Risk factors of pelvic organ prolapsed in women qualified to reconstructive surgery – the Polish multicenter study

Abstract

To evaluate the prevalence rate of various pelvic floor disorders among patients treated in 8 academic centers in Poland due to pelvic organ prolapse (POP). Results: The mean age of affected women with POP was 61,25 years (median 61), and mean BMI – 27.62 (median – 27.29). 80% of women were menopausal. Mean time of symptoms related to disease was 65,6 months; whereas the time relapsed from first doctor diagnosis of POP to hospital admission was 50.6 months. 97.4% affected women were multiparous. Only 1.21% women with POP were nulliparous. Family history of prolapse was found in 13.4% of patients, whereas familial positive history of urinary incontinence was 10%. Lower urinary tract symptoms (LUTS) among the analyzed group were as follows: frequency – almost 50%, urgency 32.2%, feeling of improper voiding – 29,6% and voiding difficulty – 17.7%. Functional disorders of lower bowel were found in 43% of patients and the most prevalent symptom was constipation (31%), followed by empting difficulty (12%), dyschesia (9%), and urge stool empting (7.7%). Cardiovascular diseases were found among 43% of respondents, whereas pulmonary diseases with chronic coughing were present in 20% of the analyzed population. Subjective POP symptoms reported by women were as follows: feeling of heaviness in lower abdomen – 37.8%, perineal pain – 27.8%, lumbosacral pain – 34.2%, and abdominal pain – 28.4%. Female sexual disorders were reported by 9,8% women and dyspareunia was found in 7.6% of responders. POP was the main reason for sexual abstinence only in 1 out of 10 patients. More than 30% of patients from the study group underwent previously pelvic surgery due to various reasons. POP related quality of life measured by VAS (Visual Analogue Scale) was 61.4 points (median – 60). The most common finding during gynecological examination was cystocele – 96.5%, followed by rectoenterocele – 92.7%, and central defect – 79%. Mean POP quantification was stage III in POP-Q scale. LUTS symptoms (urinary incontinence, urgency and voiding difficulties) were present among 81% of patients whereas lower gastrointestinal disorders (constipation, fecal incontinence, dyschesia) were found in 43% of women affected by POP.