Determinants and Symptoms Severity of Pelvic Organ Prolapse and Its Effect on Physical Activities among the Elderly versus Childbearing Women

Abstract

Background: Pelvic organ prolapse (POP) is a common reproductive problem affecting more than one-third of women between 20–59 years of age, and more than half of women over 60 years worldwide, and negatively affecting their daily physical activities. Aim: To assess determinants and symptoms severity of pelvic organ prolapse and its effect on physical activities among the elderly versus childbearing women. Methodology: A descriptive research design was carried out on a purposive sample of 300 cases (150 for each childbearing and old age women) attended to the outpatient gynecologic clinic of Minia Maternal and Child University Hospital, at Minia governorate, Egypt, over a period of six months from October 2019 till March 2020, and met the following inclusion criteria: Females were of childbearing age (≥ 18-49 yrs.), and of old age (≥60 yrs.), diagnosed as pelvic organ prolapse (POP), able to communicate and agree to participate in the study. Tools: Three tools were utilized to collect data. First tool: A Structured questionnaire sheet covered (demographic data, medical and obstetrical history, and self-reported symptoms of POP). Second tool: Severity of POP assessment tool. Third tool: Physical activities assessment scale (ASS). Results: It was found that 50% of the elderly women versus (23%) of the childbearing women had severe symptoms of POP, moreover, (66.7% & 13.3%) of them respectively had greater impairment in their physical activities with a highly statistically significant difference between the two studied groups, and there was a positive correlation between the severity of prolapse symptoms and the degree of physical impairment among both studied groups. Furthermore, multiple linear regression analysis reflected that age, higher parity, vaginal deliveries, level of education, body mass index, duration of prolapse, and chronic constipation were significantly affected the severity of prolapse symptoms among both studied groups. Conclusion: The severity of POP symptoms was higher among the elderly versus childbearing age women which consequently lowering their physical activities. Additionally, (aging, malpractice of pelvic floor exercise, higher parity, vaginal deliveries, overweight, chronic constipation, and heavy lifting) are the commonest leading determinants of POP and are significantly associated with the severity of prolapse symptoms among the studied sample. Recommendations: An urgent need for health educational intervention by health care providers targeting the primary prevention considering the concluded leading determinants of prolapse, as well as secondary prevention for women with mild to moderate degree of genital prolapse at all places especially in the rural communities.