Prevalence of pelvic organ prolapse among US racial populations: A systematic review and meta‐analysis of population‐based screening studies

Abstract

Aims To determine the differences in pooled prevalence rates of symptomatic pelvic organ prolapse (POP) across different US racial/ethnic groups using existing screening‐based epidemiologic studies. Methods A systematic search of MEDLINE, EMBASE, Cochrane, and Scopus was conducted to retrieve eligible studies. We included studies that identified POP by either physical exam or questionnaire, conducted in non‐gynecologic care‐seeking settings, and had a representative sample of US community‐dwelling women from more than one racial/ethnic group with prevalence rates reported for each population. Meta‐analysis was performed with the pooled estimates calculated, and χ 2 tests were performed to examine the associations between race and POP prevalence. Results Of the 2604 studies reviewed, 5 were included. One study used physical exam findings while others used questionnaires to identify POP. All but one study demonstrated statistically significant differences in POP prevalence rates based on race/ethnicity. The overall pooled POP prevalence rates were determined for each racial/ethnic group—White women: 10.76% (95% confidence interval [CI], 10.30%–11.22%); Hispanic women: 6.55% (95% CI, 5.83%–7.28%); Black women: 3.80% (95% CI, 3.22%–4.38%); and Asian American women: 3.40% (95% CI, 2.09%–4.71%). There was a significant difference in the pooled prevalence rates among these four racial/ethnic groups (p < 0.01). Conclusions Our study found that White women had the highest pooled POP prevalence rate overall, while Hispanic women had the highest pooled prevalence among minority women. Additionally, American Indians and Pacific Islanders were absent from the current prolapse epidemiologic literature.

Differences in Anorectal Manometry Values Among Women With Fecal Incontinence in a Racially, Ethnically, and Socioeconomically Diverse Population

“…Existing landmark studies guiding clinical decision making for pelvic floor disorders demonstrate underrepresentation of Black and Hispanic women and an overrepresentation of White women 24,25 . Numerous studies have emphasized the importance of acknowledging race in pelvic floor disorders, given that health inequities do exist 7,24–30,54 . Considering variations in parameters used in clinical decision making, such as ARM values, is important because these differences could point to varying etiologies and suggest specific treatment options that could be more beneficial for different subgroups of women.…”

“…Health inequities are known to exist among women of varying racial groups with pelvic floor disorders, with differences described in symptom severity, health-seeking behavior, and treatment outcomes. 4,[26][27][28][29][30] The value of racial and ethnic involvement in research is well established especially given the changing demographics of the U.S. population, and social factors, including race, are significant contributors to an individual's health given the exposure to extrinsic factors via systemic and structural racism. [31][32][33][34] Accordingly, understanding any differences in ARM values between racial groups in women with FI is important to better address the needs of these women who are experiencing this debilitating condition.…”

“…Moreover, whether any differences in ARM values exist between racial groups is unknown. Health inequities are known to exist among women of varying racial groups with pelvic floor disorders, with differences described in symptom severity, health-seeking behavior, and treatment outcomes 4,26–30 . The value of racial and ethnic involvement in research is well established especially given the changing demographics of the U.S. population, and social factors, including race, are significant contributors to an individual's health given the exposure to extrinsic factors via systemic and structural racism 31–34 .…”

Does the Contractile Capability of Pelvic Floor Muscles Improve with Knowledge Acquisition and Verbal Instructions in Healthy Women? A Systematic Review

“…These processes entail hormone alterations and changes in anatomy and biochemistry levels [ 3 ] that can predispose individuals to PF dysfunctions (PFD), among which the most common are urinary incontinence (UI), anal incontinence, pelvic organ prolapse (POP), and sexual dysfunctions. Over 40% of women are estimated to suffer from PFDs; the prevalence of any type of UI ranges between 25% and 45% [ 4 ], anal incontinence affects nearly 14% of parous women, even in the absence of suspected sphincter injuries [ 5 ], and 12% of women present moderate POP [ 6 ].…”

Risk factors of pelvic organ prolapse: an ultrasound based retrospective study

“…POP mostly occurs in women because of the adverse effects of pregnancy and childbirth (2)(3)(4). According to a research, the incidence of POP ranges from 3.4-10.76% among different ethnic groups (5). Pop is not always symptomatic, only if the leading edge reaches 0.5 cm or more distal to the hymenal ring (6).…”