UNDERSTANDING PELVIC ORGAN PROLAPSE: CAUSES, SYMPTOMS, AND RISK FACTORS

Abstract

Background: Pelvic organ prolapse (POP) refers to the downward displacement of one or more organs, which include the uterus, vagina, urethra, bladder, rectum, sigmoid colon, and small intestine, from their normal anatomical location. This displacement arises due to the structural support's collapse and might vary in severity. Objective: This study was contributed to present and analyse the basic criteria in terms of causes, symptoms, and risk factors which related to Pelvic Organ Prolapse. Patients and methods: The current study conducted a thorough examination of data pertaining to individuals with pelvic organ prolapse. Data pertaining to the baseline characteristics of participants with pelvic organ prolapse were gathered. A total of 45 patients, ranging in age from 30 to 60 years, were enrolled. Data was collected from samples obtained from different hospitals in Iraq, spanning from February 15, 2022, until September 26, 2023. The purpose of the study was to examine the major findings about pelvic organ prolapse, specifically focusing on the symptoms, causes, as well as risk factors which affect the overall quality of life for patients. Results: This study revealed that women aged 50 and above experienced the highest level of impact, accounting for more than half (55.56%) of the total number of participants. This group consisted of 31 patients with a body mass index exceeding 29.5. These findings emphasise the significant influence of older individuals on the overall patient population. This study identified the prevalence of common symptoms in patients, particularly affecting women. These symptoms included mass descending per vagina in 12 patients, a feeling of bulge in the vagina with ten patients, vaginal bleeding in 8 patients, as well as urinary incontinence in 8 patients. Moreover, this research discovered risk factors impacting patients in the long term since it found operative delivery, a family history of POP, vaginal haemorrhage, vaginal tear, along with hormonal changes as well. Conclusion: This study indicated that risk factors such as chronic cough, old age, history of multiple pregnancies, and other comorbidities promote deteriorating as well as poor quality of life health for women who suffer from pelvic organ prolapse. Key words: Pelvic organ prolapse (POP); Causes; Symptoms; Risk factors; and quality of life. Introduction Pelvic organ prolapse (POP) refers to the downward displacement of one or more organs, such as the uterus, vagina, urethra, bladder, rectum, sigmoid colon, and small intestine, from their normal anatomical location [1]. This displacement arises from the structural support's collapse and might vary in severity [2]. Pelvic floor dysfunctions, such as pelvic organ prolapse (POP) and urine incontinence (UI), impose a large burden on public health owing to their widespread occurrence, considerable decline in quality of life, and huge economic impact [3]. Ambulatory major surgery (AMS) can be a viable option to determine as caused a result in a simultaneous reduction in three key factors associated with surgical specialties: the waiting list, the duration of hospitalisation, and the financial expenses [4]. Genital prolapse occurs when the weakening of pelvic support and tearing of the perineum in certain women allow the movement of tissues from the female reproductive system and other anatomically linked organs into the vagina and vulva [5-7]. The prolapse may vary in severity, and the symptoms are directly connected to the level of displacement of the affected organs, including the vagina, urethra, bladder, uterus, intestine, and rectum [8]. The clinical entities colpourethrocele, colpocystocele, hysterocele, enterocele, and colporrectocele are distinct conditions that may occur alone or in combination. [9] Female pelvic floor dysfunction encompasses a range of clinical disorders, such as urine incontinence, faecal incontinence, and pelvic organ prolapse [10,11]. Similarly, changes in the pelvic floor, the process of emptying the bladder in the lower reproductive system, persistent discomfort in the perineal regions, difficulties with sexual function, and problems with bowel movements are all components of this under-researched medical condition [12,13]. These dysfunctions are a significant public health issue and impact 23.7% of women who experience the specified symptoms at some time in their life [14]. The impact of human evolution towards an upright posture and its effects on the female pelvis have been extensively studied, particularly in relation to women's reproductive health [15]. These studies have considered factors such as the increasing lifespan of women, the preservation of physical well-being, and the implications for healthcare policies. [16] Approximately 50% of adult women are identified with pelvic floor dysfunction following a gynaecological examination [17]. It is crucial to acknowledge that only a small percentage, namely 10 to 20%, of patients exhibit symptoms, and a limited number seek medical care in a hospital facility [18]. Conversely, many studies have shown that over 33% of women in the perimenopause and post-menopausal stages encounter some kind of disruption in this condition during their lifetime [19]. Approximately 11% of women are projected to require surgical intervention. [20] Patients and methods The current study performed a thorough examination of data pertaining to individuals with pelvic organ prolapse. Data pertaining to the baseline characteristics of individuals with pelvic organ prolapse were gathered. A total of 45 patients, ranging in age from 30 to 60 years, were enrolled. Data was gathered from samples obtained from different hospitals in Iraq, spanning from February 15, 2022, to September 26, 2023. Clinical and demographic outcomes determined data related to many participants in terms of age, body mass index, delivery type, obstetric history, marital status, education level, employment status, and economic situation.