Prevalence of pelvic organ prolapse in women, associated factors and impact on quality of life in rural Pakistan: population-based study.

Abstract

<title>Abstract</title> Background Pelvic organ prolapse (POP) is a gynecological condition resulting from pelvic floor dysfunction in women. The objective of this study is to estimate the prevalence of pelvic organ prolapse associated factors, duration and impact on women's quality of life in rural Pakistan. Methods A large population-based cross-sectional study was conducted in which a three stage random sampling strategy was applied: randomly selected health centres and randomly selected Lady Health Workers from each health centre who then interviewed a random sample of women in their households. The interview used a structured questionnaire to collect symptom data. Female gynaecologists then conducted a clinical examination at the local health centres on women who reported symptoms of prolapse to verify and grade pelvic organ prolapse using Baden-Walker classification system. Results Among the 5064 women interviewed (95.8% response rate), 521 women had clinically confirmed POP, a prevalence of 10.3% (95% CI 9-11%). Among women with POP 37.8% had grade III or IV prolapse. The highest rate of POP (25%) was found in women aged 36-40 years and a rate of 77.2% was found in women of parity 4 or more. Among women with POP, 60.8% reported their quality of life as greatly or moderately affected; 44.3% had it for more than 5 years; and 78.7% never consulted a doctor. Conclusions Pelvic organ prolapse is highly prevalent in rural Pakistan and impacts on women’s everyday lives and remains mainly untreated. Measures should be taken to provide health care services to reduce this burden of disease among women.