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Fleecs JD, Ngobi MD, Kiweewa FM, Vemulapalli R, Jensen JE, Steffen HA, Wendt LH, Jackson JB, Kenne KA. Association Between Physical Activity and Pelvic Floor Disorders in Parous Ugandan Women. Int Urogynecol J 2024:10.1007/s00192-024-05859-4. [PMID: 39002045 DOI: 10.1007/s00192-024-05859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/11/2024] [Indexed: 07/15/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The aim was to assess the association between the degree of physical activity (PA) and the presence of pelvic floor disorders (PFDs) in a cohort of parous Ugandan women. METHODS In this cross-sectional study, PFDs were measured using symptom assessment, standardized questionnaires (Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire), and a standardized physical examination (POP-Q and cough stress test [CST]). Degree of PA was assessed using the International Physical Activity Questionnaire. Interquartile ranges were used to describe the age, parity, and body mass index (BMI) of participants. To examine the association between PA and PFDs, a log transformation was applied to the weekly minutes of PA variable and a logistic regression model was constructed with weekly minutes of moderate/vigorous PA, age, BMI, and parity as the predictors. RESULTS A total of 159 women were enrolled. Median age was 35 (IQR 32-37), median parity 4 (IQR 3-5), and median BMI 29.0 (IQR 24-33). The prevalence of PFD as determined by symptom assessment was 28% (n=44). The most frequent stage of prolapse identified by POP-Q was stage II (57%, n=91). Thirty-six percent of the women (n=58) reported vigorous PA. Ninety-nine percent of the cohort (n=158) reported moderate PA. When controlling for age, parity, and BMI there was a significant positive association between PFD (defined as a combination of stage II prolapse, positive CST, and urinary incontinence (UI)) and moderate PA (OR 2.20, 95% CI 1.08-5.14, p value 0.045). CONCLUSIONS Pelvic floor disorders are common among parous Ugandan women and are associated with moderate PA when controlling for age, BMI, and parity. Understanding the risk factors associated with PFD in this population may better equip providers to screen and care for individuals.
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Affiliation(s)
| | | | | | | | | | | | - Linder Hagstrom Wendt
- University of Iowa Institute for Clinical and Translational Science, Iowa City, IA, USA
| | - Jay Brooks Jackson
- Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Kimberly Ann Kenne
- Department of Obstetrics and Gynecology, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 31674 PFP, USA.
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Tega A, Yenealem F, Belay G, Asmare E, Getaneh T, Desalegn M, Dechasa N, Addis Z. Quality of life and its associated factors among women with pelvic organ prolapse who attend gynecology clinics Southern Ethiopia 2022. BMC Womens Health 2024; 24:398. [PMID: 38997642 PMCID: PMC11241974 DOI: 10.1186/s12905-024-03238-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION Pelvic organ prolapse is the implosion of one or more pelvic floor structures which affect womens quality of life by compromising overall health, physical, social, structural, functional and emotional well-being. OBJECTIVE To assess the quality of life and its associated factors among women with pelvic organ prolapse who attend gynecology clinics at Gurage zone hospitals, Southern Ethiopia 2022. METHODS Facility-based cross-sectional study was applied in gurage zone hospital from April, 30 to Jun 30, 2022. Systematic random sampling was employed to select 416 women. Interview based structured questionnaires were applied to collect the data. The collected data were analyzed using Statistical Produte and Service Solution. Binary and multivariable logistic regressions were fitted to assess the association between dependent and independent variables. P-value < 0.05 was used to declare the final statistical significance. RESULT The mean (SD) score of quality of life in this study was 53.57 (21.59). The most affected domains were general health perception and physical limitation (mean (SD) score 67.45 29.24) and (64.26 32.36)) respectively. Had no formal education (AOR = 1.50, 95% CI: 1.02, 3.12), stage III/IV POP (AOR = 2.02, 95% CI: 1.19, 3.60), constipation (AOR = 3.51, 95% CI: 2.12, 7.21), urge urinary incontinence (AOR = 3.89, 95% CI: 2.32, 6.95), and not did regular physical exercise (AOR = 2.18, 95% CI: 1.41, 3.37) were significantly associated with poor quality of life. CONCLUSION More than half of the participants in this study had impaired quality of life. The factor associated with quality of life was had no formal education, stage III/IV, constipation, urge urinary incontinence, and regular physical activity. It is recommended to have access education, counseling regular physical activity, detection, and management of its comorbidity.
