PREVALECE AND RISK FACTORS FORPELVIC ORGAN PROLAPSE IN WOMEN FROM A RIVERSIDE AND URBAN REGIONS OFBRAZILIAN AMAZON: COMPARATIVE STUDY
A. D. REGO;
OBSTETRICS ANDGYNECOLOGY, USP, SÃO PAULO, Brazil.
Introduction: Pelvic organprolapse (POP) is the abnormal descent or herniation of the pelvicorgans from their normal attachment sites or their normal position inthe pelvis. It is a common condition, with estimated prevalencebetween 3.4 and 56%. Lifetime risk of undergoing surgery for POP isup to 19%. Main risk factors for POP include vaginal delivery, age,obesity and multiparity. (1,2,3)
Objective: To compare theprevalence of Pelvic Organ Prolapse in women from riverside and urbanregions of Brazilian Amazon and correlate the findings with commonrisk factors for POP
Methods: Patients with age 20 yearsold and over from Bailique - an Amazon riverside region (most ofindigenous origin preserving same lifestyle - Figure 1) and fromMacapá (urban region from Amapá) were evaluated by one singleurogynecologist and underwent a structured interview and physicalexamination. All enrollees also completed epidemiologicalquestionnaires. Pelvic organ prolapse was accessed by “Pelvic OrganProlapse Quantification” (POP-Q). Sample size was calculatedaccording to a previous study on stress urinary incontinence (SUI)performed with the same populations. Riverside group included 120women and urban group comprised 260 patients.
Results:Riverside patients had greater parity than urban women (p <0.05),as demonstrated in Table 1. Riverside Group had a greater incidenceof vaginal deliveries (92.4% vs. 73.1; p<0,05) and as well as homechildbirths (p<0,05) as seen in Table 2. The presence of obesitywas significantly higher in the Urban Group (p <0.05) (Table 3).Menopausal status was similar in the groups (p> 0.05). (Table-3)POP-Q comparison between the two groups revealed a significantlyhigher number of patients with grade 0 prolapse in the Urban Groupand a significantly higher number of Grade 1 prolapse in theRiverside group (p <0.05). More advanced prolapse (stages 2 andover) were similar in the groups (p> 0.05). (Table-4)
Conclusions:There was no significant difference in advanced pelvic organ prolapse(POP-Q stages 2 and 3) despite a higher incidence of risk factors forPOP, such as multiparity and homebirths in the Riverside Group.Indigenous lifestyle might play a role protecting pelvic floor from ahigher occurrence of POP.