Abstract:
OBJECTIVE: This study aimed to determine the prevalence of pelvic organ prolapse (POP) in a village in East Lebanon and to evaluate related risk factors and clinical predictors. METHODS: Five hundred four ever-married women, aged 15 to 60 years, were interviewed and underwent physical and pelvic examinations and laboratory testing. Prolapse was determined according to a simplified version of the POP quantification system. RESULTS: Two hundred fifty-one (49.8percent) women had clinically significant POP. When stratified by life decade, POP prevalence was 20.4percent for women aged 20 to 29 years, 50.3percent for women aged 30 to 39 years, 77.2percent for women aged 40 to 49 years, and 74.6percent for women aged 50 to 59 years, suggesting a plateau in prevalence in the decade after menopause. Clinically significant POP was found in 3.6percent of nulliparous, 6.5percent of primiparous, 22.7percent of secondiparous, 32.9percent of triparous, and 46.8percent of tetraparous women. Increasing age, increasing vaginal parity, and a body mass index higher than 24 kg-m were found to be significant risk factors for POP, with relative risks of 1.09 (P 0.001), 2.31 (P 0.0001), and 1.62 (P = 0.048) respectively. Combined clinical symptoms of pelvic heaviness, urinary disturbances, and a feeling of bulge in the vagina were predictive of POP. CONCLUSIONS: Our findings suggest that cost-efficient interventions to reduce the burden of POP in this and similar remote communities include the following: family planning awareness campaigns focusing on the risks of grand multiparity; nutritional education and weight management programs to help reduce the progression of POP before the age of menopause; and consideration of symptom-based screening to identify affected women who might benefit from a referral to specialty care at a tertiary care center. Copyright © 2012 The North American Menopause Society.