Worldwide Prevalence of Pelvic Organ Prolapse: A Systematic Review and Meta-Analysis
,
Abstract
Background: The prevalence of pelvic organ prolapse is varied in different countries. For validating the results of numerous studies on the prevalence of Pelvic organ prolapse in the world, a meta-analysis study seems necessary to provide an accurate and valid prevalence for planners and researchers in this field. Therefore, we aimed to investigate the worldwide prevalence of pelvic organ prolapse using the meta-analysis method.
Methods: By using valid keywords, searching was done in ISI Web of Science, PubMed, Scopus, and Medline databases, and 22 articles were selected based on inclusion criteria between 2009 and 2021. The quality of articles was checked using The Joanna Briggs Institute (JBI) checklist. Meta-analysis was performed on collected data using Comprehensive Meta-Analysis Software (CMA, Version 2). Meta-analysis of data was done with a random-effects model. The heterogeneity of the study was checked using the I2 index. Publication bias was assessed by the Egger test and funnel graph.
Results: The overall prevalence of included studies was 30.9% (95% confidence interval: 24.4-38.2%), (P<0.001, heterogeneity I2=99.8%). Meta-analysis of subgroups in studies that used a questionnaire to estimate the prevalence rate showed the prevalence was 25.0% and in the studies used the physical examination was 41.8%.
Conclusion: Studies carried out in different parts of the world have examined the prevalence of pelvic organ prolapse using different tools. Since some cases are asymptomatic, especially in the low stage of prolapse, physical examination of pelvic organ prolapse should be considered an essential tool in evaluating pelvic organ prolapse.
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2. Yuk J-S, Lee JH, Hur J-Y, Shin J-H (2018). The prevalence and treatment pattern of clinically diagnosed pelvic organ prolapse: a Korean National Health Insurance Database-based cross-sectional study 2009–2015. Sci Rep, 8 (1):1334.
3. Alipour Z, Eskandari N, Ebrahimi Z, Bagheri A (2014). Prevalence of Urinary and Intestinal Incontinence in Postpartum Period and Its Related Factors. The Iranian Journal of Obstetrics, Gynecology and Infertility, 16 (86):9-15.
4. Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A (2002). Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol, 186 (6):1160-6.
5. Hadizadeh-Talasaz Z, Khadivzadeh T, Khadem ghaebi N, Ebrahimipour H (2022). Exploration of sexual experience among women with pelvic organ prolapse: a qualitative study. Sex Relation Ther, 37 (2):238-252.
6. Felippe MR, Zambon JP, Girotti ME, Burti JS, Hacad CR, Cadamuro L, Almeida F (2017). What is the real impact of urinary incontinence on female sexual dysfunction? A case control study. Sex Med, 5 (1):e54-e60.
7. Masenga GG, Shayo BC, Rasch V (2018). Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: A population based study in Tanzanian rural community. PLoS One, 13 (4):e0195910.
8. Hadizadeh-Talasaz Z, Khadivzadeh T, Ebrahimipour H, Ghaebi NK (2021). The Experiences of Women who Live with Pelvic Floor Disorders: A Qualitative Study. Int J Community Based Nurs Midwifery, 9 (2):159-171.
9. Ghandour L, Minassian V, Al-Badr A, Abou Ghaida R, Geagea S, Bazi T (2017). Prevalence and degree of bother of pelvic floor disorder symptoms among women from primary care and specialty clinics in Lebanon: an exploratory study. Int Urogynecol J, 28 (1):105-118.
10. Barat S, Javadian Y, Talebi G, Aghajani M (2015). Frequency of Urinary Incontinence in Female Patients Attending Pelvic Floor Disorders Clinic. Journal of Mazandaran University of Medical Sciences, 24 (121):189-196.
11. Li Z, Xu T, Li Z, Gong J, Liu Q, Wang Y, Wang J, Xia Z, Zhu L (2018). an epidemiologic study on symptomatic pelvic organ prolapse in obese chinese women: a population-based study in china. Diabetes, Metab Syndr Obes, 11:761-766.
12. Chow D, Rodriguez LV (2013). Epidemiology and prevalence of pelvic organ prolapse. Curr Opin Urol, 23 (4):293-8.
13. Bureau M, Carlson KV (2017). Pelvic organ prolapse: A primer for urologists. Can Urol Assoc J, 11 (6Suppl2):S125-S130.
14. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, et al (2009). The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. Int Urogynecol J Pelvic Floor Dysfunct, 20 (9):1037-45.
15. Nygaard IE, Clark E, Clark L, et al (2017). Physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery: a protocol for a mixed-methods prospective cohort study. BMJ Open, 7 (1):e014252.
16. Barber MD, Maher C (2013). Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J, 24 (11):1783-90.
17. Wu JM, Vaughan CP, Goode PS, et al (2014). Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol, 123 (1):141-148.
18. Hallock JL, Handa VL (2016). The epidemiology of pelvic floor disorders and childbirth: an update. Obstet Gynecol Clin North Am, 43 (1):1-13.
19. Walker GJ, Gunasekera P (2011). Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J, 22 (2):127-35.
20. Moher D, Liberati A, Tetzlaff J, Altman DG (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med, 151 (4):264-269, W64.
21. Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C (2015). Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc, 13 (3):147-153.
22. Pang H, Zhang L, Han S, et al (2021). A nationwide population‐based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China–a pelvic organ prolapse quantification system‐based study. BJOG, 128 (8):1313-1323.
23. Beketie ED, Tafese WT, Assefa ZM, et al (2021). Symptomatic pelvic floor disorders and its associated factors in South-Central Ethiopia. PLoS One, 16 (7):e0254050.
24. Jokhio AH, Rizvi RM, MacArthur C (2020). Prevalence of pelvic organ prolapse in women, associated factors and impact on quality of life in rural Pakistan: population-based study. BMC Womens Health, 20 (1):82.
25. Gaddam R, Gangadharan K, Shivaraju P, Basappa PK (2020). Prevalence of pelvic floor dysfunction in women attending obstetrics and gynaecology OPD at PES Institute of Medical Sciences asnd Research, Kuppam. Int J Reprod Contracept Obstet Gynecol, 9 (12):5087-5094.
26. Li Z, Xu T, Li Z, Gong J, Liu Q, Zhu L (2019). An epidemiologic study of pelvic organ prolapse in rural Chinese women: a population-based sample in China. Int Urogynecol J, 30(11):1925-1932.
27. Belayneh T, Gebeyehu A, Adefris M, Rortveit G, Awoke T (2020). Pelvic organ prolapse in Northwest Ethiopia: a population-based study. Int Urogynecol J, 31 (9):1873-1881.
28. Chen CCG, Avondstondt AM, Khatry SK, et al (2020). Prevalence of symptomatic urinary incontinence and pelvic organ prolapse among women in rural Nepal. Int Urogynecol J, 31(9):1851-1858.
29. Dheresa M, Worku A, Oljira L, et al (2018). One in five women suffer from pelvic floor disorders in Kersa district Eastern Ethiopia: a community-based study. BMC Womens Health, 18 (1):95.
30. Akter F, Gartoulla P, Oldroyd J, Islam RM (2016). Prevalence of, and risk factors for, symptomatic pelvic organ prolapse in Rural Bangladesh: a cross-sectional survey study. Int Urogynecol J, 27 (11):1753-1759.
31. Islam RM, Bell RJ, Billah B, Hossain MB, Davis SR (2016). The prevalence of symptomatic pelvic floor disorders in women in Bangladesh. Climacteric, 19 (6):558-564.
32. Zeleke BM, Bell RJ, Billah B, Davis SR (2016). Symptomatic pelvic floor disorders in community-dwelling older Australian women. Maturitas, 85:34-41.
33. Elbiss HM, Osman N, Hammad FT (2015). Prevalence, risk factors and severity of symptoms of pelvic organ prolapse among Emirati women. BMC Urol, 15:66.
34. Megabiaw B, Adefris M, Rortveit G, et al (2013). Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study. Int Urogynecol J, 24 (7):1135-1143.
35. Direkvand-Moghadam A, Ghazanfari Z, Montazeri A, et al (2014). Risk factors of pelvic organ prolapse in Iranian women: a cross-sectional study. Int J Epidemiol Res, 1 (1):29-34.
36. Aytan H, Ertunç D, Tok EC, Yaşa O, Nazik H (2014). Prevalence of pelvic organ prolapse and related factors in a general female population. Turk J Obstet Gynecol, 11 (3):176-180.
37. Cooper J, Annappa M, Dracocardos D, et al (2015). Prevalence of genital prolapse symptoms in primary care: a cross-sectional survey. . Int Urogynecol J, 26:505-510.
