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Addisu D, Mekie M, Belachew YY, Degu A, Gebeyehu NA. The prevalence of pelvic organ prolapse and associated factors in Ethiopia: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1193069. [PMID: 37476611 PMCID: PMC10354282 DOI: 10.3389/fmed.2023.1193069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
Background Pelvic organ prolapse (POP) affects millions of women globally, with resource-limited countries, such as Ethiopia, carrying the highest burden. Previously, the prevalence of POP was estimated using seven studies. However, this study lacks generalization because of the limited number of studies and low geographical representation. In total, 12 additional primary studies were conducted after this review, and their reported prevalence was significantly variable across the studies. In addition, different new factors were reported in the primary studies. Therefore, this study aimed to update the pooled prevalence of POP and its associated factors in Ethiopia. Methods This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Articles that were published between 2000 and 2023 were searched using the African Journal of Online, ScienceDirect, DOAJ, PubMed, and Google Scholar. The quality of the studies was evaluated using the modified Newcastle-Ottawa quality assessment tool. The data were extracted using Microsoft Excel and analyzed by Stata version 11. A random effect model was used to investigate the pooled prevalence of POP and its associated factors. The I2 test and Egger's regression test were used to detect the presence of heterogeneity and publication bias across studies, respectively. Result A total of 21 studies met the inclusion criteria and represented the data of 14,575 women. The pooled prevalence of POP was found to be 22.70%. History of home delivery (pooled odds ratio (OR) =2.93, 95% CI =1.46, 5.91), prolonged labor (OR = 4.63, 95% CI = 2.56, 8.38), history of perineal tear (OR = 4.83, 95% CI = 2.31, 10.11), instrumental delivery (OR =3.70, 95% CI =2.01, 6.81), grand multipara (OR = 5.42, 95% CI = 4.06, 7.23), family history of POP (OR = 3.30, 95% CI = 2.07, 5.25), and carrying heavy objects (OR = 3.23, 95% CI = 2.22, 4.70) were significantly associated with POP. Conclusion The pooled prevalence of POP was high in Ethiopia. The Ministry of Health and clinicians should emphasize counseling on modifiable risk factors and develop further prevention strategies.
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Affiliation(s)
- Dagne Addisu
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Maru Mekie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yismaw Yimam Belachew
- Department of Obstetrics and Gynecology, College of Health Sciences, School of Medicine, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alemu Degu
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Atnafu Gebeyehu
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
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Edmealem A, Ademe S, W/Selassie M. Determinants of pelvic organ prolapse among gynecologic patients, Northeastern Ethiopia, 2020: A case-control study. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231164549. [PMID: 36999278 PMCID: PMC10071158 DOI: 10.1177/17455057231164549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND The majority of women in developing countries, including Ethiopia, do not seek medical help; as a result, they face substantial impacts on their health. There is a lack of attention to screening women at high risk for pelvic organ prolapse. Identifying the determinants of pelvic organ prolapse is essential for the early screening and prevention of adverse health outcomes in women. OBJECTIVES To identify the determinants of pelvic organ prolapse among gynecologic patients at Akesta Hospital, 2020. DESIGN An unmatched case-control study was conducted among 70 cases and 140 controls. METHODS The study participants were selected using a systematic sampling technique. Data were collected by reviewing patient charts. The data were entered into EpiData version 4.6 and analyzed using SPSS version 25. Text, tables, and figures were used for data presentation. P values less than 0.2 in binary logistic regression were entered in multivariable logistic regression. Finally, P values less than 0.05 were considered significant factors for the determinants of pelvic organ prolapse. RESULTS A total of 189 respondents participated in the study. Of the total respondents, 63 were cases and 126 were controls. Patients whose parity was four or above developed pelvic organ prolapse three times more likely than those whose parity number was less than four (adjusted odds ratio = 3.05; 95% confidence interval: 1.35-6.90; P = 0.007). Patients who are overweight are 8.5 times more likely to develop pelvic organ prolapse than patients with normal weight (adjusted odds ratio = 8.5, 95% confidence interval: 2.75-26.51; P = 0.001). Patients with a history of intestinal obstruction were five times more likely to develop pelvic organ prolapse than their counterparts (adjusted odds ratio = 4.87, 95% confidence interval: 1.61-14.75, P = 0.005). CONCLUSION Educational level, being overweight, having four parities and above, minimum duration of labor, history of urinary retention, and intestinal obstruction were determinants of pelvic organ prolapse. Screening should target women with illiteracy, overweight, and whose parity is four and above. Early diagnosis and treatment of urinary retention and intestinal obstruction should be provided to women with pelvic organ prolapse.
