Author:
Pradnyandita Dewa Gede Sidan,Megadhana I Wayan,Suwiyoga Ketut,Darmayasa I Made,Suardika Anom,Widiyanti Endang Sri
Abstract
Introduction: As life expectancy increases, so does the incidence of pelvic organ prolapse (POP). Low expression of p53 may lead to reduced production and deposition of elastin in the extracellular matrix thus it may increase the risk for POP. This study aims to determine the relationship between p53 expression and the incidence of grade III-IV POP.
Methods: This observational case-control study involved women with grade III-IV POP that underwent a total hysterectomy at Sanglah General Hospital Denpasar as the case group. The control group was non-prolapsed women who were matched to the case for the variables of age, parity, body mass index (BMI), and occupation to minimize bias. The p53 expression was grouped into low (<146.90) and high (≥146.90) expressions according to the optimal cut-off value obtained from the receiver operating characteristic curve. Bivariate analysis between p53 expression and risk of POP was performed using the Chi-square test.
Results: A total of 44 patients were included in this study with 22 patients with grade III-IV POP and 22 patients without POP. There were no significant differences in age, parity, BMI, and occupation between the two groups. Low p53 expression increased the risk of stage III-IV uterine prolapse by 20.25 times higher (OR = 20.25; 95% CI = 4.375-93.722; p = 0.000).
Conclusion: The low p53 expression in the sacrouterine ligament is a significant risk factor for grade III and IV POP.
Publisher
European Open Science Publishing
Reference26 articles.
1. Herschorn S. Female pelvic floor anatomy: the pelvic floor, supporting structures, and pelvic organs. Rev Urol. 2004; 6 Suppl 5(Suppl 5): S2-S10.
2. Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013; 24(11): 1783-1790.
3. Bradley CS. Progress toward understanding pelvic organ prolapse. Am J Obstet Gynecol. 2018; 218(3): 267-268.
4. Kusuma IGYS, Megaputra IG, Megadhana IW, Sanjaya INH, Manuaba IF. Characteristic of patients with pelvic organ prolapse in obstetric and gynecologic outpatient clinic in Sanglah Hospital, Bali, Indonesia from January 2014 to December 2015. Bali Med J. 2017; 6(1): 76.
5. Kastenhuber ER, Lowe SW. Putting p53 in Context. Cell. 2017; 170(6): 1062-1078.