Prevalence and risk factors of pelvic organ prolapse among women in Sidama region, Ethiopia: A community-based survey

Abstract

Background: Pelvic organ prolapse is a descent of the vaginal compartments and the surrounding organ due to loss of support of the vaginal tissue. It has a significant psychological, physical, and social impact that affects women’s quality of life. However, its true prevalence is unknown due to the variability in the methods used to diagnose the disorder. Objectives: This study aimed to determine the prevalence of pelvic organ prolapse and its associated risk factors among women in Sidama region, Ethiopia. Study design: A community-based cross-sectional survey was conducted in the Dale–Wonsho Health and Demographic Surveillance Site, Sidama region, from March to October 2023. Methods: A multi-stage stratified cluster sampling was used to select a sample of 816 women. Anatomical prolapse was diagnosed based on the standardized pelvic organ prolapse quantification method, and symptomatic prolapse was assessed by patient-reported symptoms. A complex survey-based modified Poisson regression was used to assess the risk factors associated with prolapse. Results: A total of 815 participated in the interview, and 779 (95.6%) underwent pelvic examination to assess for prolapse status. Anatomical prolapse (Stages II–IV) was observed in 241 (30.9%; 95% confidence interval = 24–38.7) of the participants. The prevalence of symptomatic pelvic organ prolapse was 78.5% (95% confidence interval = 69.1–85.7) among women with anatomical prolapse (189/241). This prevalence falls to 24.27% (95% confidence interval = 19.98–29.16) for the total sample population. Higher frequency of childbirth, prolonged heavy lifting activities, and prolonged labor increased the likelihood of developing anatomical prolapse. Childbirth at an early age and prolonged heavy lifting activities were significantly associated with symptomatic prolapse. Conclusion: Anatomical prolapse and symptomatic prolapse are high in the study area. Parity, prolonged heavy lifting, prolonged labor, and early age childbirth were associated with pelvic organ prolapse. Community-based education and interventions that focus on the modification of risk factors are needed.