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Affiliation(s)
- Afework Edmealem
- Department of Comprehensive Nursing,
School of Nursing and Midwifery, Debre Markos University, Debre Markos,
Ethiopia
| | - Sewunet Ademe
- Department of Comprehensive Nursing,
School of Nursing and Midwifery, Injibara University, Injibara, Ethiopia
| | - Mulugeta W/Selassie
- Department of Pediatrics and Child
Health Nursing, School of Nursing and Midwifery, Wollo University, Dessie,
Ethiopia
- Mulugeta W/Selassie, Department of
Pediatrics and Child Health Nursing, Wollo University, Dessie, Ethiopia.
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Dora BT, Kassa ZY, Hadra N, Tsigie BB, Esayas HL. Determinants of pelvic organ prolapse at public hospitals in Hawassa city, Southern Ethiopia, 2020: unmatched case control study. BMC Womens Health 2022; 22:301. [PMID: 35858912 PMCID: PMC9301820 DOI: 10.1186/s12905-022-01890-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Even though the Pelvic organ prolapse (POP) is outstanding gynecologic problem, most private and asymptomatic nature of the illness makes it the “hidden epidemic.” The aim of this study was to identify the determinants of POP.
Methods
Facility based unmatched case control study was conducted from June 15 to September 10, 2020. All cases diagnosed with POP were enrolled in the study by using consecutive random sampling method by assuming that patient flow by itself is random until the required sample size was obtained. Then 1:2 cases to control ratio was applied. A structured interviewer-administered questionnaire and chart review for type and degree of prolapse was used. Epi-data was used for data entry and SPSS were used for analysis. Chi square test and binary and multivariable logistic regression analysis was employed. Multicollinearity was checked.
Result
On multivariate logistic regression, heavy usual work load(AOR = 2.3, CI(1.066–4.951), number of pregnancy ≥ 5(AOR = 3.911, CI(1.108–13.802), birth space of < 2 years(AOR = 2.88, CI(1.146–7.232), history of fundal pressure (AOR = 5.312, CI(2.366–11.927) and history of induced labor (AOR = 4.436, CI(2.07–9.505) were significantly associated with POP with P value < 0.05 and 95% CI after adjusting for potential confounders.
Conclusion
Heavy usual work load, having pregnancy greater than five, short birth space, history of induced labor, and history of fundal pressure are independent predictors of pelvic organ prolapse. Hence the responsible body and obstetric care providers should counsel the women about child spacing, minimizing heavy usual work load and effect of multigravidity on POP. Incorporation of health education on those risk factors related to POP on antenatal and postnatal care should be considered. The obstetric care providers also avoid fundal pressure and labor induction without clear indication and favorability, and the hospital officials set a law to ban fundal pressure during labor.
