A NATIONAL POPULATION-BASED SURVEYOF THE PREVALENCE, POTENTIAL RISK FACTORS & SYMPTOM-SPECIFICBOTHER IN SYMPTOMATIC PELVIC ORGAN PROLAPSE IN ADULT CHINESE WOMEN
Department ofObstetrics and Gynecology, Peking Union Med. Coll. Hosp., BeiJing,China.
Introduction: Fewepidemiological studies have investigated pelvic organ prolapse (POP)at a national level, especially diagnosed in a physicalexamination.
Objective: We conducted a national study toestimate the prevalence, risk factors and bother associated withsymptomatic POP among adult Chinese women.
Methods:Design:Cross-sectional study from February 2014 through March2016. Setting:General female population in mainland China.Participants:Women were sampled using multi-stage, stratified,cluster sampling at six populous provinces in mainland China amongparticipants of National Mass Screening on Breast and CervicalCancers. A nationally representative sample of 54,000 adults who were20 years old or older were recruited. Exposures: Geographicregions, sociodemographic characteristics, physiological conditions,chronic and gynecological diseases, and health behaviors.MainOutcomes and measures: POP was assessed using Pelvic OrganProlapse Quantification (POP-Q) stage and validation questionnaires.Multivariable logistic regression was used to assess factorsassociated with each degree or bother POP.
Results: Theprevalence of symptomatic POP (POP-Q stage II or higher) was 9.56%.Stage II POP was the most common (7.52%). The prevalence was 1.68%for stage III POP and 0.36% for stage IV POP. Incidence increasedwith age for all stages (P≤0.05). Minor or moderate bother were themost common responses that were reported for every stage of POP(9.72%). Only 0.08% of the participants reported that the conditionhad a severe impact on their quality of life. Older age,postmenopausal status, and multiple vaginal deliveries increased theodds of every kind of POP (p ≤ 0.05). Stage IV and III POP-Q andsevere bother POP were more common in urban women (p <0.001). Urban women experienced more stage II POP-Q and minor tomoderate bother POP.
Conclusions: Our study yielded asimilar prevalence to that in other surveys performed throughout theworld. The prevalence of bother POP was higher, which suggests thatit should be considered for medical intervention. Older age,postmenopausal status, and multiple vaginal deliveries increased theodds of every kind of POP. Women with higher stage POP were morelikely to report discomfort. Symptoms in the urinary system were themost likely to be rated as bothersome.