Aytan Hakan, Ertunç Devrim, Tok Ekrem C, Yaşa Osman, Nazik Hakan
Mersin University Faculty of Medicine, Department of Obstetrics and Gynecology, Mersin, Turkey.
Adana Numune Training and Research Hospital, Clinic of Obstetrics and Gynecology, Adana, Turkey.
Turk J Obstet Gynecol. 2014 Sep;11(3):176-180. doi: 10.4274/tjod.90582. Epub 2014 Sep 15.
The aim of this study was to assess the prevalence and the related factors of pelvic organ prolapse (POP) in a female population to whom health care services are offered.
1354 of the 3000 women admitted to the outpatient clinic between June 2008 and December 2008 were enrolled as they accepted to participate to the study. 34 of these patients with a history of previous hysterectomy and/or any kind of pelvic reconstructive surgery were excluded. Baseline characteristics, as well as medical and obstetric history of the patients were recorded. All women underwent vaginal examination to determine the degree of prolapse by pelvic organ prolapse quantification (POPQ) system. POP-Q stages ≥2 were defined as prolapse. Women with and without prolapse were compared. Regression analysis was used in order to determine the independent predictors.
Prolapse (stage ≥2) was detected in 358 patients (27.1%). Patients with prolapse were found to be significantly older and heavier. They had a higher waist to hip ratio and had a higher parity. Compared to women without prolapse, cesarean rate was significantly lower in women with prolapse (10.6% vs. 20.8%; p<0.001), and the mean birth weight of the babies of the women with prolapse was significantly higher (3584±574 vs. 3490±389 g, p=0.004). Prevalence of prolapse was found to be decreased as the level of education increased. Waist to hip ratio (OR:46.2, CI: 3.3-655, p=0.005), parity (OR:1.5, CI:1.3-1.7, p<0.001), vaginal delivery (OR:1.5, CI: 0.3-0.8, p=0.005), and menopausal status (OR:1.2, CI: 1.1-1.4, p=0.005) were found to be independent predictors of development of POP.
In the present study, POP was found to be associated with waist to hip ratio, parity, vaginal delivery, and menopausal status.
本研究旨在评估接受医疗保健服务的女性人群中盆腔器官脱垂(POP)的患病率及其相关因素。
2008年6月至2008年12月期间到门诊就诊的3000名女性中,有1354名因同意参与本研究而被纳入。其中34名有子宫切除术史和/或任何类型盆腔重建手术史的患者被排除。记录患者的基线特征以及医疗和产科病史。所有女性均接受阴道检查,通过盆腔器官脱垂定量(POPQ)系统确定脱垂程度。POP-Q分期≥2被定义为脱垂。对有脱垂和无脱垂的女性进行比较。采用回归分析以确定独立预测因素。
358例患者(27.1%)检测到脱垂(分期≥2)。发现有脱垂的患者年龄明显更大、体重更重。她们的腰臀比更高且产次更高。与无脱垂的女性相比,有脱垂的女性剖宫产率显著更低(10.6%对20.8%;p<0.001),且有脱垂女性所生孩子的平均出生体重显著更高(3584±574对3490±389g,p=0.004)。发现脱垂患病率随教育程度升高而降低。腰臀比(比值比:46.2,可信区间:3.3 - 655,p=0.005)、产次(比值比:1.5,可信区间:1.3 - 1.7,p<0.001)、阴道分娩(比值比:1.5,可信区间:0.3 - 0.8,p=0.005)以及绝经状态(比值比:1.2,可信区间:1.1 - 1.4,p=0.005)被发现是POP发生的独立预测因素。
在本研究中,发现POP与腰臀比、产次、阴道分娩和绝经状态相关。