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Abebe D, Kure MA, Demssie EA, Mesfin S, Demena M, Dheresa M. One in ten ever-married women who visited health facilities for various reasons have pelvic organ prolapse in Harari regional state, Eastern Ethiopia. BMC Womens Health 2022; 22:223. [PMID: 35690856 PMCID: PMC9188719 DOI: 10.1186/s12905-022-01817-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pelvic organ prolapse remains a neglected public health problem in developing countries. The burden of pelvic organ prolapse varies by region and ranges from 9 to 20%. It poses an impact on women’s quality of life and affects their role at the community and family level. Although it has negative consequences and extensive burden, the true feature of pelvic organ prolapse is not well known among ever-married women attending health facilities for various reasons in the study area. Therefore, this study was aimed to assess the magnitude of pelvic organ prolapse and associated factors among ever-married women attending health care services in public Hospitals, Eastern Ethiopia.
Methods
A facility-based cross-sectional study design was conducted from March 4th to April 5th, 2020 among 458 ever-married women attending public Hospitals in Harar town, Eastern Ethiopia. The study subjects were selected through systematic sampling. The data were collected using a structured questionnaire through face-to-face interviews. Data were analyzed using SPSS version 22 (IBM SPSS Statistics, 2013). The prevalence was reported by proportion and summary measures. Predictors were assessed using a multivariable logistic regression analysis model and reported using an adjusted odds ratio with 95% CI. Statistical significance was declared at p-value < 0.05.
Result
Of 458 women enrolled in the study, 10.5% of them had pelvic organ prolapse based on women’s reporting of symptoms. History of lifting heavy objects [AOR = 3.22, 95% CI (1.56, 6.67)], history of chronic cough [AOR = 2.51, 95% CI (1.18, 5.31)], maternal age of greater than or equal to 55 years [AOR = 3.51, 95% CI (1.04, 11.76)], history chronic constipation (AOR = 3.77, 95% CI (1.54, 9.22) and no history of contraceptive utilization [AOR = 2.41, 95% CI (1.13, 5.05)] were significantly associated with pelvic organ prolapse.
Conclusion
In this study, one in ten ever-married women who visited health facilities for various reasons have pelvic organ prolapse. Modifiable and non-modifiable risk factors were identified. This result provides a clue to give due consideration to primary and secondary prevention through various techniques.
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Ali A, Yadeta E, Eyeberu A, Abdisa L, Bekana M, Dheresa M. Pelvic organ prolapse and associated factors among women admitted to gynecology ward at the Hiwot Fana Comprehensive Specialized Hospital, Harar, eastern Ethiopia. SAGE Open Med 2022; 10:20503121221126363. [PMID: 36172569 PMCID: PMC9511300 DOI: 10.1177/20503121221126363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives The major aim of this study was to assess the magnitude of pelvic organ prolapse and its associated factors among patients admitted to the gynecology ward at Hiwot Fana Specialized University Hospital, eastern Ethiopia. Methods A retrospective review of records was undertaken at Hiwot Fana Specialized University Hospital. We used a simple random sampling technique to pick 387 gynecology ward-admitted patient records from 30 December 2020 to 10 January 2021. Data were extracted from maternal medical charts using a pretested checklist. The extracted data were entered into EpiData version 3.1 and then exported into SPSS version 25 for analysis. Binary logistic regression was carried out to observe a significant correlation between independent and pelvic organ prolapse. An adjusted odds ratio and 95% confidence interval was used to report the result. A p-value of less than 0.05 was used to declare statistical significance. Results Among 387 responded women, 39 (10.1%; 95% confidence interval = 8.3-15.6) of them had at least one stage of pelvic organ prolapse. Multiparty (adjusted odds ratio = 1.88, 95% confidence interval = 1.41-10.60), grand multiparty (adjusted odds ratio = 2.63, 95% confidence interval = 1.53-12.90), older maternal age (adjusted odds ratio = 2.29, 95% confidence interval = 1.220-7.52), lifting a heavy object (adjusted odds ratio = 4.61, 95% confidence interval = 2.31-15.83), and having chronic cough (adjusted odds ratio = 2.39, 95% confidence interval = 1.10-5.19) were significantly associated with pelvic organ prolapse. Conclusion Among women admitted to the hospital because of gynecological morbidity, one in ten of them had pelvic organ prolapse. Multiparty, advanced maternal age, having a chronic cough, and lifting heavy objects were identified to be risk factors for pelvic organ prolapse. Tailored primary prevention would enhance the well-being of reproductive-age women.
