Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors,☆☆,

https://doi.org/10.1016/S0002-9378(99)70203-6Get rights and content

Abstract

Objective: Our objective was to study the prevalence of genital prolapse and possible related factors in a general population of women 20 to 59 years of age. Study Design: Of 641 eligible women in a primary health care district, 487 (76%) answered a questionnaire and accepted an invitation to a gynecologic health examination. Results: The prevalence of any degree of prolapse was 30.8%. Only 2% of all women had a prolapse that reached the introitus. In a set of multivariate analyses, age (P < .0001), parity (P < .0001), and pelvic floor muscle strength (P < .01)—and among parous women, the maximum birth weight (P < .01)—were significantly and independently associated with presence of prolapse, whereas the woman’s weight and sustained hysterectomy were not. Conclusions: Signs of genital prolapse are frequently found in the female general population but are seldom symptomatic. Of factors associated with genital prolapse found in this study, pelvic floor muscle strength appears to be the only one that could be affected. (Am J Obstet Gynecol 1999;180:299-305.)

Section snippets

Subjects and methods

Women 20 to 59 years old in a primary health care district (11,000 inhabitants) in an urban area in mid-Sweden are regularly invited to a gynecologic health examination every third year unless they have had a cervical smear taken during the past year. Women scheduled for health examination during 1993 were invited to participate in this study. Exclusion criteria were, in addition to a cervical smear taken during the last year, ongoing pregnancy, lactation, or mental retardation.

A postal

Genital prolapse

Characteristics of the study population are shown in Table I.

. Characteristics of study population

Empty CellMeanSD
Age (y)39.012.68
Weight (kg)64.99.65
Parity (%)
 Nulliparous45.7
 Uniparous17.5
 Biparous23.6
 Triparous10.3
 Quadriparous or pentaparous2.9
Smoking (%)
 Never46.4
 Formerly or occasionally26.3
 Daily27.3
Postmenopausal (%)17.7
Cesarean section (% of deliveries)5.9
Episiotomy (% of deliveries)24.3
Estrogen treatment in women >44 y (%)25.8
 Estradiol16.5
 Estriol in low dose9.3
The mean age was 39.0 years (range 20 to 60

Comment

The study population is representative of a female population in these ages and has previously been described.12 The International Continence Society standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction3 was not available at the time the study was performed. In a comparison between the International Continence Society grading system and the traditional vaginal profile,14 there was significant interobserver agreement by overall stage, stage-specific

References (20)

There are more references available in the full text version of this article.

Cited by (544)

  • Does monthly self-management of vaginal ring pessaries reduce the rate of adverse events? A clinical audit

    2022, European Journal of Obstetrics and Gynecology and Reproductive Biology: X
  • Mesh deformation: A mechanism underlying polypropylene prolapse mesh complications in vivo

    2022, Acta Biomaterialia
    Citation Excerpt :

    Pelvic organ prolapse (POP), defined as the unnatural descent of the pelvic organs (bladder, rectum, uterus, urethra) into the vagina, is a life-altering condition that primarily impacts aging parous women. Nearly half of all women over the age of 50 experience symptoms of POP, and by the age of 80, approximately 12.6% of women will undergo a surgical repair [1,2]. Surgeries that utilize the patient's own tissues are associated with high failure rates, up to 70% at 5 years [3,4].

View all citing articles on Scopus

Reprint requests: Eva C. Samuelsson, MD, Krokoms HC, Genv 5, S-83531 Krokom, Sweden.

☆☆

†Deceased March 15, 1997.

6/1/94842

View full text