Skip to main content


Log in

Association Between Striae and Pelvic Organ Prolapse in Women: A Systematic Review and Meta-Analysis

  • Review Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript


Introduction and Hypothesis

The high prevalence of pelvic organ prolapse (POP) and related complications shows the necessity of early identification of risk factors. It is considered that striae and POP share a similar physiopathology. However, the link between the two is still inconclusive and requires further investigation. We conducted this study to evaluate the association between striae and POP.


Databases such as PubMed, Embase, Cochrane Library, Scopus, Web of Science, and Google Scholar were searched to find relevant literature from inception up to May 2023. Full-text articles published in English or other languages and observational studies were included. The statistical analysis was performed using STATA 14.2. The random effects model was performed and heterogeneity was ≥ 50%. Statistical tools such as the Chi-squared test and the I2 index were used to calculate the level of heterogeneity among studies. Additionally, we utilized Funnel plots and Egger tests to assess the presence of publication bias.


Seven studies were selected for meta-analysis, yielding a total of 605 patients and 660 control subjects, to assess the link between striae and POP. The overall pooled odds ratio (OR) was 2.08 (95% confidence interval 1.04–4.19, I2 = 80.40%). Our analysis revealed a strong relationship between POP and striae (p < 0.001).


This study recommends that stretch marks may be used as a helpful indicator of the risk for POP. Evaluation of striae as a risk factor and screening tool for detecting women at risk for the development of POP should be addressed in future well-designed studies. However, there is a need for high-quality studies in this field owing to the low quality of evidence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data Availability

The corresponding author can provide the datasets used and/or analyzed during the current study upon receiving a reasonable request.



Body mass index


Confidence interval


Odds ratio


Pelvic organ prolapse


Preferred Reporting Items for Systematic Reviews and Meta-Analyses


  1. Carroll L, O’Sullivan C, Perrotta C, Fullen BM. Biopsychosocial profile of women with pelvic organ prolapse: a systematic review. Womens Health. 2023;19:17455057231181012.

    Article  CAS  Google Scholar 

  2. Ahmed AA, Taha OT, Elprince M. Evaluation of the severity of striae gravidarum in women with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol. 2020;253:21–4.

    Article  PubMed  Google Scholar 

  3. Zielinski R, Miller J, Low LK, et al. The relationship between pelvic organ prolapse, genital body image, and sexual health. Neurourol Urodyn. 2012;31(7):1145–8.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Abhyankar P, Uny I, Semple K, et al. Women’s experiences of receiving care for pelvic organ prolapse: a qualitative study. BMC Womens Health. 2019;19(1):1–12.

    Article  Google Scholar 

  5. Brækken IH, Majida M, Ellström Engh M, et al. Pelvic floor function is independently associated with pelvic organ prolapse. BJOG. 2009;116(13):1706–14.

    Article  PubMed  Google Scholar 

  6. DeLancey JOL, Low LK, Miller JM, et al. Graphic integration of causal factors of pelvic floor disorders: an integrated life span model. Am J Obstet Gynecol. 2008;199(6):610–e1.

    Article  PubMed Central  Google Scholar 

  7. Runqi G, Xia Z. Collagen changes in pelvic support tissues in women with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol. 2019;234:185–9.

    Article  Google Scholar 

  8. Chen YF, Xu HN, Duan YN, Xia ZJ. Altered expression of COMP, collagen 1, and MMP9 in pelvic organ prolapse. Biomed Environ Sci. 2023;36(10):979–82.

    Article  CAS  PubMed  Google Scholar 

  9. Lichtman Y, Horev A, Matyashov T, et al. Association between striae gravidarum and pelvic floor dysfunction symptoms during pregnancy. Int Urogynecol J. 2022;33(12):3441–7.

    Article  PubMed  Google Scholar 

  10. Salter SA, Batra RS, Rohrer TE, Kohli N, Kimball AB. Striae and pelvic relaxation: two disorders of connective tissue with a strong association. J Investig Dermatol. 2006;126(8):1745–8.

    Article  CAS  PubMed  Google Scholar 

  11. Zagami SE, Ghavami V. The relationship between perineal trauma and striae gravidarum: a systematic review and meta-analysis. Iran J Nurs Midwifery Res. 2022;27(5):363.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kurt S, Toz E, Canda MT, et al. Can striae be used as a marker for the prediction of pelvic organ prolapse? Eur J Obstet Gynecol Reprod Biol. 2014;180:116–9.

    Article  CAS  PubMed  Google Scholar 

  13. Furlani LA, Cunha PR, Borges JBR, et al. Striae: a risk factor for urogenital dystopia. Surg Cosmet Dermatol. 2010;2(1):18–22.

