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Pelvic Organ Prolapse in Perimenopausal and Menopausal Women

Abstract

Background

Pelvic organ prolapse (pop) is a chronic disorder, often asymptomatic. There are several factors involved in the aetio-pathogenesis of POP. Perimenopausal women bear most of the burden of pop. Vaginal delivery is an established risk factor and clinical presentation may take years when women are symptomatic in menopausal age.

Method

A cross-sectional study was done for one year in a rural teaching hospital, where 150 pop women were included. Variables associated with both asymptomatic & symptomatic pop were analyzed. The mean, proportion, & simple logistic regression were used to analyze the data and p value < 0.05 was considered significant.

Results

The prevalence of pop was 4.8%. Associated socio-economic & obstetrical variables were age group of 41–50 years (82.7%), housewives (84%), multiparty (93.33%), lower economic conditions (86.7%), home deliveries (74.71%), and early resumption of work after delivery (61.3%). Bulging in the vagina (p < 0.001), & difficulties in micturition (p = 0.001) were significant symptoms. Among asymptomatic & symptomatic pop, difference in BMI (p = 0.042), education level (p = 0.001), menstrual history (p = 0.001) & place of delivery (p = 0.037) were significant. Different stages of pop were significantly associated with differences in age groups (p < 0.001), menstrual history (p < 0.001) & place of delivery (p = 0.039). Differences in the proportion of constipation were significant with anterior compartment defects (p < 0.001), whereas the association of chronic lung diseases was found significant (p = 0.028) in the case of apical compartment prolapse. Simple logistic regression of co-variants shows age can predict the severity of pop stages (OR 7.25; 95% CI 1.95–26.99).

Conclusion

All stages of pop were present mostly in the age group of 41–50 years rather than in the over 50 years age group. Menopause is associated with the severity of prolapse and is mostly symptomatic. Age can predict the severity of pop.

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Authors and Affiliations

Authors

Contributions

MD KA &SK-design, data collection, analysis, interpretation of data and drafting of the article. PPS: conception, design, acquisition of data, analysis and revise critically for intellectual content of the article and final approval of the version.

Corresponding author

Correspondence to Partha Pratim Sharma.

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Conflict of interest

None declared regarding financial, personal, political, intellectual, or religious interests.

Ethical Approval

This study on human participants was approved by the institutional ethics committee and has been performed in accordance with the ethical standard as laid down in the Helsinki Declaration. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Patients written, informed consent for the study was taken before enrollment.

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Md. Kamaluddin Ansari, M.B.B.S, M.S, RMO is an Department of Obstetrics and Gynecology, North Bengal Medical College and Hospital, Sushrutanagar, Darjeeling, West Bengal, India; Partha Pratim Sharma, M.B.B.S, M.D, Associate Professor is an Department of Obstetrics and Gynecology, Midnapore Medical College and Hospital, Paschim Midnapore, West Bengal, 721101, India; Sharmin Khan, M.B.B.S, M.D, Senior Resident, Department of Pharmacology, MidnaporeMedical College and Hospital, Paschim Midnapore, West Bengal, India.

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Ansari, M.K., Sharma, P.P. & Khan, S. Pelvic Organ Prolapse in Perimenopausal and Menopausal Women. J Obstet Gynecol India 72, 250–257 (2022). https://doi.org/10.1007/s13224-021-01524-8

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Keywords

  • Perimenopause
  • Menopause
  • Pelvic organ prolapse
  • Symptomatic and asymptomatic pop