Analysis of Risk Factors with the Degree of Pelvic Organs Prolapse at Dr. Mohammad Hoesin General Hospital Palembang

Abstract

Background. Pelvic organ prolapse (POP) is a condition in which one or more pelvic organs (consisting of the uterus, vaginal cuff, bladder, intestines, and rectum) or more are still in or out of the vagina. Risk factors that influence the incidence of POP consist of obstetric risk factors (number of parity and birth method) and non-obstetric risk factors (age, menopause, BMI, comorbid disease, and hypertension). The purpose of this study was to analyze the risk factors associated with the degree of POP.
 Methods. This study is an observational study with a cross-sectional approach to 111 patients examined at the Department of Obstetrics and Gynecology, Dr. Mohammad Hoesin general hospital Palembang on January 2017 to December 2019, who was diagnosed with pelvic organ prolapse.
 Results. The results showed the effect of variables with the degree of POP using the chi-square test, consisting of parity (p=0.007), birth method (p=<0.001), age (p=0.016), menopause (p=0.001), BMI (p =0.005), indicates that there is a significant effect on the degree of POP. Meanwhile, comorbid factors (p=0.481) and hypertension (p=0.415) did not show a significant relationship with the degree of POP. The results of the binary logistic regression analysis of all risk factors, the number of parity >4, overweight, and age 40 years, will have a 99.85% chance of experiencing grade 3 or 4 prolapse.
 Conclusion. Age is the most dominant risk factor affecting the degree of pelvic organ prolapse, with 19 times the chance of developing POP 3 or 4 degrees.

Low Expression of p53 in Sacrouterine Ligament as A Risk Factor for Stage III-IV Uterine Prolapse

“…Vaginal birth and parity may significantly increase the risk of POP later in life. There is study found that most women with POP (80%) had more than two parities [12]. Similarly, Putra et al also found a higher incidence of POP in multiparous women (68.5%) [13].…”

“…At the age of 80 years, it was reported that the risk for women in the United States to undergo at least one POP operation was 6.3% with the risk of undergoing reoperation reaching 30% [10]. Other studies in Indonesia also reported that almost all POP patients were aged older than 40 years old [5], [12]. The estrogen levels tend to decrease in older women (aged more than 40 years until before menopause) so that the production and degradation of extracellular matrix proteins that maintain tissue stability and prevent collagen degradation will also decrease, causing weakness of the pelvic floor muscles which later manifests 5-10 years post-menopause.9 After menopause, the function of the ovaries and the estrogen levels will decrease even further.…”

“…4.5.1461 Vol 4 | Issue 5 | October 2022 103 [18]. Housewives in Surakarta also had a significant risk of POP due to heavy lifting in daily activities, such as carrying a child or heavy goods at home [12]. In theory, a heavy lifting job is considered to increase the risk of uterine prolapse because it increased the intra-abdominal pressure for a long time.…”