An epidemiologic study of pelvic organ prolapse in postmenopausal women: a population-based sample in China

Abstract

Objective: This study aimed to assess the prevalence and factors associated with symptomatic pelvic organ prolapse (POP) in a representative sample of postmenopausal Chinese women.

Methods: A total of 20,008 postmenopausal Chinese women were recruited to this cross-sectional study between February 2014 and March 2016. The prevalence of symptomatic POP, defined as any stage II or higher POP resulting in symptoms, was assessed using questionnaires and physical examinations. Multivariable logistic regression was used to assess factors associated with symptomatic POP.

Results: Among all women with natural menopause included in the study (mean age =61.98 ± 10.62 years), 2962 of 20,008 women (14.80%, 95% confidence interval [CI] 14.3–15.3%) had symptomatic POP. In the multivariate analysis, women were more likely to have symptomatic POP if aged 50–59 years (adjusted odds ratio [AOR] 1.322, 95% CI 1.123–1.560), 60–69 years (AOR 1.603, 95% CI 1.352–1.907), or above 70 years (AOR 1.824, 95% CI 1.158–2.197), compared with women aged 40–49 years. Having delivered two times (AOR 1.145, 95% CI 1.105–1.292) or three or more times (AOR 1.384, 95% CI 1.214–1.578) was significantly associated with symptomatic POP. Compared with normal weight women, overweight women (AOR 1.365, 95% CI 1.247–1.494) and obese women (AOR 1.548, 95% CI 1.344–1.780) were more likely to have POP. Living in an urban area, smoking, alcohol consumption, cough, constipation, mental labor, physical disease, and gynecological diseases were also associated with symptomatic POP.

Conclusions: Symptomatic POP affects nearly 15% of postmenopausal women in China. The prevalence of symptomatic POP increases significantly with age, body mass index, and parity.

Chinese abstract

目的：本研究旨在评估中国绝经后女性代表性样本中盆腔器官脱垂（POP）有症状的患病率和相关因素。

方法：本横断面研究在2014年2月至2016年3月期间共招募20,008名中国绝经后女性。症状性POP, 定义为任何II期或更高期别的POP均可以导致症状, 通过问卷调查和体格检查评估症状性POP的患病率。多变量逻辑回归用于评估症状性POP的相关因素。

结果：在研究中纳入自然绝经的所有女性中（平均年龄= 61.98±10.62岁）, 20,008名女性中2962名（14.80％, 95％置信区间[CI] 14.3-15.3％）有症状性POP。在多变量分析中, 与40-49岁的女性相比, 年龄在50-59岁之间, （调整后的比值比[AOR] 1.322,95％CI 1.123-1.560）, 60-69岁（AOR 1.603,95％CI 1.352-1.907） ）, 或70岁以上（AOR 1.824,95％CI 1.158-2.197）女性更容易出现症状性POP。分娩两次（AOR 1.145,95％CI 1.105-1.292）或三次或更多次（AOR 1.384,95％CI 1.214-1.578）与症状性POP显著相关。与正常体重女性相比, 超重女性（AOR 1.365,95％CI 1.247-1.494）和肥胖女性（AOR 1.548,95％CI 1.344-1.780）更容易发生POP。生活在城市地区, 吸烟, 酗酒, 咳嗽, 便秘, 脑力劳动, 身体疾病和妇科疾病也均与症状性POP有关系。

结论：症状性POP影响了中国近15％的绝经后女性。随着年龄, 体重指数和分娩次数的增加, 症状性POP的患病率显著增加。

Keywords:

• Epidemiology
• pelvic organ prolapse
• postmenopausal
• prevalence
• risk factors

Ethical approval

This study obtained ethical approval from clinical trials.gov and http://www.chictr.org.cn.

Conflict of interest

Nil.

Additional information

Funding

This study received financial support from the Chinese government via the 12th Five-Year Plan national project and the CAMS Initiative for Innovative Medicine (CAMS-I2 M; 2017-I2 M-1-002).

This work was supported by the Chinese Academy of Medical Sciences Initiative for Innovative Medicine (CAMS-I2M) (No. 2017-12M-1-002)