Heidi W Brown1, Aparna Hegde2, Markus Huebner3, Hedwig Neels4, Hayley C Barnes5, Gisele Vissoci Marquini6, Narmin Mukhtarova7, Bernard Mbwele8, Visha Tailor9, Ervin Kocjancic10, Elisa Trowbridge11, Lynsey Hayward12. 1. Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 1010 Mound Street, 4th floor, Madison, WI, 53715, USA. hwbrown2@wisc.edu. 2. Tata Center for Urogynecology and Pelvic Health, Cama Hospital, Grant Government Medical College, Mumbai, India. 3. Department of Obstetrics and Gynecology, Medical Center - University of Freiburg, Germany, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 4. Faculty of Medicine and Health Sciences, MOVANT, Antwerp University Hospital, Gynaecology and Urology, Belgium, University of Antwerp, Belgium, Antwerp, Belgium. 5. Department of Obstetrics/Gynecology and Urology, Loyola University Chicago Stritch School of Medicine and Loyola University Medical Center, Maywood, IL, USA. 6. Department of Gynecology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. 7. Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 1010 Mound Street, 4th floor, Madison, WI, 53715, USA. 8. Department of Epidemiology and Biostatistics, Mbeya College of Health and Allied Sciences UDSM-MCHAS, University of Dar es Salaam, Mbeya, Tanzania. 9. Department of Urogynaecology, Imperial College Healthcare, London, UK. 10. Department of Urology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA. 11. Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville, VA, USA. 12. Department of Urogynecology, Middlemore Hospital, Auckland, New Zealand.
Abstract
INTRODUCTION AND HYPOTHESIS: This narrative review describes the existing epidemiologic literature and identifies gaps regarding pelvic organ prolapse (POP) prevalence, incidence, natural history, and current and future service needs. MATERIALS AND METHODS: A PubMed search identified relevant citations published in 2000 or later. Pre-specified criteria were used to screen titles, abstracts, and manuscripts, including reference sections. Study findings were summarized to define what is known, identify gaps in current knowledge, and suggest priority areas for future research. RESULTS: The reported prevalence of POP varies widely (1-65%) based on whether its presence is ascertained by symptoms (1-31%), pelvic examination (10-50%), or both (20-65%). Most existing population-based surveys do not include physical examination data. White women from higher income countries are overrepresented in the existing literature. Incidence and natural history data are limited and consist mainly of cohorts that follow women after pregnancy or menopause. Given global increases in aging populations in well-resourced countries, the need for POP treatment is anticipated to increase in the coming decades. In lower and middle income countries (LMICs) where demographic trends are different, there is a dearth of information about anticipated POP service needs. CONCLUSION: Future POP incidence, prevalence, and natural history studies should include non-white women from LMICs and should combine pelvic examination data with validated patient-reported outcome measures when feasible. Anticipated future service needs differ globally, with a greater demand for POP treatment services in well-resourced settings where aging populations are prevalent.
INTRODUCTION AND HYPOTHESIS: This narrative review describes the existing epidemiologic literature and identifies gaps regarding pelvic organ prolapse (POP) prevalence, incidence, natural history, and current and future service needs. MATERIALS AND METHODS: A PubMed search identified relevant citations published in 2000 or later. Pre-specified criteria were used to screen titles, abstracts, and manuscripts, including reference sections. Study findings were summarized to define what is known, identify gaps in current knowledge, and suggest priority areas for future research. RESULTS: The reported prevalence of POP varies widely (1-65%) based on whether its presence is ascertained by symptoms (1-31%), pelvic examination (10-50%), or both (20-65%). Most existing population-based surveys do not include physical examination data. White women from higher income countries are overrepresented in the existing literature. Incidence and natural history data are limited and consist mainly of cohorts that follow women after pregnancy or menopause. Given global increases in aging populations in well-resourced countries, the need for POP treatment is anticipated to increase in the coming decades. In lower and middle income countries (LMICs) where demographic trends are different, there is a dearth of information about anticipated POP service needs. CONCLUSION: Future POP incidence, prevalence, and natural history studies should include non-white women from LMICs and should combine pelvic examination data with validated patient-reported outcome measures when feasible. Anticipated future service needs differ globally, with a greater demand for POP treatment services in well-resourced settings where aging populations are prevalent.
Authors: Jeanette S Brown; L Elaine Waetjen; Leslee L Subak; David H Thom; Stephen Van den Eeden; Eric Vittinghoff Journal: Am J Obstet Gynecol Date: 2002-04 Impact factor: 8.661