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Affiliation(s)
- Ayenew Tega
- Department of Midwifery, Hosanna health science colleg, Hosanna, Ethiopia.
| | - Fentahun Yenealem
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getahun Belay
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eden Asmare
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Temesgen Getaneh
- Department of Midwifery, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Misgana Desalegn
- Department of Midwifery, Hossana College of Health Science, Hossana, Ethiopia
| | - Natnael Dechasa
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Zemenu Addis
- Department of Nursing, Hosanna health science colleg, Hosanna, Ethiopia
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Chen MC, Lai PH, Ding DC. The beneficial effects of conservative treatment with biofeedback and electrostimulation on pelvic floor disorders. Tzu Chi Med J 2024; 36:291-297. [PMID: 38993823 PMCID: PMC11236079 DOI: 10.4103/tcmj.tcmj_174_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/07/2023] [Accepted: 08/24/2023] [Indexed: 07/13/2024] Open
Abstract
Objectives Pelvic floor disorders (PFDs) such as stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can be managed through conservative treatments, such as conservative management involving biofeedback (BF) and electrostimulation. This study aimed to investigate the therapeutic effects of conservative treatments on PFDs. Materials and Methods A retrospective cohort study was conducted. Women with PFD who underwent 1-3 months of BF and electrostimulation between January 1, 2020, and January 31, 2021, were included in the study. BF treatment was administered using three sensors to monitor pelvic floor muscle activity, providing patients with immediate feedback and guidance on muscle exercises. One session lasted for 5-10 min. Electrostimulation treatment utilized a specially made pelvic belt with electrode sheets to stimulate and contract pelvic floor muscles passively. One session lasted for 15 min. Six therapies in 1 month were prescribed. Pre- and post-treatment Pelvic Floor Distress Inventory (PFDI-20) scores, including POP distress inventory 6 (POPDI-6), colorectal-anal distress inventory (CRAD-8), and urinary distress inventory 6 (UDI-6) scores, were compared. Subgroup analysis by age, menopause, body mass index (BMI), and child delivery mode was performed. Results The study included 51 women with PFDs (SUI, POP, frequency or urgency or nocturia, and pain) treated with BF and electrostimulation, with a mean age of 49.94 ± 13.63 years. Sixteen patients (37.1%) were menopausal, with a mean menopause age of 50 ± 5.20 years. Twenty-six patients (68.4%) had a history of normal vaginal delivery. The mean PFDI-20 scores before and after treatment were 32.67 (standard deviation [SD] 10.05) and 25.99 (SD 9.61), respectively (P < 0.001). This decrease in scores reflected an improvement in subjective perceptions of symptoms and quality of life. The POPDI-6, CRAD-8, and UDI-6 scores significantly decreased after treatment. Subgroup analysis of scores change regarding age, menopause, BMI, and child delivery mode was not statistically significant. Conclusion The study demonstrated the effectiveness of BF and electrostimulation for treating women with PFDs. The findings contributed to the understanding of treatment duration, patient characteristics, and the potential benefits of a multimodal approach. Moreover, the study's diverse participant population and the use of validated outcome measures enhance the generalizability and scientific rigor of the findings.