38. Awwad J, Sayegh R, Yeretzian J, Deeb ME (2012). Prevalence, risk factors, and predictors of pelvic organ prolapse: a community-based study. Menopause, 19 (11):1235-1241.
39. Lien YS, Chen GD, Ng SC (2012). Prevalence of and risk factors for pelvic organ prolapse and lower urinary tract symptoms among women in rural Nepal. Int J Gynecol Obstet, 119 (2):185-188.
40. Miedel A, Tegerstedt G, Maehle-Schmidt M, Nyren O, Hammarstrom M (2009). Nonobstetric risk factors for symptomatic pelvic organ prolapse. Obstet Gynecol, 113 (5):1089-97.
41. Rashad M, Fadel EA, El-Nemer A (2018). Women's knowledge regarding pelvic organ prolapse. Mansoura Nursing Journal, 5(3):57-67.
42. Tehrani FR, Hashemi S, Simbar M, Shiva N (2011). Screening of the pelvic organ prolapse without a physical examination; (a community based study). BMC Womens Health, 11:48.
43. Hadizadeh-Talasaz Z, Ebrahimipour H, Khadem Ghaebi N (2019). Explaining facilitators and barriers to treatment-seeking in women with pelvic organ prolapse: A qualitative study. The Iranian Journal of Obstetrics, Gynecology and Infertility, 22 (3):16-31.
44. Karl M. Luber M, Sally Boero, MD, Jennifer Y. Choe, MD. (2000). Female Pelvic Floor Dysfunction 2010 to 2050. Presented at the Sixty-seventh Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society, Kamuela, Hawaii.
45. Jelovsek JE, Chagin K, Gyhagen M, et al (2018). Predicting risk of pelvic floor disorders 12 and 20 years after delivery. Am J Obstet Gynecol, 218 (2):222.e1-222.e19.
46. Kirby AC, Luber KM, Menefee SA (2013). An update on the current and future demand for care of pelvic floor disorders in the United States. Am J Obstet Gynecol, 209 (6):584.e1-5.
47. Garshasbi A, Faghih-Zadeh S, Falah N (2006). The status of pelvic supporting organs in a population of iranian women 18 - 68 years of age and possible related factors. Arch Iran Med, 9 (2):124-8.
48. Kinman CL, Lemieux CA, Agrawal A, et al (2017). The relationship between age and pelvic organ prolapse bother. Int Urogynecol J, 28 (5):751-755.
49. Wu JM, Kawasaki A, Hundley AF, et al (2011). Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Am J Obstet Gynecol, 205 (3):230.e1-5.
2. Yuk J-S, Lee JH, Hur J-Y, Shin J-H (2018). The prevalence and treatment pattern of clinically diagnosed pelvic organ prolapse: a Korean National Health Insurance Database-based cross-sectional study 2009–2015. Sci Rep, 8 (1):1334.
3. Alipour Z, Eskandari N, Ebrahimi Z, Bagheri A (2014). Prevalence of Urinary and Intestinal Incontinence in Postpartum Period and Its Related Factors. The Iranian Journal of Obstetrics, Gynecology and Infertility, 16 (86):9-15.
4. Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A (2002). Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol, 186 (6):1160-6.
5. Hadizadeh-Talasaz Z, Khadivzadeh T, Khadem ghaebi N, Ebrahimipour H (2022). Exploration of sexual experience among women with pelvic organ prolapse: a qualitative study. Sex Relation Ther, 37 (2):238-252.
6. Felippe MR, Zambon JP, Girotti ME, Burti JS, Hacad CR, Cadamuro L, Almeida F (2017). What is the real impact of urinary incontinence on female sexual dysfunction? A case control study. Sex Med, 5 (1):e54-e60.
7. Masenga GG, Shayo BC, Rasch V (2018). Prevalence and risk factors for pelvic organ prolapse in Kilimanjaro, Tanzania: A population based study in Tanzanian rural community. PLoS One, 13 (4):e0195910.
8. Hadizadeh-Talasaz Z, Khadivzadeh T, Ebrahimipour H, Ghaebi NK (2021). The Experiences of Women who Live with Pelvic Floor Disorders: A Qualitative Study. Int J Community Based Nurs Midwifery, 9 (2):159-171.
