson TV, Karp DR, Aguilar VC, Davila GW. Validation of a global pelvic floor symptom bother questionnaire. Int Urogynecol J. 2010;21(9):1129–35. https://doi.org/10.1007/s00192-010-1148-7.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine. 2000;25 Suppl 22:2940–52; discussion 2952. https://doi.org/10.1097/00007632-200011150-00017.
Barber MD, Walters MD, Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103–13. https://doi.org/10.1016/j.ajog.2004.12.025.
Hoy D, Bain C, Williams G, March L, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028–37. https://doi.org/10.1002/art.34347
Kapoor DS, Thakar R, Sultan AH, Oliver R. Conservative versus surgical management of prolapse: what dictates patient choice? Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(10):1157–61. https://doi.org/10.1007/s00192-009-0930-x.
Borahay MA, Zeybek B, Patel P, Lin YL, Kuo YF, Kilic GS. Pelvic pain and apical prolapse surgery: a population-based retrospective cohort study. Female Pelvic Med Reconstr Surg. 2020;26(11):704–11. https://doi.org/10.1097/spv.0000000000000674.
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K Donaldson: Project development, Data analysis, Manuscript writing
J Meilan: Data collection
T Rivers: Data collection
K Rutherford: Data collection
K Shine: Data collection
V Manríquez: Project development, Data collection, Manuscript editing
GA Digesu: Project development, Data collection, Manuscript editing
A Edenfield: Project development, Data analysis, Manuscript editing
S Swift: Project development, Data analysis, Manuscript editing
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Donaldson, K., Meilan, J., Rivers, T. et al. The Incidence of Pelvic and Low Back Pain in Patients with Pelvic Organ Prolapse. Int Urogynecol J 35, 609–613 (2024). https://doi.org/10.1007/s00192-024-05732-4
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DOI: https://doi.org/10.1007/s00192-024-05732-4