Genitourinary prolapse and joint hypermobility in women

Abstract

To determine whether joint hypermobility, a clinical marker for connective tissue abnormalities, is associated with genital prolapse. One hundred seven women were recruited from a university gynecology clinic. Subjects were examined in the standing and nonstraining positions for cystocele, rectocele, and uterine or vault prolapse. The degree of prolapse was graded 0-3. A separate investigator, blinded to the results of the gynecologic examination and using accepted criteria, evaluated each subject for joint hypermobility. Clinical joint hypermobility was found in 39 of 107 (36%) study patients. Subjects with joint hypermobility had a significantly higher prevalence of cystocele (33 of 37 [89%] versus 40 of 69 [58%], P = .001), rectocele (32 of 38 [84%] versus 33 of 69 [48%], P = .0002), and uterine or vault prolapse (25 of 38 [66%] versus 20 of 69 [29%], P = .0002) compared to women with normal joint mobility, respectively. No differences in the prevalence of stress incontinence were found between the two groups. Women with joint hypermobility have a significantly higher prevalence of genital prolapse compared to women with normal mobility, which suggests an underlying connective tissue abnormality as one etiology of pelvic relaxation.