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Affiliation(s)
- Abdek Ali
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Elias Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemesa Abdisa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Miressa Bekana
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Obsa MS, Worji TA, Kedir NA, Kute NG. Risk factors of pelvic organ prolapse at Asella Teaching and Referral Hospital: Unmatched case control study. Front Glob Womens Health 2022; 3:833823. [PMID: 36177338 PMCID: PMC9513197 DOI: 10.3389/fgwh.2022.833823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundProlapse is one of the sub-types of pelvic floor dysfunction (PFD) which occurs due to abnormal fall of the pelvic organs from their normal anatomic positions. Although the cause of prolapse is multifactorial, it primarily occurs due to pregnancy and vaginal delivery. Hence, the present study aimed to identify risk factors of prolapse among women who undergo gynecological surgery.Materials and methodsFacility-based-unmatched case–control design was employed. Cases were all gynecological women who were diagnosed with pelvic organ prolapse (POP) at Asella teaching referral hospital (ATRH) while controls were all charts of gynecological women who were diagnosed with other gynecological problems rather than POP at ATRH. For each case, two controls were selected using a simple random sampling technique. The data were entered into Epidata version 4.3.1 and finally exported to SPSS version 25 for further analysis. Then variables that had an association in the bivariate model (p < 0.25) were entered and analyzed by a multivariable conditional logistic regression model to identify the independent effect of different factors. Statistical significance was declared at p < 0.05.ResultsA total of 147 cases and 293 controls were included in this study. Women who had a history of chronic cough, previous pelvic floor surgery, constipation, and vaginal tear during delivery, history of pelvic trauma, age of the women, rural resident, and maternal gravidity were strongly associated with prolapse at p-value of < 0.05. Multigravida [adjusted odds ratio (AOR) 2.987 (95% CI 1.237–6.853), p = 0.014], age >50 years [AOR: 2.496 (95% CI 1.372–4.539), p = 0.003], women with a history of pelvic floor surgery [AOR: 0.3.666 (95% CI 1.328–10.124), p = 0.012], women who had diabetes mellitus [AOR: 4.676 (95% CI 0.908–24.075), p = 0.065], and resided in rural areas [AOR = 1.878; (95% CI: 0.984–3.585), I2 = 47.5%, p = 0.056] were the independent predictors were of prolapse.ConclusionsIn this study, women with diabetes mellitus, previous pelvic floor surgery, rural residents, being multigravida, and age >40 were independent predictors of prolapse. Therefore, delivering health education by focusing on the identified risk factors was strongly recommended.