9. Ghandour L, Minassian V, Al-Badr A, Abou Ghaida R, Geagea S, Bazi T (2017). Prevalence and degree of bother of pelvic floor disorder symptoms among women from primary care and specialty clinics in Lebanon: an exploratory study. Int Urogynecol J, 28 (1):105-118.
10. Barat S, Javadian Y, Talebi G, Aghajani M (2015). Frequency of Urinary Incontinence in Female Patients Attending Pelvic Floor Disorders Clinic. Journal of Mazandaran University of Medical Sciences, 24 (121):189-196.
11. Li Z, Xu T, Li Z, Gong J, Liu Q, Wang Y, Wang J, Xia Z, Zhu L (2018). an epidemiologic study on symptomatic pelvic organ prolapse in obese chinese women: a population-based study in china. Diabetes, Metab Syndr Obes, 11:761-766.
12. Chow D, Rodriguez LV (2013). Epidemiology and prevalence of pelvic organ prolapse. Curr Opin Urol, 23 (4):293-8.
13. Bureau M, Carlson KV (2017). Pelvic organ prolapse: A primer for urologists. Can Urol Assoc J, 11 (6Suppl2):S125-S130.
14. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, et al (2009). The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. Int Urogynecol J Pelvic Floor Dysfunct, 20 (9):1037-45.
15. Nygaard IE, Clark E, Clark L, et al (2017). Physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery: a protocol for a mixed-methods prospective cohort study. BMJ Open, 7 (1):e014252.
16. Barber MD, Maher C (2013). Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J, 24 (11):1783-90.
17. Wu JM, Vaughan CP, Goode PS, et al (2014). Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol, 123 (1):141-148.
18. Hallock JL, Handa VL (2016). The epidemiology of pelvic floor disorders and childbirth: an update. Obstet Gynecol Clin North Am, 43 (1):1-13.
19. Walker GJ, Gunasekera P (2011). Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. Int Urogynecol J, 22 (2):127-35.
20. Moher D, Liberati A, Tetzlaff J, Altman DG (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med, 151 (4):264-269, W64.
21. Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C (2015). Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc, 13 (3):147-153.
22. Pang H, Zhang L, Han S, et al (2021). A nationwide population‐based survey on the prevalence and risk factors of symptomatic pelvic organ prolapse in adult women in China–a pelvic organ prolapse quantification system‐based study. BJOG, 128 (8):1313-1323.
23. Beketie ED, Tafese WT, Assefa ZM, et al (2021). Symptomatic pelvic floor disorders and its associated factors in South-Central Ethiopia. PLoS One, 16 (7):e0254050.
24. Jokhio AH, Rizvi RM, MacArthur C (2020). Prevalence of pelvic organ prolapse in women, associated factors and impact on quality of life in rural Pakistan: population-based study. BMC Womens Health, 20 (1):82.
25. Gaddam R, Gangadharan K, Shivaraju P, Basappa PK (2020). Prevalence of pelvic floor dysfunction in women attending obstetrics and gynaecology OPD at PES Institute of Medical Sciences asnd Research, Kuppam. Int J Reprod Contracept Obstet Gynecol, 9 (12):5087-5094.
26. Li Z, Xu T, Li Z, Gong J, Liu Q, Zhu L (2019). An epidemiologic study of pelvic organ prolapse in rural Chinese women: a population-based sample in China. Int Urogynecol J, 30(11):1925-1932.
27. Belayneh T, Gebeyehu A, Adefris M, Rortveit G, Awoke T (2020). Pelvic organ prolapse in Northwest Ethiopia: a population-based study. Int Urogynecol J, 31 (9):1873-1881.
28. Chen CCG, Avondstondt AM, Khatry SK, et al (2020). Prevalence of symptomatic urinary incontinence and pelvic organ prolapse among women in rural Nepal. Int Urogynecol J, 31(9):1851-1858.
29. Dheresa M, Worku A, Oljira L, et al (2018). One in five women suffer from pelvic floor disorders in Kersa district Eastern Ethiopia: a community-based study. BMC Womens Health, 18 (1):95.
30. Akter F, Gartoulla P, Oldroyd J, Islam RM (2016). Prevalence of, and risk factors for, symptomatic pelvic organ prolapse in Rural Bangladesh: a cross-sectional survey study. Int Urogynecol J, 27 (11):1753-1759.
31. Islam RM, Bell RJ, Billah B, Hossain MB, Davis SR (2016). The prevalence of symptomatic pelvic floor disorders in women in Bangladesh. Climacteric, 19 (6):558-564.