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Affiliation(s)
- Mei-Chen Chen
- Department of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Pei-Hsuan Lai
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
- Institute of Medical Science, College of Medicine, Tzu Chi University, Hualien, Taiwan
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Dayican DK, Hosbay Z, Ozyurek B, Utku Umut G. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with cerebral palsy: a pilot cross-sectional study. Women Health 2024; 64:404-415. [PMID: 38706221 DOI: 10.1080/03630242.2024.2349559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 04/24/2024] [Indexed: 05/07/2024]
Abstract
Pelvic floor symptoms may occur in women with low back pain due to dysfunction of the spinal stabilization muscles. Low back pain is the most common musculoskeletal problem experienced by the mothers of children with cerebral palsy (CP). Therefore, our aim in this study was to examine pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP. The study included 48 mothers of children with CP (n = 23) or without neurodevelopmental problems (n = 25). The mothers' pelvic floor symptoms and symptom-related quality of life were evaluated with the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). PFDI-20 and PFIQ-7 scores did not differ between the two groups of mothers (p > .05). Additionally, moderately significant positive correlations were found between the age of the child with CP and duration of carrying and the PFDI-20 (r = 0.419, p = .047) and PFIQ-7 (r = 0.427, p = .042) scores. Pelvic floor symptoms and symptom-related quality of life in the mothers of children with CP were similar to those in the mothers of children without neurodevelopmental problems. As the age of the child with CP and duration of carrying increase, the urinary symptoms and urinary and colorectoanal symptoms-related quality of life in their mothers may worsen.
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Affiliation(s)
- Damla Korkmaz Dayican
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İzmir Tınaztepe University, İzmir, Turkey
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
| | - Zeynep Hosbay
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Burcin Ozyurek
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Pelvic Floor Center, Yeditepe University Hospital, İstanbul, Turkey
| | - Gulsena Utku Umut
- Department of Physiotherapy and Rehabilitation, Graduate Education Institute, Biruni University, İstanbul, Turkey
- Department of Physiotherapy and Rehabilitation (English), Faculty of Health Sciences, Haliç University, İstanbul, Turkey
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Hadizadeh-Talasaz Z, Khadivzadeh T, Mohajeri T, Sadeghi M. Worldwide Prevalence of Pelvic Organ Prolapse: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2024; 53:524-538. [PMID: 38919293 PMCID: PMC11194659 DOI: 10.18502/ijph.v53i3.15134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/18/2023] [Indexed: 06/27/2024]
Abstract
Background The prevalence of pelvic organ prolapse is varied in different countries. For validating the results of numerous studies on the prevalence of Pelvic organ prolapse in the world, a meta-analysis study seems necessary to provide an accurate and valid prevalence for planners and researchers in this field. Therefore, we aimed to investigate the worldwide prevalence of pelvic organ prolapse using the meta-analysis method. Methods By using valid keywords, searching was done in ISI Web of Science, PubMed, Scopus, and Medline databases, and 22 articles were selected based on inclusion criteria between 2009 and 2021. The quality of articles was checked using The Joanna Briggs Institute (JBI) checklist. Meta-analysis was performed on collected data using Comprehensive Meta-Analysis Software (CMA, Version 2). Meta-analysis of data was done with a random-effects model. The heterogeneity of the study was checked using the I2 index. Publication bias was assessed by the Egger test and funnel graph. Results The overall prevalence of included studies was 30.9% (95% confidence interval: 24.4-38.2%), (P<0.001, heterogeneity I2=99.8%). Meta-analysis of subgroups in studies that used a questionnaire to estimate the prevalence rate showed the prevalence was 25.0% and, in the studies, used the physical examination was 41.8%. Conclusion Studies carried out in different parts of the world have examined the prevalence of pelvic organ prolapse using different tools. Since some cases are asymptomatic, especially in the low stage of prolapse, physical examination of pelvic organ prolapse should be considered an essential tool in evaluating pelvic organ prolapse.