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Affiliation(s)
| | - Tahir A Worji
- Department of Anesthesia, Wolaita Sodo University, Sodo, Ethiopia
| | - Nemo A Kedir
- School of Medicine, Arsi University, Asella, Ethiopia
| | - Negeso G Kute
- Department of Anesthesia, Hawassa University, Hawassa, Ethiopia
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Sirage N, Hailu D, Kahsay T, Amaje E. Determinants of pelvic organ prolapse among gynecologic patients attending public referral hospitals in Amhara region, Ethiopia, 2020: Institution-based unmatched case-control study design. SAGE Open Med 2022; 10:20503121221094182. [PMID: 35492885 PMCID: PMC9047810 DOI: 10.1177/20503121221094182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Pelvic organ prolapse is a common disorder, with up to 40% of women worldwide
having some form of anatomical prolapse, and it is a significant public
health problem in developing countries including Ethiopia. The prevalence of
pelvic organ prolapse in Ethiopia is 13% in Benchi Maji. This study is
designed to provide information about the determinants of pelvic organ
prolapse among gynecologic patients attending public referral hospitals in
the Amhara region, 2020. Method: Institution-based unmatched case-control study design was conducted from
March to June 2020 among randomly selected 348 mothers (116 cases and 232
controls). A convenient sampling technique was used to select cases, and
controls were selected by systematic random sampling technique. A pre-tested
and structured interviewer-administered questionnaire was used to collect
the data. Data were coded and entered into Epi data version 3.1 and then
exported to the Statistical Package for Social Science IBM version 25 for
analysis. Finally, adjusted odds ratio and 95% confidence intervals were
used to declare statistical significance. Result: The result showed that being unable to read and write (illiterate) (adjusted
odds ratio = 3.91; 95% confidence interval = 1.06–14.39), age of
women >= 40 (adjusted odds ratio = 2.91; 95% confidence
interval = 1.255–6.736), giving first birth before age of 20 (adjusted odds
ratio = 5.72; 95% confidence interval = 1.73–18.94), carrying heavy objects
(adjusted odds ratio = 2.296; 95% confidence interval = 1.102–4.785),
parity ⩾ 4 (adjusted odds ratio = 7.02; 95% confidence
interval = 1.16–42.45), and family history of pelvic organ prolapse
(adjusted odds ratio = 3.09; 95% confidence interval = 1.24–7.71) were
significantly associated with pelvic organ prolapse. Conclusion: This study concluded that being unable to read and write, age ⩾ 40,
multiparity, family history of pelvic organ prolapse, early childbirth, and
carrying heavy objects were the risk factors of pelvic organ prolapse.
Providing health education on planning the number of children, and the
impact of carrying heavy loads on pelvic organs, preventing early
childbirth, and encouraging women to pursue their education at least up to
primary school level is recommended.
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Affiliation(s)
- Nurye Sirage
- Department of Midwifery, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
| | - Desta Hailu
- Department of Maternal and Reproductive Health Nursing, School of Nursing, Mekelle University, Mekelle, Ethiopia
| | - Tensay Kahsay
- Department of Maternal and Reproductive Health Nursing, School of Nursing, Mekelle University, Mekelle, Ethiopia
| | - Elias Amaje
- Department of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
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Basazin Mingude A, Derbie Habtegiorgis S, Getacher L. Determinants of pelvic organ prolapse in Ethiopia: Systematic review and meta-analysis. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Firdisa G, Tilahun T, Kejela G. Determinants of uterovaginal prolapse in Western Ethiopia. Int Urogynecol J 2021; 33:421-429. [PMID: 34142182 DOI: 10.1007/s00192-021-04883-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Uterovaginal prolapse is a significant public health concern in developing countries like Ethiopia where access to health care is limited. It significantly affects women's health and productivity. Thus, it is very important to identify determinant factors and take preventive actions. METHODS A hospital-based unmatched case-control study was conducted on 86 cases and 258 controls who attended gynecologic outpatient departments in Nekemte town from May 1 to July 30, 2019. Cases were women with grade II, III and IV uterovaginal prolapse while controls were women free from uterovaginal prolapse but with other gynecologic diseases. Data were collected using pretested interviewer-administered questionnaires, and measurements on height and weight were taken to calculate the women's body mass index. Data were entered using Epi Data version 3.1, and analysis was carried out by SPSS version 20. Descriptive, bivariate and multivariable logistic regressions were performed. The adjusted odds ratio with a 95% confidence interval was used, and statistical significance was declared at p < 0.05. RESULTS This study revealed age ≥ 40 years (AOR = 10.49; 95% CI: 4.03, 27.35), duration of labor ≥ 24 h (AOR = 8.32; 95% CI: 3.58, 19.33), instrumental delivery (AOR = 7.40; 95% CI: 1.21, 45.28), non- utilization of family planning (AOR = 3.14; 95% CI: 1.32, 7.47) and underweight (BMI < 18.5 kg/m2) (AOR = 5.30; 95% CI: 1.83, 15.33) were determinants of uterovaginal prolapse. CONCLUSION Age ≥ 40 years, prolonged labor, instrumental delivery, non-utilization of family planning and underweight were identified as determinant factors of uterovaginal prolapse. Thus, family planning service utilization and appropriate and timely obstetric care are advisable.