32. Zeleke BM, Bell RJ, Billah B, Davis SR (2016). Symptomatic pelvic floor disorders in community-dwelling older Australian women. Maturitas, 85:34-41.
33. Elbiss HM, Osman N, Hammad FT (2015). Prevalence, risk factors and severity of symptoms of pelvic organ prolapse among Emirati women. BMC Urol, 15:66.
34. Megabiaw B, Adefris M, Rortveit G, et al (2013). Pelvic floor disorders among women in Dabat district, northwest Ethiopia: a pilot study. Int Urogynecol J, 24 (7):1135-1143.
35. Direkvand-Moghadam A, Ghazanfari Z, Montazeri A, et al (2014). Risk factors of pelvic organ prolapse in Iranian women: a cross-sectional study. Int J Epidemiol Res, 1 (1):29-34.
36. Aytan H, Ertunç D, Tok EC, Yaşa O, Nazik H (2014). Prevalence of pelvic organ prolapse and related factors in a general female population. Turk J Obstet Gynecol, 11 (3):176-180.
37. Cooper J, Annappa M, Dracocardos D, et al (2015). Prevalence of genital prolapse symptoms in primary care: a cross-sectional survey. . Int Urogynecol J, 26:505-510.
38. Awwad J, Sayegh R, Yeretzian J, Deeb ME (2012). Prevalence, risk factors, and predictors of pelvic organ prolapse: a community-based study. Menopause, 19 (11):1235-1241.
39. Lien YS, Chen GD, Ng SC (2012). Prevalence of and risk factors for pelvic organ prolapse and lower urinary tract symptoms among women in rural Nepal. Int J Gynecol Obstet, 119 (2):185-188.
40. Miedel A, Tegerstedt G, Maehle-Schmidt M, Nyren O, Hammarstrom M (2009). Nonobstetric risk factors for symptomatic pelvic organ prolapse. Obstet Gynecol, 113 (5):1089-97.
41. Rashad M, Fadel EA, El-Nemer A (2018). Women's knowledge regarding pelvic organ prolapse. Mansoura Nursing Journal, 5(3):57-67.
42. Tehrani FR, Hashemi S, Simbar M, Shiva N (2011). Screening of the pelvic organ prolapse without a physical examination; (a community based study). BMC Womens Health, 11:48.
43. Hadizadeh-Talasaz Z, Ebrahimipour H, Khadem Ghaebi N (2019). Explaining facilitators and barriers to treatment-seeking in women with pelvic organ prolapse: A qualitative study. The Iranian Journal of Obstetrics, Gynecology and Infertility, 22 (3):16-31.
44. Karl M. Luber M, Sally Boero, MD, Jennifer Y. Choe, MD. (2000). Female Pelvic Floor Dysfunction 2010 to 2050. Presented at the Sixty-seventh Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society, Kamuela, Hawaii.
45. Jelovsek JE, Chagin K, Gyhagen M, et al (2018). Predicting risk of pelvic floor disorders 12 and 20 years after delivery. Am J Obstet Gynecol, 218 (2):222.e1-222.e19.
46. Kirby AC, Luber KM, Menefee SA (2013). An update on the current and future demand for care of pelvic floor disorders in the United States. Am J Obstet Gynecol, 209 (6):584.e1-5.
47. Garshasbi A, Faghih-Zadeh S, Falah N (2006). The status of pelvic supporting organs in a population of iranian women 18 - 68 years of age and possible related factors. Arch Iran Med, 9 (2):124-8.
48. Kinman CL, Lemieux CA, Agrawal A, et al (2017). The relationship between age and pelvic organ prolapse bother. Int Urogynecol J, 28 (5):751-755.
49. Wu JM, Kawasaki A, Hundley AF, et al (2011). Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Am J Obstet Gynecol, 205 (3):230.e1-5.
| Files | ||
| Issue | Vol 53 No 3 (2024) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i3.15134 | |
| Keywords | ||
| Pelvic organ prolapse Prevalence Meta-analysis Systematic review | ||
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How to Cite
1.
Hadizadeh-Talasaz Z, Khadivzadeh T, Mohajeri T, Sadeghi M. Worldwide Prevalence of Pelvic Organ Prolapse: A Systematic Review and Meta-Analysis. Iran J Public Health. 2024;53(3):524-538.
