Rate and Risk Factors and Symptoms of Pelvic Organs Prolapse and its Effects on Quality of Women's Life in Clinic of Taleghani and Alzahra Centers, Tabriz, 2002.

Abstract

Abstract: Background: Pelvic organ prolapse (POP) is a common condition and a major indication for gynecologic surgery and is associated with several physical, emotional problems, and sexual dysfunction. In spite of its importance, intervention and prevention in early stage is compromised by our inability to identify susceptible patients because of limited studies and lake if information about its risk factors. In spite of its distressing condition, there is little data on the effect of this condition on quality of life (QOL). Therefore, in order to diagnosis susceptible women and correct management of this condition, the goal of this study was determining the rate and risk factors of POP and its effect on women's quality of life in clinics of Taleghani and Alzahra. Materials & Methods: This was a cross –sectional study, with easy sampling of 330 women referred to two clinics center of Taleghani and Alzahra. Zero or first degree of pelvic organ support was considered as a good support and second degree or so as pelvic organ prolapse. International Continence Society system was used to determine stages of pop, pelvic measurements and pelvic muscle strength. The examination of connective tissue disorder, weight and height were done, too. A questionnaire consisted of risk factors, POP symptoms and generic and disease specific quality of life were completed for each patient by interviewing by a midwife who blinded to examination results. Data were then analyzed using SPSS version 9, and frequency, valid percent, mean and standard deviation, x2 and t student, Mann –Whitney and multiple logistic regression were used to analyze. Results: The overall distribution of POP quantification system stages was as follows: stage 0, 5.5%; stage 1. 31.2%; stage 2, 55.5% and stage 3, 8.2%. No subjects examined had POPQ system stage 4. At whole, 63.3% were with POP, 50.3 had anterior, 2.4% apical and 47.9 posterior vaginal vault prolapse. The means of age, gravid, delivery, vaginal delivery, delivery without episiotomy, body mass index, vaginal length, Coledusac depth and genital hiatus diameter in POP group were significantly more than women with good support. Other variables with a statistically significant trend toward increased POPQ system stage were vaginal delivery of a macrosomic infant, heavy lifting, exercise, education and arthritis, constipation, hemorrhoid and varicose. By using multiple logistic regression analyze, age, prior POP surgery, body mass index and familial history of disorders of pelvic floor were diagnosed as predictor variables for POP. The mean score of generic QOL was not significantly different in two groups. There were more prevalence of urinary, bowel and POP symptoms in women with POP compared women with good support and high percent of women with POP suffer their symptoms in moderate or severe limit. Conclusion: In accordance with the younger age of our studied women (15 -49 year), high prevalence of POP (>50%), high percent of urinary, bowel and POP symptoms and distressing severity of their symptoms and poor QOL in women with POP, it seems necessary to pay more attention to this condition and more efforts should be done in order to begin prevention steps and evaluation of associated disorders. Midwives and other health professionals have an important role in informing women of risk factors and training prevention methods and early treatment. According to our results and predictor variables, it can be suggested that reduces unnecessary surgery and obtaining an ideal weight can be helpful in decrease the risk of POP. Further study is necessary to clear vague points of pop.