Study On Risk Factors Of Female Pelvic Organ Prolapse

Objective:To study the risk factors and factors affecting severity of female pelvic organ prolapse by analyzing various clinical data of patients with pelvic organ prolapse and healthy people.In order to provide new ideas and theoretical basis for the prevention and treatment of female pelvic organ prolapse.Methods:216 patients with pelvic organ prolapse who were treated or hospitalized in the gynecology department of the Second Hospital of Shandong University from September 1st 2017 to March 31st 2019 were selected as the POP group,and 132 healthy people who underwent physical examination in our department during the same period were selected as the control group.In addition,the POP group was divided into POP-Q stage Ⅰ-Ⅱ group(97 cases)and POP-Q stage Ⅲ-Ⅳ group(119 cases)according to the POP-Q stage of patients.To collect relevant clinical data by investigating the incidence of urinary incontinence,age,delivery frequency,delivery mode,age of first delivery,maximum neonatal weight,menstrual status,menopausal age,education level,body mass index,chronic cough,chronic constipation,waist disease,history of hysterectomy and family history of pelvic organ prolapse in all subjects.SPSS 20.0 statistical software was used for data collation and analysis.The counting data was compared by χ2 test,P<0.05 was considered statistically significant.Relevant factors with statistical significance were included in the multivariate logistic regression analysis to obtain the influencing factors of prevalence and severity of POP.Results:1.The incidence of urinary incontinence in POP patients was significantly higher than that in healthy women,but the incidence of urinary incontinence had no significant correlation with the degree of pelvic organ prolapse.2.Analysis of influencing factors of POP revealed:(1)With the increase of age,the incidence of POP gradually increased,and the degree of prolapse in POP patients generally increased.Delivery frequency was significantly related to the incidence and severity of POP.The more delivery frequency,the higher the incidence of POP.When delivery frequency was ≤3,the severity of POP increased with delivery frequency.When delivery frequency was≥4,the incidence of POP-Q stage Ⅲ-Ⅳ decreased slightly.The incidence of POP was higher in transvaginal delivery than in cesarean section,and the degree of prolapse was more serious in transvaginal delivery.Menopausal people had a higher incidence of POP than non-menopausal people,and the degree of prolapse of menopausal POP patients was more serious.The higher the education level,the lower the incidence of POP.There was a significant correlation between the education level and the severity of POP,and the degree of prolapse was the most serious in POP patients with elementary school education and below.Those with a high BMI had a high incidence of POP and a severe degree of prolapse.People with waist disease had a higher incidence of POP and more severe prolapse than those without waist disease.The incidence of POP in people with a history of hysterectomy was significantly higher than that in people without a history of hysterectomy,and the degree of prolapse of POP patients with a history of hysterectomy was significantly more severe.Compared with those without a family history of pelvic organ prolapse,those with a family history had a higher incidence of POP and more severe prolapse.The incidence of POP was significantly higher in people with chronic cough than in those without chronic cough,but there was no significant correlation between chronic cough and the degree of pelvic organ prolapse.People with chronic constipation had a higher incidence of POP than those without chronic constipation,but no significant association was found between chronic constipation and severity of POP.In addition,there was no significant correlation between the age of first delivery,maximum neonatal weight,menopausal age and the incidence and severity of POP.(2)Multivariate logistic regression analysis of the prevalence of POP showed that women of≥60 years old had a significantly increased risk of POP compared with women of<40 years old.The risk of POP in women with delivery frequency≥3 was significantly higher than that in women with delivery frequency=1.Besides,transvaginal delivery(OR:3.076,95%CI:1.606-5.891),BMI≥24kg/m2(OR:1.522,95%CI:1.005-2.304),chronic constipation(OR:3.897,95%CI:2.342-6.485),waist disease(OR:2.430,95%CI:1.338-4.417),history of hysterectomy(OR:5.106,95%CI:1.014-25.704)and family history of pelvic organ prolapse(OR:3.314,95%CI:1.413-7.775)were all risk factors for POP.(3)Multivariate logistic regression analysis of the severity of POP showed that the risk of POP-Q stage Ⅲ-Ⅳ in POP patients of>60 years was significantly increased compared with POP patients of<40 years.The risk of POP-Q stageⅢ-Ⅳ in POP patients with delivery frequency=3 was significantly higher than that in POP patients with delivery frequency=1(OR:2.681,95%CI:1.063-6.765).Transvaginal delivery(OR:17.830,95%CI:4.243-74.918),BMI≥24kg/m2(OR:2.741,95%CI:1.581-4.751),waist disease(OR:4.622,95%CI:2.160-9.886),history of hysterectomy(OR:10.607,95%CI:2.456-45.798)and family history of pelvic organ prolapse(OR:6.466,95%CI:2,907-14.383)were also risk factors for POP-Q stage Ⅲ-Ⅳ.Conclusions:1.Age≥60 years,transvaginal delivery,BMI≥24kg/m2,waist disease,history of hysterectomy,and family history of pelvic organ prolapse were both risk factors for POP and POP-Q stage Ⅲ-Ⅳ.Delivery frequency≥3,chronic constipation were risk factors for POP,and delivery frequency=3 was risk factor for POP-Q stage Ⅲ-Ⅳ.2.There was no significant correlation between the age of first delivery,maximum neonatal weight,menstrual status,menopausal age,education level,chronic cough and the prevalence and severity of POP.And no correlation was found between chronic constipation and the severity of POP.3.By comprehensively analyzing the clinical data of POP patients and healthy controls,the study had well obtained the risk factors of POP and POP-Q stage Ⅲ-Ⅳ,and found that waist disease was closely related to the prevalence and the severity of POP.New risk factors for POP were proposed,which provided new ideas for the prevention and treatment of female POP and had important clinical guiding significance.