Determinants of pelvic organ prolapse among gynecologic patients, Northeastern Ethiopia, 2020: A case-control study

Abstract

BACKGROUND: The majority of women in developing countries, including Ethiopia, do not seek medical help; as a result, they face substantial impacts on their health. There is a lack of attention to screening women at high risk for pelvic organ prolapse. Identifying the determinants of pelvic organ prolapse is essential for the early screening and prevention of adverse health outcomes in women. OBJECTIVES: To identify the determinants of pelvic organ prolapse among gynecologic patients at Akesta Hospital, 2020. DESIGN: An unmatched case-control study was conducted among 70 cases and 140 controls. METHODS: The study participants were selected using a systematic sampling technique. Data were collected by reviewing patient charts. The data were entered into EpiData version 4.6 and analyzed using SPSS version 25. Text, tables, and figures were used for data presentation. P values less than 0.2 in binary logistic regression were entered in multivariable logistic regression. Finally, P values less than 0.05 were considered significant factors for the determinants of pelvic organ prolapse. RESULTS: A total of 189 respondents participated in the study. Of the total respondents, 63 were cases and 126 were controls. Patients whose parity was four or above developed pelvic organ prolapse three times more likely than those whose parity number was less than four (adjusted odds ratio = 3.05; 95% confidence interval: 1.35-6.90; P = 0.007). Patients who are overweight are 8.5 times more likely to develop pelvic organ prolapse than patients with normal weight (adjusted odds ratio = 8.5, 95% confidence interval: 2.75-26.51; P = 0.001). Patients with a history of intestinal obstruction were five times more likely to develop pelvic organ prolapse than their counterparts (adjusted odds ratio = 4.87, 95% confidence interval: 1.61-14.75, P = 0.005). CONCLUSION: Educational level, being overweight, having four parities and above, minimum duration of labor, history of urinary retention, and intestinal obstruction were determinants of pelvic organ prolapse. Screening should target women with illiteracy, overweight, and whose parity is four and above. Early diagnosis and treatment of urinary retention and intestinal obstruction should be provided to women with pelvic organ prolapse.