Risk Factors for Prolapse Development in White, Black, and Hispanic Women

Kudish, Bela; Iglesia, Cheryl B.; Gutman, Robert E.; Sokol, Andrew I.; Rodgers, Allison K.; Gass, M.L.; OʼSullivan, Mary J.; Larson, Joseph C.; Abu-Sitta, Moeen; Howard, Barbara V.

doi:10.1097/spv.0b013e31820e5d06

Cited by 46 publications

(47 citation statements)

References 21 publications

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“…Incidence of prolapse was found to be increasing with increase in parity. This was similar to the studies conducted by Kim et al and Kudish et al [10,11] The incidence of leiomyoma was more in nulliparous and was found to be decreasing with increase in parity. The remodeling of uterus after pregnancy could be the possible explanation for this.…”

Section: Section: Pathology Discussionsupporting

confidence: 80%

Clinicopathological Study of Uterine Lesions in Hysterectomy Specimens

Kaur¹,

Gupta²,

Kaur³

2017

AIMDR

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Background: Women worldwide suffer from various gynaecological disorders that require hysterectomy as a treatment option. Objectives: Our aim was to conduct a histopathological study of various uterine lesions in hysterectomy specimens and to correlate the findings with clinical indications. Methods: A prospective study was done on 200 hysterectomy specimens. The specimens were fixed in formalin and the tissue was adequately processed. The sections were stained with routine Haematoxylin and Eosin stain. Results: In this study the most common clinical indication for hysterectomy was leiomyoma (57.0%) followed by utero-vaginal prolapse (28.5%). Clinical indication of leiomyoma was confirmed by histopathology in 96.5% cases, whereas that of cervical dysplasia, cervical polyp, squamous cell carcinoma cervix, chronic pelvic inflammatory disease, adenomyosis and endometrial carcinoma was confirmed in 100% cases. Conclusion: The ultimate diagnosis and prognosis depends on the histopathological examination; therefore every operated specimen must be subjected to histopathology.

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Section: Section: Pathology Discussionsupporting

confidence: 80%

Clinicopathological Study of Uterine Lesions in Hysterectomy Specimens

Kaur¹,

Gupta²,

Kaur³

2017

AIMDR

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“…Recent studies using a graded or quantitative physical examination suggest that prolapse is more common among parous versus nulliparous women [25]. In addition, vaginal childbirth, particularly operative vaginal delivery, increases the risk of pelvic organ descent to or beyond the hymen [10 ▪ ,11 ▪ ▪ ].…”

Section: Pelvic Organ Prolapse and Vaginal Childbirthmentioning

confidence: 99%

Pelvic floor disorders following vaginal or cesarean delivery

Memon

Handa

2012

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review Pelvic floor disorders affect women of all ages and are associated with significant economic burden and poor quality of life. Current literature suggests an association between childbirth and these disorders. In this review, we summarize recent advancements in our understanding of this association. Recent findings Vaginal childbirth appears to be strongly associated with stress urinary incontinence and pelvic organ prolapse. There is less evidence to suggest an association between vaginal delivery and overactive bladder symptoms. History of more than one perineal laceration increases the likelihood of developing prolapse. Similar association has not been established for episiotomy. Disruption or denervation of structural components of pelvic floor support system, particularly levator ani muscle complex, is associated with later development of pelvic floor disorders. Imbalance in homeostasis of connective tissue remodeling of the vaginal wall from overstretching during childbirth is another possible mechanism. Summary Pelvic floor disorders represent a significant health problem affecting women of all ages. Identification of potential modifiable risk factors and advancement in understanding of the underlying pathophysiology is crucial for primary and secondary prevention of these disorders and for improvement in treatment strategies.

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“…Several studies have reported on varying rates of and risk factors for POP in different racial/ethnic groups. 23,25 As such, the external validity of our results may be somewhat limited. Furthermore, our population was also recruited from a urogynecology practice, where patients are more likely to have pelvic floor disorders compared to the general population.…”

Section: Discussionmentioning

confidence: 88%

Characterizing the Phenotype of Advanced Pelvic Organ Prolapse

Levin

Visco

Shah

et al. 2012

Female Pelvic Medicine &Amp; Reconstructive Surgery

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Objective Genetic studies require a clearly defined phenotype to reach valid conclusions. Our aim was to characterize the phenotype of advanced prolapse by comparing women with stage III to IV prolapse with controls without prolapse. Methods Based on the pelvic organ prolapse quantification examination, women with stage 0 to stage I prolapse (controls) and those with stage III to stage IV prolapse (cases) were prospectively recruited as part of a genetic epidemiologic study. Data regarding sociodemographics; medical, obstetric, and surgical history; family history; and body mass index were obtained by a questionnaire administered by a trained coordinator and abstracted from electronic medical records. Results There were 275 case patients with advanced prolapse and 206 controls with stage 0 to stage I prolapse. Based on our recruitment strategy, the women were younger than the controls (64.7±10.1 vs 68.6±10.4 years; P<0.001); cases were also more likely to have had one or more vaginal deliveries (96.0% vs 82.0%; P<0.001). There were no differences in race, body mass index, and constipation. Regarding family history, cases were more likely to report that either their mother and/or sister(s) had prolapse (44.8% vs 16.9%, P<0.001). In a logistic regression model, vaginal parity (odds ratio, 4.05; 95% confidence interval, 1.67–9.85) and family history of prolapse (odds ratio, 3.74; 95% confidence interval, 2.16–6.46) remained significantly associated with advanced prolapse. Conclusions Vaginal parity and a family history of prolapse are more common in women with advanced prolapse compared to those without prolapse. These characteristics are important in phenotyping advanced prolapse, suggesting that these data should be collected in future genetic epidemiologic studies.

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Risk Factors for Prolapse Development in White, Black, and Hispanic Women

Cited by 46 publications

References 21 publications

Clinicopathological Study of Uterine Lesions in Hysterectomy Specimens

Clinicopathological Study of Uterine Lesions in Hysterectomy Specimens

Pelvic floor disorders following vaginal or cesarean delivery

Characterizing the Phenotype of Advanced Pelvic Organ Prolapse

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