Associate Professor Hawassa University Hawassa, YeDebub Biheroch Bihereseboch na Hizboch, Ethiopia
Objectives: This study aimed to determine the prevalence of pelvic organ prolapse and its associated risk factors among women in Sidama Region, Ethiopia.
Methods: A community-based cross-sectional survey was conducted in the Dale-Wonsho Health and Demographic Surveillance Site, Sidama Region, from March to October 2023. 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 (POP-Q) 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 exam to assess for prolapse status. Anatomical prolapse (stages II-IV) was observed in 241 (30.9%, [95%CI: 24 – 38.7%]) of the participants. The prevalence of symptomatic pelvic organ prolapse was 78.5% (95%CI: 69.1 – 85.7) among women with anatomical prolapse (189 out of 241). This prevalence falls to 24.27% (95%CI: 19.98 – 29.16) for the total sample population. Higher frequency of childbirth (adjusted prevalence ratio (APR) =1.7; [95% CI: 1.1-1.24]), prolonged heavy lifting activities (adjusted prevalence ratio (APR) = 1.26; [95% CI: 1.1-11.4], and prolonged labor (APR =1.32; [95% CI: 1.1-1.56]) increased the likelihood of developing anatomical prolapse. Childbirth at an early-age (APR =1.29; [95% CI: 1.1-1.52]) and prolonged heavy lifting activities (Adjusted prevalence ratio =1.16; [95% CI: 1.1 -1.28]) were significantly associated with symptomatic prolapse
Conclusions: 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. All risk factors are preventable. Community-based education and interventions that focus on the modification of risk factors are needed