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Affiliation(s)
- Zahra Hadizadeh-Talasaz
- Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talaat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Taraneh Mohajeri
- Department of Obstetrics & Gynecology, Mashhad Medical Sciences Branch, Islamic Azad University, Mashhad, Iran
| | - Masoumeh Sadeghi
- Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Siyoum M, Nardos R, Teklesilasie W, Astatkie A. Prevalence and risk factors of pelvic organ prolapse among women in Sidama region, Ethiopia: A community-based survey. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241265078. [PMID: 39054684 DOI: 10.1177/17455057241265078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
BACKGROUND Pelvic organ prolapse is a descent of the vaginal compartments and the surrounding organ due to loss of support of the vaginal tissue. It has a significant psychological, physical, and social impact that affects women's quality of life. However, its true prevalence is unknown due to the variability in the methods used to diagnose the disorder. OBJECTIVES This study aimed to determine the prevalence of pelvic organ prolapse and its associated risk factors among women in Sidama region, Ethiopia. STUDY DESIGN A community-based cross-sectional survey was conducted in the Dale-Wonsho Health and Demographic Surveillance Site, Sidama region, from March to October 2023. METHODS A multi-stage stratified cluster sampling was used to select a sample of 816 women. Anatomical prolapse was diagnosed based on the standardized pelvic organ prolapse quantification method, and symptomatic prolapse was assessed by patient-reported symptoms. A complex survey-based modified Poisson regression was used to assess the risk factors associated with prolapse. RESULTS A total of 815 participated in the interview, and 779 (95.6%) underwent pelvic examination to assess for prolapse status. Anatomical prolapse (Stages II-IV) was observed in 241 (30.9%; 95% confidence interval = 24-38.7) of the participants. The prevalence of symptomatic pelvic organ prolapse was 78.5% (95% confidence interval = 69.1-85.7) among women with anatomical prolapse (189/241). This prevalence falls to 24.27% (95% confidence interval = 19.98-29.16) for the total sample population. Higher frequency of childbirth, prolonged heavy lifting activities, and prolonged labor increased the likelihood of developing anatomical prolapse. Childbirth at an early age and prolonged heavy lifting activities were significantly associated with symptomatic prolapse. CONCLUSION Anatomical prolapse and symptomatic prolapse are high in the study area. Parity, prolonged heavy lifting, prolonged labor, and early age childbirth were associated with pelvic organ prolapse. Community-based education and interventions that focus on the modification of risk factors are needed.
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Affiliation(s)
- Melese Siyoum
- Department of Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Rahel Nardos
- Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minnesota, MN, USA
| | - Wondwosen Teklesilasie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Kurniawati EM, Rahmawati NA, Widyasari A. Differences Between 25-hydroxyvitamin D Levels in Patients with Pelvic Organ Prolapse and Non-Pelvic Organ Prolapse: A Systematic Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2023; 45:102198. [PMID: 37633644 DOI: 10.1016/j.jogc.2023.102198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVES Treatment options for cases of pelvic organ prolapse still lead to the use of a pessary rather than a surgical method. Additional therapy is needed to help treat or prevent pelvic organ prolapse. Vitamin D deficiency has consistently been associated with decreased muscle function, so it is assumed that it will affect the pelvic floor muscles. This paper systematically explores the differences between 25-hydroxyvitamin D levels in patients with pelvic organ prolapse and non-pelvic organ prolapse. STUDY DESIGN A systematic review was conducted through the PubMed, Google Scholar, Cochrane Library, and ScienceDirect databases using relevant keywords. Articles published in the last 10 years-from 2012 to 2022-that were written in English, that discuss the status or effect of vitamin D on pelvic organ prolapse, and that focus on 25 OH-vitamin D were included in the review. RESULTS In total, 717 articles were filtered but 8 articles met the criteria. A total of 1339 women with prolapse and without prolapse with ages ranging from 20 years to 78 years were included in the study. The studies found did not use the same standard threshold in determining deficiency status. Most studies have found that there are lower levels of vitamin D in women who have had pelvic organ prolapse. A total of 7 of 8 studies confirmed the comparison of vitamin D-25OH levels in women with pelvic organ prolapse and without pelvic organ prolapse at P < 0.05. CONCLUSIONS There are differences between 25-hydroxyvitamin D levels in patients with pelvic organ prolapse and non-pelvic organ prolapse.