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Affiliation(s)
- Gamachis Firdisa
- Department of Nursing, College of Medicine and Health Sciences, Mettu University, Mettu, Ethiopia
| | - Temesgen Tilahun
- Department of Gynecology and Obstetrics, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Gemechu Kejela
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
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Zenebe CB, Chanie WF, Aregawi AB, Andargie TM, Mihret MS. The effect of women's body mass index on pelvic organ prolapse: a systematic review and meta analysis. Reprod Health 2021; 18:45. [PMID: 33608022 PMCID: PMC7893921 DOI: 10.1186/s12978-021-01104-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/09/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Pelvic organ prolapse remains the public health challenge globally. Existing evidences report the effect of woman's weight on the pelvic organ prolapse inconsistently and this urges the need of pooled body weight effect on the pelvic organ prolapse. Although there was a previous work on this regard, it included papers reported before June 18/2015. Thus, updated and comprehensive evidence in this aspect is essential to devise strategies for interventions. OBJECTIVE This review aimed at synthesizing evidence regarding the pooled effect of body weight on the pelvic organ prolapsed. METHODS For this review, we searched all available articles through databases including PubMed, Web of Sciences, CINAHL, JBI library, Cochran library, PsycInfo and EMBASE as well as grey literature including Mednar, worldwide science, PschEXTRA and Google scholar. We included cohort, case-control, cross-sectional and experimental studies which had been reported between March 30, 2005 to March 30, 2020. In the effect analysis, we utilized random model. The heterogeneity of the studies was determined by I2 statistic and the publication bias was checked by Egger's regression test. Searching was limited to studies reported in the English language. RESULTS A total of 14 articles with 53,797 study participants were included in this systematic review (SR) and meta analysis (MA). The pooled result of this Meta analyses depict that body mass index (BMI) doesn't have statistical significant association with pelvic organ prolapse. CONCLUSION This review point out that women's body mass index has no significant effect on the development of pelvic organ prolapse. However, the readers should interpret the result with cautions due to the presence of considerable limitations in this work. Trial registration The protocol of this systematic review (SR) and meta analysis (MA) has been registered in PROSPERO databases with the Registration number of CRD42020186951.
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Affiliation(s)
- Chernet Baye Zenebe
- Gynecology and Obstetrics Department, University of Gondar, Gondar, Ethiopia
| | - Wagaye Fentahun Chanie
- United Nations Population Fund Supported Maternal Health Project, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | | | - Muhabaw Shumye Mihret
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Po. Box 196, Gondar, Ethiopia.
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Singh R, Mahat S, Singh S, Nyamasege CK, Wagatsuma Y. The relationship between pelvic organ prolapse and short birth intervals in a rural area of Nepal. Trop Med Health 2021; 49:5. [PMID: 33451367 PMCID: PMC7809744 DOI: 10.1186/s41182-021-00298-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/07/2021] [Indexed: 11/14/2022] Open
Abstract
Background Pelvic organ prolapse (POP) is one of the main contributors to reproductive health problems that affect women’s quality of life. Previous studies have reported the risk factors and prevalence of POP. The aim of this study is to examine the association between POP and short birth intervals in a rural area of Nepal. Methods A cross-sectional study was conducted in Panchapuri municipality, located in Surkhet District of Karnali Province in Nepal. A questionnaire was used to collect information on POP, birth intervals, and other known confounding factors, such as age and parity. Multiple logistic regression analysis was used to examine the association between minimum birth intervals and POP. Results The study recruited 131 women. The prevalence of POP was 29.8%. The mean (SD) of maternal age was 32.3 (0.7) years. The median parity was 2, with a range of 2–6 children. More than half (64.9%) of the women reported a minimum birth interval of less than 2 years. Maternal age at birth, minimum birth interval, parity, and latest birth interval were significantly associated with POP in univariate analyses. After adjusting for the potential confounding factors such as age and occupation, the minimum birth interval was significantly associated with POP [AOR = 3.08, 95% CI 1.04–9.19]. Conclusion The prevalence of POP was high in this rural area of Nepal. Age, parity, occupation, and minimum birth interval were significantly associated with POP. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-021-00298-z.
