Uterine prolapse and associated factors among reproductive-age women in south-west Ethiopia: A community-based cross-sectional study

Abstract

Background Uterine prolapse is an important but neglected public health problem that causes maternal morbidity and mortality in women of reproductive age in low- and middle-income countries, including Ethiopia. However, little data are available concerning uterine prolapse in Ethiopia. The objective of this study was to assess the prevalence of and factors associated with uterine prolapse in women of reproductive age in Ethiopia. Methods A community-based cross-sectional study was conducted in Loma Woreda, Dawro, south-west Ethiopia, in November and December 2019. Four hundred and twenty-two randomly selected women of reproductive age participated in the study. Face-to-face interviews with a pre-structured questionnaire collected data, and diagnoses were made clinically. Epi Data v3.2.1 and SPSS v24 were used for data entry, processing, and analysis. Binary logistic regression was used to determine associations between dependent and independent variables. Variables with P-values less than 0.25 in bivariate logistic regression were further examined using multivariate logistic regression to investigate associations between the dependent variable and independent variables. Results The mean age of respondents was 35.4 ±7.994 years. The prevalence of symptomatic and anatomical uterine prolapse was 6.6% (28) and 5.9% (25), respectively. The prevalence of anatomical prolapse was used as a reference when determining associated factors. Age at first marriage (Adjusted Odd Ratio (AOR): 0.25, 95%CI 0.07, 0.89), place of delivery (AOR: 3.33, 95%CI 1.21, 9.13), birth attendant-assisted delivery (AOR 0.21; 95%CI 0.06, 0.71), and history of abortion (AOR: 2.94, 95%CI 1.08, 7.97) were found significantly and independently associated with the prevalence of uterine prolapse. Conclusion Uterine prolapse is common in women of reproductive age. Age at first marriage, place of delivery, birth attendant-assisted delivery, and history of abortion were independent predictors of the prevalence of uterine prolapse. We recommend that the health system link primary health care to hospital-set for uterine prolapse treatment programs. Health institution delivery should be encouraged by the local government. Early marriage and unwanted pregnancy need to be prevented through appropriate strategies.

Pelvic organ prolapse and associated factors among women admitted to gynecology ward at the Hiwot Fana Comprehensive Specialized Hospital, Harar, eastern Ethiopia

“…The prevalence of POP in this study is higher than the report of studies done in Southwest Ethiopia (5.9%), 13 Nigeria (3.9%), 32 and Ghana (2.6%). 33 The discrepancy in the estimation of the prevalence of POP might be due to variations in sample size, study setting, and study participants.…”

“…12 It causes a variety of physical disabilities, such as the inability to work, difficulty in walking or standing up, peeing or defecating, painful intercourse, increasing social stigma, and economic destitution. 13 POP mostly affects women between the ages of 50 and 70 years, many women spend a significant portion of their lives dealing with its effects as it became a more serious issue as women's life expectancies have been increasing, and it is anticipated to double in the next 25 years. 2,14 The report of studies done across the world has identified risk factors for the development of POP such as obesity, 2 age at last birth, [15][16][17] parity, 15,18 gravidity, 15 mode of delivery, 19 delivery by unskilled birth attendants, 16,18 family history of POP, 18 prolonged labor, 17 educational status, 18 occupational status, 15,18 genetic factors, anemia, 17 body mass index, 18 and carrying heavy objects.…”

“…12 It causes a variety of physical disabilities, such as the inability to work, difficulty in walking or standing up, peeing or defecating, painful intercourse, increasing social stigma, and economic destitution. 13 POP mostly affects women between the ages of 50 and 70 years, many women spend a significant portion of their lives dealing with its effects as it became a more serious issue as women’s life expectancies have been increasing, and it is anticipated to double in the next 25 years. 2,14…”

Effect of Mayan Abdominal Massage Technique on Sexuality and Quality of Life among Women with Uterine Prolapse

“…Frequently reported risk factors to include multiparty, excessive intra-abdominal pressure, tissue atrophy due to aging and loss of estrogen, joint hypermobility, congenital ligament weakness, as well as direct and indirect injuries to the muscles, ligaments, and nerves related to the pelvic floor/organs which also appears to be the cause of uterine prolapse [5] . Other reported risk factors are Age, high parity, obesity, cigarette smoking/chronic cough, constipation, and estrogen deficiency [6] . Manifestations of uterine prolapse vary depending on the stage, but in general, symptoms include the following: pelvic heaviness, vaginal bleeding or increased vaginal discharge, difficulty in sexual intercourse, urinary incontinence, cystitis, incidence of constipation, low back pain, and the presence of a protrusion in the vaginal opening by prolapsed uterus, feeling sitting on a ball or something falling from the vagina, and weakening of the vaginal tissues [7] .…”

Efficacy of mesh bilaterally sacrospinous ligament suspension versus laparoscopic sacrocolpopexy in patients with uterine prolapse

“…Hence the severe cases are often accompanied by the bulge of the anterior wall of the vagina, stress urinary incontinence, di culty in urination, and even with the need of pushing the anterior wall of the vagina to help urination, complicated with urinary tract infection. Moreover, they may suffer from posterior wall swelling, defecation di culty, and constipation, etc., which seriously affects their health and quality of life 3 . Since the aging of the population in China, there has been a trend towards gradual increase in the incidence rate of the disease with the passage of time, especially the high incidence rate of female urinary incontinence due to aging.…”