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Risk index for pelvic organ prolapse based on established individual risk factors

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To identify known risk factors for pelvic organ prolapse (POP) in a hospital cohort and to develop a prolapse risk index (PRI).

Methods

Risk factors for POP were recorded in women who underwent surgery with symptomatic POP (n = 500) or non-POP gynaecological conditions (n = 236). Descriptive statistics were determined by Chi-squared and Mann–Whitney U tests. Stepwise multivariate regression analysis was performed for all patients and subgroups by age (<60 and ≥60 years). Primary outcome measures were variables with the strongest impact on prolapse and PRI development. Secondary: specificity, sensitivity, positive and negative predictive values (PPV and NPV, respectively), and Cohen’s kappa statistic (κ).

Results

Stepwise multivariate regression analysis (n = 736) showed difficult obstetric history [odds ratio (OR) 10.04], family history of POP (OR 7.28), and ≥10 years since menopause (OR 4.53) were independent risk factors for prolapse (P < 0.001). When one of the three variables with the strongest influence on POP development was present, the PRI for all women showed a PPV of 82 %, NPV of 68 %, and κ of 0.47 for predicting symptomatic POP requiring treatment. In women under 60 years (n = 349), logistic regression revealed difficult obstetric history (OR 9.108), positive family history (OR 8.016), and body mass index (OR 2.274) as independent risk factors.

Conclusions

Eighty-seven percent of our patient cohort with symptomatic POP requiring therapy could be identified by the PRI, which may be useful for counselling and education.

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Acknowledgments

The authors thank Mrs. Monika Feesche and Mrs. Anett Krahmer, Department of Gynaecology and Obstetrics, University Hospital, Jena, Germany, for assistance with data collection.

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Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, Jena University Hospital, Friedrich-Schiller-University Jena, Bachstraße 18, 07743, Jena, Germany

    A. R. Mothes, M. P. Radosa & I. B. Runnebaum

  2. Department of General, Visceral, and Vascular Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Jena, Germany

    A. Altendorf-Hofmann

Authors
  1. A. R. Mothes
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  2. M. P. Radosa
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  3. A. Altendorf-Hofmann
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  4. I. B. Runnebaum
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Corresponding author

Correspondence to I. B. Runnebaum.

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Details of ethics approval

This research proposal was covered by approval for data use and clinical studies from the General Ethics Commission, Faculty of Medicine, Jena University Hospital, Germany (No. 4142-07/14). Additional ethical approval was not necessary from the Ethics Commission of the Faculty of Medicine, Jena University Hospital, Germany, as only anonymised data were analysed in this study.

Conflict of interest

The authors declare that they have not received any funding from any institution for the submitted work, have had no financial relationships with any institution that might have an interest in the submitted work in the last 5 years, and have no other relationship or activities that could appear to influence the submitted work.

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Mothes, A.R., Radosa, M.P., Altendorf-Hofmann, A. et al. Risk index for pelvic organ prolapse based on established individual risk factors. Arch Gynecol Obstet 293, 617–624 (2016). https://doi.org/10.1007/s00404-015-3863-2

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  • DOI: https://doi.org/10.1007/s00404-015-3863-2

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