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Affiliation(s)
- Rupa Singh
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Sandeep Mahat
- Resident Medical Officer, Department of Radiology, Bir Hospital, Kathmandu, Nepal
| | - Sonam Singh
- Medical Officer at Birendra Sainik Hospital, Chauni, Kathmandu, Nepal
| | - Carolyn K Nyamasege
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukiko Wagatsuma
- Faculty of Medicine, Department of Clinical Trials and Clinical Epidemiology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Chen CCG, Avondstondt AM, Khatry SK, Singh M, Klasen EM, LeClerq SC, Katz J, Tielsch JM, Mullany LC. Prevalence of symptomatic urinary incontinence and pelvic organ prolapse among women in rural Nepal. Int Urogynecol J 2019; 31:1851-1858. [PMID: 31813031 DOI: 10.1007/s00192-019-04129-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 09/16/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Although pelvic floor disorders (PFDs) are a significant public health issue in higher income countries, less is known about these disorders and associated risk factors in low income countries. We aimed to determine prevalence and associated risk factors for stress urinary incontinence (SUI), urge urinary incontinence (UUI), and pelvic organ prolapse (POP) in reproductive age women in Sarlahi District in rural Nepal. METHODS We conducted a community-based cross-sectional survey of parous, reproductive age women in rural Nepal and screened for pelvic floor disorders using validated screening questions for PFDs. Overall frequency of self-reported symptoms for SUI, UUI, and POP was estimated and compared across demographic and pregnancy history information. RESULTS Of 14,469 women available for analysis, the mean (SD, range) age was 33.5 (8.2, 13-52) years, and median (range) number of pregnancies was 4 (1-15). The prevalence of SUI was 24.1% (95% CI: 23.3-24.8), of UUI was 13.5% (95% CI: 13.0-14.1), and of POP was 8.0% (95% CI: 7.5-8.4). Bivariate analysis identified the risk of PFD increased incrementally with age and number of vaginal deliveries; these covariates were highly correlated. Multivariable logistic regression revealed age, vaginal deliveries, and previous pelvic surgeries were independently associated with PFD. CONCLUSIONS PFDs are common in a community of parous, reproductive age women in rural Nepal. Risk factors for these conditions are similar to risk factors found in higher income countries.
