Abstract
Introduction and hypothesis
Little is known about the prevalence of pelvic organ prolapse (POP). We aimed to evaluate the prevalence of POP and identify its risk factors in Japan.
Methods
This was a single-centre, cross-sectional study. We recruited Japanese women seen for a Pap smear from July 2018 through May 2019. After providing their informed consent, subjects were asked to complete questionnaires. Pelvic organ support was assessed using the POP quantification (POP-Q) system by an examiner. Logistic regression analyses were conducted to identify risk factors for POP.
Results
There were 1032 women aged 21 to 84 years. The distribution of POP-Q stage was stage 0, 38.0%; stage I, 45.0%; stage II, 16.4%; stage III, 0.6%; and stage IV, 0%. Rates (95% confidence interval [CI]) of stage II or greater in each age group were 6.6% (2.4–10.8) in 20 s–30 s; 17.6% (13.3–21.9) in 40 s; 17.1% (12.9–21.3) in 50 s; 18.0% (12.6–23.4) in 60 s; and 28.7% (19.6–37.9) in 70 s and over. Multivariate analysis revealed the following risk factors for POP, with odds ratio (95% CI): body mass index [BMI] ≥ 25 kg/m2, 1.63 (1.05–2.51); BMI < 18.5 kg/m2, 0.40 (0.17–0.94); hysterectomy, 4.09 (1.55–10.80); ≥ 3 vaginal deliveries, 2.26 (1.19–4.28); and ≥ 1 cup of coffee per day, 0.63 (0.43–0.92).
Conclusion
Among Japanese women undergoing routine gynaecological examinations, 17.1% (14.7–19.5) had POP-Q stage II or greater. Overweight, hysterectomy and ≥ 3 vaginal deliveries increased the risk for POP, whereas underweight and daily coffee consumption decreased it.
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References
Samuelsson EC, Arne Victor FT, Tibblin G, Svärdsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol. 1999;180:299–305.
Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D, Wang W, Schaffer J. Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol. 2005;192:795–806.
Seo JT, Kim JM. Pelvic organ support and prevalence by Pelvic Organ Prolapse-Quantification (POP-Q) in Korean women. J Urology. 2006;175:1769–72.
Lien YS, Chen GD, Ng SC. Prevalence of and risk factors for pelvic organ prolapse and lower urinary tract symptoms among women in rural Nepal. Int J Gynaecol Obstet. 2012;119:185–8.
Awwad J, Sayegh R, Yeretzian J, Deeb ME. Prevalence, risk factors, and predictors of pelvic organ prolapse: a community-based study. Menopause. 2012;19:1235–41.
Miedel A, Tegerstedt G, Mæhle-Schmidt M, Nyrén O, Hammarström M. Nonobstetric risk factors for symptomatic pelvic organ prolapsed. Obstet Gynecol. 2009;113:1089–97.
Snooks SJ, Swash M, Setchell M, Henry MM. Injury to innervations of pelvic floor sphincter musculature in childbirth. Lancet. 1984;2:546–50.
Lukacz ES, Lawrence JM, Contreras R, Nager CW, Luber KM. Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol. 2006;107:1253–60.
Tegerstedt G, Miedel A, Mæhle-Schmidt M, Nyrén O, Hammarström M. Obstetric risk factors for symptomatic prolapse: a population-based approach. Am J Obstet Gynecol. 2006;194:75–81.
Bump RC, Mattiasson A, Bø K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175:10–7.
Weber AM, Abrams P, Brubaker L, Cundiff G, Davis G, Dmochowski RR, Fisher J, Hull T, Nygaard I, Weidner AC. The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J. 2001;12:178–86.
Murase N, Katsumura T, Ueda C, Inoue S, Shimomitsu T. Validity and reliability of Japanese version of International Physical Activity Questionnaire. Journal of Health and Welfare Statistics [in Japanese]. 2002;49:1–9.
Mikako Y, Murayama R, Ota E, Nakata M, Kozuma S, Homma Y. Reliability and validity of the Japanese version of the pelvic floor distress inventory-short form 20. Int Urogynecol J. 2013;24:1039–46.
Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association study. Br J Obstet Gynaecol. 1997;104:579–85.
Gurel H, Gurel SA. Pelvic relaxation and associated risk factors: the results of logistic regression analysis. Acta Obstet Gynecol Scand. 1999;78:290–3.
Henderson JW, Wang S, Egger MJ, Masters M, Nygaard I. Can women correctly contact their pelvic floor muscles without formal instruction? Female Pelvic Med Reconstr Surg. 2013;19:8–12.
Tajik N, Tajik M, Mack I, Enck P. The potential effects of chlorogenic acid, the main phenolic components in coffee, on health: a comprehensive review of the literature. Eur J Nutr. 2017;56:2215–44.
Kim E, Chung N, Park S, Lee K, Kim S, Kim J, Bai S, Jeon M. Involvement of oxidative stress and mitochondrial apoptosis in the pathogenesis of pelvic organ prolapse. J Urol. 2013;189:588–94.
Takacs P, Gualtieri M, Nassiri M, Candiotti K, Medina C. Vaginal smooth muscle cell apoptosis is increased in women with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:1559–64.
National Health and Nutrition Survey. [in Japanese]. http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa16/dl/04.pdf. Accessed 20 July 2020
Kato J, Miwa K, Yamagiwa S, Ohta T, Naganani M, Ito N, Moriyama Y, Kikuchi M, Masue T. Interobserver reliability of pelvic organ prolapse quantification (POP-Q) system. Journal of Female Pelvic Floor Medicine. 2021;17:60–64.
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J Kato: Data collection, Manuscript writing
C Nagata: Preparation of questionnaires, Manuscript editing
N Ito: Research
K Miwa: Study preparation
K Morishige: Study management
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Kato, J., Nagata, C., Miwa, K. et al. Pelvic organ prolapse and Japanese lifestyle: prevalence and risk factors in Japan. Int Urogynecol J 33, 47–51 (2022). https://doi.org/10.1007/s00192-021-04672-7
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DOI: https://doi.org/10.1007/s00192-021-04672-7