Prevalence of pelvic organ prolapse in women, associated factors and impact on quality of life in rural Pakistan: population-based study.

Abstract

Background: Pelvic organ prolapse (POP) is a gynecological condition resulting from pelvic floor dysfunction in women. The objective of this study is to estimate “the prevalence of pelvic organ prolapse” associated factors, duration and impact on women's quality of life in rural Pakistan. Methods: A cross-sectional study was conducted with a three stage random sampling strategy.Three health centers were selected and selected Lady Health Workers from each health center interviewed a random sample of women in their households. The interview used a structured questionnaire to collect symptom data. Female gynaecologists then conducted a clinical examination at the local health centres on women who reported symptoms of prolapse to verify and grade pelvic organ prolapse using Baden-Walker classification system. Results : Among the 5064 women interviewed (95.8% response rate), 521 women had clinically confirmed POP, a prevalence of 10.3% (95% CI 9-11%). Among women with POP 37.8% had grade III or IV prolapse. Women with four or more children had the highest proportion of pelvic organ prolapse (75%) followed by women aged 36-40 years (25%).Among women with POP, 60.8% reported their quality of life as greatly or moderately affected; 44.3% had it for more than 5 years; and 78.7% never consulted a doctor. Conclusions : Pelvic organ prolapse is highly prevalent in rural Pakistan, impacts on women’s everyday lives and remains mainly untreated. Measures should be taken to provide health care services to reduce this burden of disease among women. Keywords Community-based; Pelvic organ prolapse; Prevalence; Quality of life; Pakistan

Determinants and Symptoms Severity of Pelvic Organ Prolapse and Its Effect on Physical Activities among the Elderly versus Childbearing Women

“…This finding was supported by (Masenga et al, 2018) who illustrated a significant relation between the severity of prolapse and the educational level in the Tanzanian rural community. Moreover, our findings are in agreement with (Jokhio et al, 2020) who found the severity of POP was higher among illiterate Pakistan women as compared to educated women with a low rate of reporting and consultation among them.…”

“…These findings were similar to the findings of (Laganà et al, 2018) that revealed POP symptoms were negatively impacting women QOL in all domains (physical function, role limitation, social activities, occupational activities, and sexual). Also, these findings were consistent with a study conducted in Pakistan by (Jokhio et al, 2020), and found oldaged women reported a great impact on their daily life activities which including; hygiene, home/work life, and social life versus the middle-aged women.…”

“…Moreover, findings reflected that increased body mass index is significantly associated with the severity of prolapse. This fact was in the same line of the studies conducted by (Belayneh et al, 2019 andJokhio et al, 2020) and documented that there was a direct relationship between obesity and prolapse severity and discussed that obesity makes extrapressure on the pelvic organs and causing them to further descend and aggravate. Furthermore, it was found that constipation is another detected determinant that significantly associated with the severity of prolapse symptoms, as chronic constipation is associated with chronic straining and increased intra-abdominal pressure, and this finding is consistent with the related studies of (Wu et al, 2014, Sumathi., 2017& Jokhio et al, 2020).…”

Impact of Surgery on Quality of Life of Ugandan Women With Symptomatic Pelvic Organ Prolapse: A Prospective Cohort Study

“…The Quality of Life among women with POP at MRRH is poor with an overall mean score of 45.5%. This is similar to ndings from high income countries where women with POP had a poor QOL (34,35). Pelvic organ prolapse affects women's physical, social, emotional, sleep and sexual performance.…”