    Google Scholar 

  14. Hafizi L, Mirfeizi Z, Razmjoo N, et al. The association between women’s pelvic organ prolapse and joint hypermobility. J Pak Med Assoc. 2013;63(9):1152–6.

    PubMed  Google Scholar 

  15. Miranne JM, Kramer ME, Mete M, et al. The association of abdominal striae with pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2019;25(4):305–8.

    Article  PubMed  Google Scholar 

  16. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906.

    Article  PubMed  Google Scholar 

  17. Abbas AM, Khalaf M, Abdel-Reheem F, et al. Prediction of pelvic adhesions at repeat cesarean delivery through assessment of striae gravidarum score: a cross-sectional study. J Gynecol Obstet Hum Reprod. 2020;49(1):101619.

    Article  PubMed  Google Scholar 

  18. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Committee on the Application of Global Harmonization of Methodological Approaches to Nutrient Intake Recommendations for Young Children and Women of Reproductive Age. Harmonization of approaches to nutrient reference values: applications to young children and women of reproductive age. Washington (DC): National Academies Press (US). 2018. Appendix D, Tools and Methods to Evaluate the Risk of Bias in Individual Studies. Available from:

  19. Goldet G, Howick J. Understanding GRADE: an introduction. J Evid Based Med. 2013;6(1):50–4.

    Article  PubMed  Google Scholar 

  20. Higgins JPT, Altman DG, Sterne JAC. Assessing risk of bias in included studies. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.1.0 (updated March 2011). 2011, London: The Cochrane Collaboration. p. 243–96.

  21. Miranne JM, Marek T, Mete M, et al. The association of vaginal wind and abdominal striae with pelvic organ prolapse. J Minim Invasive Gynecol. 2014;21:S1–24.

    Article  Google Scholar 

  22. Ibrahim Z, Taha O, Lotfy M, Ghoneim H. Association between striae gravidarum and the occurrence of pelvic organ prolapse. SeekingPro J Gynaecol Clin Obstet. 2020;sjgco.05.2020.1.2.05.

  23. Ren P, Zhao W, Dai X, et al. Risk factors for the formation of striae gravidarum in women in Jiangsu Province of China. Taiwan J Obstet Gynecol. 2019;58(5):640–4.

    Article  PubMed  Google Scholar 

  24. Reimers C, Siafarikas F, Stær-Jensen J, et al. Risk factors for anatomic pelvic organ prolapse at 6 weeks postpartum: a prospective observational study. Int Urogynecol J. 2019;30(3):477–82.

    Article  PubMed  Google Scholar 

  25. Goepel C, Hefler L, Methfessel HD, et al. Periurethral connective tissue status of postmenopausal women with genital prolapse with and without stress incontinence. Acta Obstet Gynecol Scand. 2003;82(7):659–64.

    Article  PubMed  Google Scholar 

  26. Higgins JPT, Thomas J, Chandler J, et al, editors. Cochrane handbook for systematic reviews of interventions version 6.4 (updated August 2023). 2023, Chichester (UK): Cochrane.

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

    Article  PubMed  PubMed Central  Google Scholar 

  28. Vergeldt TFM, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26:1559–73.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Ilunga-Mbaya E, Mukwege D, De Tayrac R, et al. Exploring risk factors of pelvic organ prolapse at Eastern of Democratic Republic of Congo: a case-control study. BMC Womens Health. 2024;24(1):199.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hagen S, Glazener C, McClurg D, et al. Pelvic floor muscle training for secondary prevention of pelvic organ prolapse (PREVPROL): a multicentre randomised controlled trial. Lancet. 2017;389(10067):393–402.

    Article  PubMed  Google Scholar 

  31. Samsonova IA, Gaifulin RF, Toktar LR, et al. Pelvic floor muscle training as a method of prevention and treatment of pelvic floor dysfunction and genital prolapse. RUDN J Med. 2023;27(1):39–45.

    Article  Google Scholar 

Download references


We extend our gratitude to the authors of the original studies who responded to our inquiries for data or clarifications.


Not applicable.

Author information

Authors and Affiliations



SHF and FY were involved in the conception and design of the research; MZ conducted the research; SQ and FY handled the acquisition and analysis of the data; ZM and ZA interpreted the data; SHF and FY drafted the manuscript. All authors critically reviewed the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Corresponding author

Correspondence to Shahla Faal Siahkal.

Ethics declarations

Ethics Approval and Consent to Participate

Not applicable.

Consent for Publication

Not applicable.

Conflicts of Interest


Additional information

Handling Editor: Symphorosa Shing Chee Chan

Editor in Chief: Kaven Baessler

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 14 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yousefi, F., Abbaspoor, Z., Siahkal, S.F. et al. Association Between Striae and Pelvic Organ Prolapse in Women: A Systematic Review and Meta-Analysis. Int Urogynecol J (2024).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: