Eleje Gu, Udegbunam Oi, Ofojebe Cj, Adichie Cv
Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Ann Med Health Sci Res. 2014 Sep;4(5):796-801. doi: 10.4103/2141-9248.141578.
The last decade has seen significant progress in understanding of the pathophysiology, anatomy and management modalities of pelvic organ prolapse. A review of the way we manage this entity in a low resource setting has become necessary.
The aim of the study is to determine the incidence, risk factors and management modalities of pelvic organ prolapse.
A 5-year cross-sectional study with retrospective data collection of women who attended the gynecologic clinic in Nnamdi Azikiwe University Teaching Hospital, Nnewi, south-east Nigeria and were diagnosed of pelvic organ prolapse was made. Proforma was initially used for data collection before transfer to Epi-info 2008 (v 3.5.1; Epi Info, Centers for Disease Control and Prevention, Atlanta, GA) software.
There were 199 cases of pelvic organ prolapse, out of a total gynecologic clinic attendance of 3082, thus giving an incidence of 6.5%. The mean age was 55.5 (15.9) years with a significant association between prolapse and advanced age (P < 0.001). The age range was 22-80 years. The leading determinants were menopause, advanced age, multiparity, chronic increase in intra-abdominal pressure (IAP) and prolonged labor. Out of the 147 patients with uterine prolapse, majority, 60.5% (89/147) had third degree prolapse. Vaginal hysterectomy with pelvic floor repair was the most common surgery performed. The average duration of hospital stay following surgery was 6.8 (2.9) days and the most common complication was urinary tract infection, 13.5% (27/199). The recurrence rate was 13.5% (27/199). Most of the patients who presented initially with pelvic organ prolapse were lost to follow-up.
The incidence of pelvic organ prolapse in this study was 6.5% and the leading determinants of pelvic organ prolapse were - multiparity, menopause, chronic increase in IAP and advanced age. Most were lost to follow-up and a lesser proportion was offered conservative management. Early presentation of women is necessary so that conservative management could be offered if feasible.
在过去十年中，我们对盆腔器官脱垂的病理生理学、解剖学及治疗方式的理解取得了重大进展。因此，有必要对在资源匮乏地区如何管理这一疾病进行综述。
本研究旨在确定盆腔器官脱垂的发病率、危险因素及治疗方式。
进行了一项为期5年的横断面研究，收集尼日利亚东南部Nnewi的纳姆迪·阿齐克韦大学教学医院妇科门诊被诊断为盆腔器官脱垂的女性的回顾性数据。最初使用表格进行数据收集，之后将数据转入Epi-info 2008（版本3.5.1；美国疾病控制与预防中心的Epi Info，佐治亚州亚特兰大）软件。
在3082名妇科门诊患者中，有199例盆腔器官脱垂病例，发病率为6.5%。平均年龄为55.5（15.9）岁，脱垂与高龄之间存在显著关联（P < 0.001）。年龄范围为22至80岁。主要决定因素为绝经、高龄、多产、腹内压慢性升高及产程延长。在147例子宫脱垂患者中，大多数（60.5%，89/147）为三度脱垂。阴道子宫切除术加盆底修复是最常进行的手术。术后平均住院时间为6.8（2.9）天，最常见的并发症是尿路感染，发生率为13.5%（27/199）。复发率为13.5%（27/199）。大多数最初表现为盆腔器官脱垂的患者失访。
本研究中盆腔器官脱垂的发病率为6.5%，盆腔器官脱垂的主要决定因素为多产、绝经、腹内压慢性升高及高龄。大多数患者失访，接受保守治疗的比例较小。女性应尽早就诊，以便在可行的情况下提供保守治疗。