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Affiliation(s)
- Eighty Mardiyan Kurniawati
- Department of Obstetrics and Gynecology Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | | | - Anis Widyasari
- Division of Urogynecology and Reconstructive Surgery, Obstetrics and Gynecology Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia
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Addisu D, Mekie M, Belachew YY, Degu A, Gebeyehu NA. The prevalence of pelvic organ prolapse and associated factors in Ethiopia: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1193069. [PMID: 37476611 PMCID: PMC10354282 DOI: 10.3389/fmed.2023.1193069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/13/2023] [Indexed: 07/22/2023] Open
Abstract
Background Pelvic organ prolapse (POP) affects millions of women globally, with resource-limited countries, such as Ethiopia, carrying the highest burden. Previously, the prevalence of POP was estimated using seven studies. However, this study lacks generalization because of the limited number of studies and low geographical representation. In total, 12 additional primary studies were conducted after this review, and their reported prevalence was significantly variable across the studies. In addition, different new factors were reported in the primary studies. Therefore, this study aimed to update the pooled prevalence of POP and its associated factors in Ethiopia. Methods This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Articles that were published between 2000 and 2023 were searched using the African Journal of Online, ScienceDirect, DOAJ, PubMed, and Google Scholar. The quality of the studies was evaluated using the modified Newcastle-Ottawa quality assessment tool. The data were extracted using Microsoft Excel and analyzed by Stata version 11. A random effect model was used to investigate the pooled prevalence of POP and its associated factors. The I2 test and Egger's regression test were used to detect the presence of heterogeneity and publication bias across studies, respectively. Result A total of 21 studies met the inclusion criteria and represented the data of 14,575 women. The pooled prevalence of POP was found to be 22.70%. History of home delivery (pooled odds ratio (OR) =2.93, 95% CI =1.46, 5.91), prolonged labor (OR = 4.63, 95% CI = 2.56, 8.38), history of perineal tear (OR = 4.83, 95% CI = 2.31, 10.11), instrumental delivery (OR =3.70, 95% CI =2.01, 6.81), grand multipara (OR = 5.42, 95% CI = 4.06, 7.23), family history of POP (OR = 3.30, 95% CI = 2.07, 5.25), and carrying heavy objects (OR = 3.23, 95% CI = 2.22, 4.70) were significantly associated with POP. Conclusion The pooled prevalence of POP was high in Ethiopia. The Ministry of Health and clinicians should emphasize counseling on modifiable risk factors and develop further prevention strategies.
