Pelvic organ prolapse (POP) is a medical condition affecting many women globally. POP is not necessarily life threatening, however it does substantially impact quality of life. Studies show that women have a 12.6% lifetime risk of undergoing surgical correction for POP by the age of 80 years. With increasing life expectancy, the number of women seeking care and undergoing surgeries for POP is significantly increasing. By identifying the etiology and risk factors of POP, hopefully effective prevention strategies will be able to be put in place and decrease rates of POP. This study orchestrated a meta-analysis on the risk factors for primary and recurrent POP in Western countries.
Studies included clinical research on the etiology or risk factors for primary POP or POP recurrence. Randomized controlled trials, cross-sectional, and cohort studies from Western developed countries were included. For primary POP, eight prospective cohort studies and eight cross-sectional studies with a total of 43,333 women were included. In regards to POP recurrence, four retrospective and six prospective cohort studies, and one secondary analysis of an RCT were included.
The risk factors that they identified could be split up into different categories:
- Obstetrical Factors
- Vaginal delivery and cesarean delivery showed significant associations with primary POP
- Lifestyle Factors
- Higher BMI and smoking showed significant associations with primary POP.
- Unmodifiable Factors
- Age was a significant risk factor for primary POP.
- Comorbidity
- Hormone replacement therapy, urinary incontinence, pulmonary disease, and hysterectomy status were analyzed. They all had mixed results.
- Social Factors
- Education level showed slight protective effects against primary POP.
- Surgical Factors
- Additional surgeries done at the same time as POP repair increased risk for recurrent POP.
- Pelvic Floor Factors
- Levator defect was identified as a significant risk factor for primary POP.
