Ansari Md Kamaluddin, Sharma Partha Pratim, Khan Sharmin
Department of Obstetrics and Gynaecology, North Bengal Medical College and Hospital, Sushrutanagar, Darjeeling, West Bengal India.
Department of Obstetrics and Gynaecology, Midnapore Medical College and Hospital, Paschim Midnapore, West Bengal 721101 India.
J Obstet Gynaecol India. 2022 Jun;72(3):250-257. doi: 10.1007/s13224-021-01524-8. Epub 2021 Jul 9.
Pelvic organ prolapse (pop) is a chronic disorder, often asymptomatic. There are several factors involved in the aetio-pathogenesis of POP. Perimenopausal women bear most of the burden of pop. Vaginal delivery is an established risk factor and clinical presentation may take years when women are symptomatic in menopausal age.
A cross-sectional study was done for one year in a rural teaching hospital, where 150 pop women were included. Variables associated with both asymptomatic & symptomatic pop were analyzed. The mean, proportion, & simple logistic regression were used to analyze the data and value < 0.05 was considered significant.
The prevalence of pop was 4.8%. Associated socio-economic & obstetrical variables were age group of 41-50 years (82.7%), housewives (84%), multiparty (93.33%), lower economic conditions (86.7%), home deliveries (74.71%), and early resumption of work after delivery (61.3%). Bulging in the vagina ( < 0.001), & difficulties in micturition ( = 0.001) were significant symptoms. Among asymptomatic & symptomatic pop, difference in BMI ( = 0.042), education level ( = 0.001), menstrual history ( = 0.001) & place of delivery ( = 0.037) were significant. Different stages of pop were significantly associated with differences in age groups ( < 0.001), menstrual history ( < 0.001) & place of delivery ( = 0.039). Differences in the proportion of constipation were significant with anterior compartment defects ( < 0.001), whereas the association of chronic lung diseases was found significant ( = 0.028) in the case of apical compartment prolapse. Simple logistic regression of co-variants shows age can predict the severity of pop stages (OR 7.25; 95% CI 1.95-26.99).
All stages of pop were present mostly in the age group of 41-50 years rather than in the over 50 years age group. Menopause is associated with the severity of prolapse and is mostly symptomatic. Age can predict the severity of pop.
盆腔器官脱垂（POP）是一种慢性疾病，通常无症状。POP的病因发病机制涉及多个因素。围绝经期女性承担了大部分POP的负担。阴道分娩是公认的危险因素，当女性在绝经年龄出现症状时，临床表现可能需要数年时间。
在一家农村教学医院进行了为期一年的横断面研究，纳入了150例POP女性。分析了与无症状和有症状POP相关的变量。使用均值、比例和简单逻辑回归分析数据，P值<0.05被认为具有统计学意义。
POP的患病率为4.8%。相关的社会经济和产科变量包括41 - 50岁年龄组（82.7%）、家庭主妇（84%）、多产妇（93.33%）、经济条件较差（86.7%）、在家分娩（74.71%）以及产后过早恢复工作（61.3%）。阴道膨出（P<0.001）和排尿困难（P = 0.001）是显著症状。在无症状和有症状的POP中，体重指数（P = 0.042）、教育水平（P = 0.001）、月经史（P = 0.001）和分娩地点（P = 0.037）存在显著差异。POP的不同阶段与年龄组差异（P<0.001）、月经史差异（P<0.001）和分娩地点差异（P = 0.039）显著相关。便秘比例在前盆腔缺陷中存在显著差异（P<0.001），而慢性肺部疾病在顶端盆腔脱垂中存在显著关联（P = 0.028）。协变量的简单逻辑回归显示年龄可以预测POP阶段的严重程度（OR 7.25；95%CI 1.95 - 26.99）。
POP的所有阶段大多出现在41 - 50岁年龄组，而非50岁以上年龄组。绝经与脱垂的严重程度相关，且大多有症状。年龄可以预测POP的严重程度。