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Affiliation(s)
- Dagne Addisu
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Maru Mekie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yismaw Yimam Belachew
- Department of Obstetrics and Gynecology, College of Health Sciences, School of Medicine, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alemu Degu
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Natnael Atnafu Gebeyehu
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Sodo, Ethiopia
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Tefera Z, Temesgen B, Arega M, Getaneh T, Belay A. Quality of life and its associated factors among women diagnosed with pelvic organ prolapse in Gynecology outpatient department Southern Nations, Nationalities, and Peoples region public referral hospitals, Ethiopia. BMC Womens Health 2023; 23:342. [PMID: 37380942 DOI: 10.1186/s12905-023-02507-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 06/24/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Pelvic organ prolapse is an important public health issue that influences millions of women's lives; through limitations on physical, social, and sexual activities as well as psychological distress. However, there were no reports on the quality of life for women with pelvic organ prolapse in Ethiopia. Therefore this study amid to assess the magnitude of quality of life and its associated factors among women who diagnosed with pelvic organ prolapse in Gynecology outpatient departments in Southern Nations, Nationalities, and Peoples region public referral hospitals; Ethiopia. METHOD An institutional-based cross-sectional study was conducted in Southern Nations, Nationalities, and Peoples region of public referral hospitals from May 1-July 4, 2022 among 419 diagnosed women with pelvic organ prolapse. A validated tool was used to collect the data. The collected data were entered into Epidata version 3.1 and analyzed using the Statistical Package for Social Sciences. Bivariable and multivariable logistic regression was computed. The p-value of < 0.05 was used to declare the final statistical significance. RESULT A total of 409 women with pelvic organ prolapse were included in the study, giving a response rate of 97.6%. The overall poor quality of life was 57.5%. Regarding the quality of life domains; personal relationships (73.6%), were highly affected, and sleep/energy (24.2%) was the least affected domain. Stage III/IV prolapse (AOR = 2.52, 95% CI: 1.34, 4.74), menopause (AOR = 3.21, 95% CI 1.75, 5.97), unmarried women (widowed, divorced) (AOR = 2.81, 95% CI: 1.48, 5.32), and longer duration of prolapse (AOR = 5.8, 95% CI: 3.13, 10.81), were significantly associated with poor quality of life. CONCLUSION More than half of women with pelvic organ prolapse had a poor quality of life. Stage III/IV prolapse, longer duration of prolapse, menopause women, and unmarried women are statistically significant factors for the quality of life of women with Pelvic organ prolapse.
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Affiliation(s)
- Zewdu Tefera
- Department of Midwifery, College of Health Science, Dilla University, Dilla, Ethiopia.
| | - Belsity Temesgen
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Mikyas Arega
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tmesgen Getaneh
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Aynalem Belay
- Department of Midwifery, College of Health Science, Wolkite University, Wolkite, Ethiopia
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Tennfjord MK, Kassie BA, Gashaw ZM, Asaye MM, Muche HA, Fenta TT, Chala KN, Mæland KS. Pelvic Floor Disorders and Pelvic Floor Muscle Exercise: A Survey on Knowledge, Attitude, and Practice among Pregnant Women in Northwest Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4201. [PMID: 36901212 PMCID: PMC10001623 DOI: 10.3390/ijerph20054201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
The purpose of the study was to investigate 1: overall knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI) as well as knowledge, attitudes, and practice of pelvic floor muscle exercise (PFME); and 2: the association of these factors with parity in pregnant women in Gondar, Ethiopia. A facility-based cross-sectional study was performed in the Central Gondar zone, northwest Ethiopia between February and April 2021. The associations between parity and knowledge of POP and UI, and knowledge, attitude, and practice towards PFME were estimated using logistics regression models and presented as crude and adjusted odds ratios with 95% confidence intervals. Nulliparous women were used as the reference. Adjustments were made for maternal age, antenatal care visits, and level of education. The study sample comprised 502 pregnant women: 133 nulliparous, and 369 multiparous. We found no association between parity and knowledge of POP, UI, or knowledge, attitude, and practice toward PFME. The sum score indicated poor knowledge about both POP, UI, and PFME in the study population, and poor attitude and practice of PFME. Despite a high attendance in antenatal care services, knowledge, attitude, and practice were poor, indicating a need for quality improvement of the services.
