An audit of uterovaginal prolapse in Ogbomoso, south-west Nigeria

Abstract

Objective: Uterovaginal prolapse (UVP) as a gynaecological problem is very common especially in multipara. This condition is important to gynaecologists practicing in Sub-Saharan Africa because of its strong link with multiparity, poor conduct of labour, and most importantly, its role as a cause of chronic morbidity in many post-menopausal women necessitating major gynaecological surgeries. Methods: A retrospective study of utero-vaginal prolapse to determine the prevalence, presentation , management patterns and complications of UVP at the Bowen University Teaching Hospital , Ogbomosho, Oyo State, Nigeria between January 1, 2010 and December 31, 2014. Relevant data were obtained from the case notes, which included age, parity, presenting symptoms, number of living children, types of delivery, types of surgical management and associated operative morbidity and mortality. The data were presented as simple percentages. Results: The prevalence of uterovaginal prolapse was 5.4%. The mean age at presentation was 51.4± 3.3 years. The mean parity was 4.2± 1.6. Fifty-six (90.3%) of them were at least 40 years old . Majority of the patients( 80.6%) were grand-multiparous. The commonest symptom was 'something coming down the vagina' in 96% of the study subjects. Difficult labour was found to be the most common associated factor in 47 (76.2%) of the patients Second degree prolapse was the commonest type of presentation (74.2%). The most common form of treatment offered was vaginal hysterectomy with pelvic floor repair, 46 (74.2%) of the patients. Twenty -four (38.7%) patients had vaginal pessaries inserted for various degrees of UVP. Conclusion: Uterovaginal prolapse is a common gynaecological condition of the parous and elderly postmenopausal women associated with a decreased body image and quality of life. Supervised hospital deliveries and limiting the family size by efficient contraception deserve priority attention to prevent this social malady. Keywords: Difficult labour, uterovaginal prolapse, hysterectomy, multiparity