Prevalence and Risk Factors of Pelvic Organ Prolapse in Rural Women

Abstract

Background: Pelvic organ prolapse (POP) is a common pelvic floor disorder that affects the quality of life of women through urinary, bowel, sexual, and psychosocial dysfunction.

Objective: This study aimed to determine the prevalence of pelvic organ prolapse and identify its associated risk factors among rural women.

Methodology: This hospital-based cross-sectional study was conducted at the Department of Gynaecology and Obstetrics, Saidu Group of Teaching Hospital, Swat, from 1^st January 2025 to 31^st December 2025 and included 190 rural women.

Results: The mean age of the participants was 46.7 ± 11.3 years, the mean BMI was 27.3 ± 4.2 kg/m², and the mean parity was 5.1 ± 2.3 deliveries. Pelvic organ prolapse was diagnosed in 68 (35.8%) women, with Stage II being the most common stage (41.2%). Anterior compartment prolapse was the predominant anatomical type (42.6%). The most frequent symptoms were vaginal bulge (86.8%), pelvic heaviness (77.9%), and lower back pain (64.7%). Women with prolapse were significantly older (53.2 ± 9.6 vs. 43.1 ± 10.8 years; p<0.001), had higher BMI (28.8 ± 4.5 vs. 26.5 ± 3.8 kg/m²; p=0.001), and greater parity (6.7 ± 2.1 vs. 4.2 ± 1.8; p<0.001) than those without prolapse. Multivariable analysis identified multiparity (AOR=3.47, 95% CI: 1.82–6.62), age ≥50 years (AOR=2.84, 95% CI: 1.46–5.53), heavy lifting (AOR=2.67, 95% CI: 1.39–5.12), postmenopausal status (AOR=2.31, 95% CI: 1.18–4.51), home vaginal delivery (AOR=2.12, 95% CI: 1.09–4.11), and chronic constipation (AOR=1.94, 95% CI: 1.01–3.75) as independent risk factors.

Conclusion: It is concluded that pelvic organ prolapse is highly prevalent among rural women and is strongly associated with multiparity, advancing age, postmenopausal status, heavy lifting, home vaginal delivery, and chronic constipation.