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Affiliation(s)
| | - Belayneh Ayanaw Kassie
- Department of Women’s and Family Health, College of Medicine and Health Science, School of Midwifery, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Zelalem Mengistu Gashaw
- Department of Gynecology and Obstetrics, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Mengstu Melkamu Asaye
- Department of Women’s and Family Health, College of Medicine and Health Science, School of Midwifery, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Haymanot Alem Muche
- Department of Clinical Midwifery, College of Medicine and Health Science, School of Midwifery, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Tibebu Tadesse Fenta
- University of Gondar Comprehensive Specialized Hospital, Gondar P.O. Box 196, Ethiopia
| | - Kalkidan Nigussie Chala
- Department of Physiotherapy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Karolina S. Mæland
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, 5063 Bergen, Norway
- Faculty of Health Sciences, SHARE-Center for Resilience in Healthcare, University of Stavanger, 4036 Stavanger, Norway
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Rashidi F, Mirghafourvand M. Pelvic floor disorder and relevant factors in Iranian women of reproductive age: a cross-sectional study. BMC Womens Health 2023; 23:71. [PMID: 36797735 PMCID: PMC9933298 DOI: 10.1186/s12905-023-02226-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND With high severity and prevalence, pelvic floor disorder is a health issue that women face worldwide. Different demographic-obstetric factors are involved in the emergence of this dysfunction that can have many adverse effects on a woman's quality of life. Hence, this study aimed to determine the prevalence of pelvic floor disorder and its related socio-demographic and obstetric factors among Iranian women of reproductive age. METHODS The statistical population of this cross-sectional study included 400 woman of reproductive age (15-49 years) covered by the health centers of Tabriz, Iran in 2022. The cluster sampling method was employed to select the participants. The data collection tools were a socio-demographic and obstetric characteristics questionnaire and the PDFI-20 (Pelvic Floor Distress Inventory-20). The chi-squared test was conducted to determine the association between socio-demographic and obstetric characteristics and prevalence of pelvic floor disorder in a bivariate analysis, whereas the multivariate logistic regression test was used in a multivariate analysis. RESULTS The general prevalence of pelvic floor disorder was 76%. The prevalence rates of pelvic organ prolapse distress 6 (POPDI-6), colorectal-anal distress 8 (CRAD-8), and urinary distress (UDI-6) were 54.3%, 61.8%, and 49.3%, respectively. The results of the multivariate logistic regression test indicated that constipation (odds ratio = 5.62; 95% CI 1.97 to 16.03; P = 0.001) increased the risk of pelvic floor disorder. CONCLUSIONS According to the findings, the prevalence of pelvic floor disorder is high among Iranian women of reproductive age. This condition is correlated with constipation. Therefore, screening is recommended through valid tools in addition to offering preventive measures such as preventing and curing constipation to reduce the risk of pelvic floor disorder.
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Affiliation(s)
- Fatemeh Rashidi
- grid.412888.f0000 0001 2174 8913Students’ Research Committee, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- grid.412888.f0000 0001 2174 8913Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Street, P.O. Box: 51745-347, Tabriz, 513897977 Iran
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Elbiss HM, Rafaqat W, Khan KS. Prevalence of pelvic floor disorders in the Eastern Mediterranean region: A meta-analysis. Saudi Med J 2023; 44:128-136. [PMID: 36773973 PMCID: PMC9987702 DOI: 10.15537/smj.2023.44.2.20220510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/16/2023] [Indexed: 02/13/2023] Open
Abstract
OBJECTIVES High prevalence of risk factors for pelvic floor disorders (PFD) in the Eastern Mediterranean may result in higher rates of prevalence of PFD in comparison to other regions. Despite individual studies, there are no clear statistics on the cumulative prevalence of PFDs in the East Mediterranean region. The aim of this study was to investigate the prevalence of PFDs in the Eastern Mediterranean region. METHODS A literature search without language restriction was conducted in PubMed, Cochrane database and Web of Science from 2016 to 01 June 2022. Cross-sectional and cohort studies that reported prevalence of urinary incontinence (UI), constipation, fecal incontinence (FI) and pelvic organ prolapse (POP) among women in the Eastern Mediterranean region were included. Study quality was assessed according to the Joanna Briggs Institute critical appraisal tool. Data were pooled and meta-analysed using a random effects model. PROSPERO CRD42021283127 RESULTS: The search yielded 390 articles, from which 12 studies containing 9905 patients were included. Five studies were high quality and seven were low quality. The prevalence of POP (12 studies, 9905 participants), UI (5 studies, 2340 participants), constipation (4 studies, 2045 participants) and FI (1 study, 166 participants) was 39% (95% CI 21-57; I2 99.8%), 48% (95% CI 16-80; I2 99.7%), 39% (CI 17-60; I2 99.1%) and 14% (95% CI 9-20) respectively. CONCLUSION In meta-analysis pooling studies of mixed quality, a high prevalence of PFDs was seen in the Eastern Mediterranean region.PROSPERO No.: CRD42021283127.