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Affiliation(s)
- Chi Chiung Grace Chen
- Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
| | - Andrea M Avondstondt
- Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Subarna K Khatry
- Nepal Nutrition Intervention Project - Sarlahi, Kathmandu, Nepal
| | - Meeta Singh
- Department of Obstetrics and Gynecology, Institute of Medicine, Kathmandu, Nepal
| | - Elizabeth M Klasen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Steven C LeClerq
- Nepal Nutrition Intervention Project - Sarlahi, Kathmandu, Nepal.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - James M Tielsch
- Milken Institute School of Public Health, Department of Global Health, George Washington University, Washington, DC, USA
| | - Luke C Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Functional pelvic floor anatomy in Nepali women attending a general gynaecology clinic. Int Urogynecol J 2017; 29:1435-1440. [PMID: 29270722 DOI: 10.1007/s00192-017-3534-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Limited existing evidence suggests that there is a high prevalence of female pelvic organ prolapse (POP) amongst Nepali women. However, to date, no comprehensive assessment of pelvic floor functional anatomy has been undertaken in this population. Our study aimed to determine functional pelvic floor anatomy in Nepali women attending a general gynaecology clinic. METHODS One hundred and twenty-nine consecutive women attending the clinic were offered an interview, clinical examination [International Continence Society Pelvic Organ Prolapse Quantification system (ICS/POP-Q)] and 4D translabial ultrasound (TLUS). Most presented with general gynaecological complaints. Five were excluded due to previous pelvic surgery, leaving 124. RESULTS A POP-Q exam was possible in 123 women, of whom 29 (24%) were diagnosed with a significant cystocele, 50 (41%) significant uterine prolapse and seven (6%) significant posterior compartment prolapse. Evaluation of 4D TLUS data sets was possible in 120 women, of whom 25 (21%) had a significant cystocele, 45 (38%) significant uterine prolapse and ten (8%) significant descent of the rectal ampulla. In 13 cases, there was a rectocele with a mean depth of 14 (10-28) mm. Of 114 women in whom uterine position could be determined, 68 (60%) had a retroverted uterus associated with significant uterine prolapse (P 0.038). CONCLUSIONS POP is common in Nepali women attending a general gynaecology clinic, with a high prevalence of uterine prolapse (40%). Uterine retroversion was seen in 60% and was associated with uterine prolapse. Patterns of POP in Nepal seem to be different from patterns observed in Western populations.
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Asresie A, Admassu E, Setegn T. Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: a case-control study. Int J Womens Health 2016; 8:713-719. [PMID: 28003773 PMCID: PMC5161336 DOI: 10.2147/ijwh.s122459] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Pelvic organ prolapse (POP) is a significant public health problem in developing countries including Ethiopia. However, less has been documented on risk factors of POP. Therefore, the aim of this study was to identify the determinants factors of POP. Methods An unmatched case–control study was conducted among gynecologic patients in Bahir Dar city, North West Ethiopia, from July to October 2014. A total of 370 women (selected from outpatient departments) were included in the study. Cases (clients with stage III or IV POP) and controls (who declared free of any stages of POP) were identified by physicians using the Pelvic Organ Prolapse Quantitative Examination tool. Data analysis was carried out by SPSS version 20.0. Descriptive, bivariate, and multivariable logistic regression analyses were performed. Statistical differences were considered at P<0.05, and the strength of association was assessed by odds ratio (OR) and respective confidence intervals (CIs). Results This study revealed that determinants such as age of women (>40 years) (adjusted OR [AOR] =3.0 [95% CI: 1.59–5.89]), sphincter damage (AOR =8.1 [95% CI: 1.67–39.7]), family history of POP (AOR =4.9 [95% CI: 1.94–12.63]), parity (≥4) (AOR =4.5 [95% CI: 2.26–9.10]), nonattendance of formal education (AOR =4.3 [95% CI: 1.25–14.8]), carrying heavy objects (AOR =3.1 [95% CI: 1.56–6.30]), body mass index (BMI) <18.5 kg/m2 (AOR =3.1 [95% CI: 1.22–7.82]), and delivery assisted by nonhealth professionals (AOR =2.6 [95% CI: 1.24–5.56]) were significantly associated with POP. Conclusion In our study, sphincter damage, family history of POP, being uneducated, having ≥4 vaginal deliveries, carrying heavy objects, BMI <18.5 kg/m2, age ≥40 years, and having delivery assisted by nonhealth professional were the independent determinants of POP. Therefore, skilled delivery, further promoting family planning and girls’ education, early pelvic floor assessment, and counseling on avoidance of carrying heavy objects are recommended.
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Affiliation(s)
- Ayalnesh Asresie
- Hamlin Fistula Center, Amhara National Regional State, Bahir Dar, Ethiopia
| | - Eleni Admassu
- Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Reproductive Health Department, Amhara National Regional State, Bahir Dar, Ethiopia
| | - Tesfaye Setegn
- Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Reproductive Health Department, Amhara National Regional State, Bahir Dar, Ethiopia
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