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Affiliation(s)
- Hassan M. Elbiss
- From the Department of Obstetrics and Gynecology (Elbiss), College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; from the Medical College (Rafaqat), Aga Khan University, Karachi, Pakistan; and from the Department of Preventive Medicine and Public Health (Khan), University of Granada, Granada, Spain.
- Address correspondence and reprint request to: Dr. Hassan M. Elbiss, Department of Obstetrics and Gynecology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. E-mail: ORCID ID: https://orcid.org/0000-0002-2908-6704
| | - Wardah Rafaqat
- From the Department of Obstetrics and Gynecology (Elbiss), College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; from the Medical College (Rafaqat), Aga Khan University, Karachi, Pakistan; and from the Department of Preventive Medicine and Public Health (Khan), University of Granada, Granada, Spain.
| | - Khalid S. Khan
- From the Department of Obstetrics and Gynecology (Elbiss), College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; from the Medical College (Rafaqat), Aga Khan University, Karachi, Pakistan; and from the Department of Preventive Medicine and Public Health (Khan), University of Granada, Granada, Spain.
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Hambisa HD, Birku Z, Gedamu S. Magnitude of Symptomatic Pelvic Floor Dysfunction and Associated Factors Amongst Women in Western Ethiopia: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231171309. [PMID: 37203183 PMCID: PMC10201172 DOI: 10.1177/00469580231171309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/25/2023] [Accepted: 04/05/2023] [Indexed: 05/20/2023]
Abstract
The goal of this research was to determine the extent of pelvic floor dysfunction and the factors that contribute to it. The study design was community-focused and cross-sectional, and participants were chosen using a systematic random sampling technique. For data entry and cleansing, we used EPI data version 3.1 software, and for analysis, we used Statistical Package for the Social Sciences version 26. The 95% confidence interval was predicted, and the factor with a significant level less than 0.05 was chosen for multivariate logistic regression analysis. The overall Magnitude of pelvic floor dysfunction was 37.7% [(95% confidence interval (31.7-42.5)]. The most common type of pelvic floor dysfunction is overactive bladder, which was reported by 135 of all participants. Pelvic organ prolapse accounted for 92 (30.4%) of all cases, and 4 factors were found to be significantly associated with pelvic floor dysfunction. In this study, age 55 years [(AOR = 2.1; 95% CI: (1.52-6.42)], heavy labor work for more than 10 years [(AOR = 3.21; 95% CI: (1.86-5.72) grand-multipara, and being menopause [(AOR = 4.03; 95% CI: (2.20-8.27)] were linked to symptoms of pelvic floor dysfunction. The magnitude of pelvic floor dysfunction in this study was slightly higher than in Ethiopian studies. Pelvic floor dysfunction has been linked to heavy load lifting, low socioeconomic status, recurrent vaginal deliveries, chronic cough, and menopause. Screening and treatment of pelvic floor disorders should be prioritized in collaboration with regional and zonal health departments.
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Affiliation(s)
- Hunduma Dina Hambisa
- College of Health Science, Department
of Midwifery, Assosa University, Asosa, Ethiopia
| | - Zelalem Birku
- College of Health Science, Department
of Midwifery, Assosa University, Asosa, Ethiopia
| | - Samuel Gedamu
- College of Health Science, Department
of Midwifery, Assosa University, Asosa, Ethiopia
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Mama ST, Chandra Regmi M. Pelvic Floor Disorders/Obstetric Fistula. Obstet Gynecol Clin North Am 2022; 49:735-749. [DOI: 10.1016/j.ogc.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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