Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity.
OBJECTIVE
The purpose of this study was to describe the prevalence of and correlates for pelvic organ prolapse.


METHODS
This was a cross-sectional analysis of women who enrolled in the Women's Health Initiative Hormone Replacement Therapy Clinical Trial (n = 27,342 women). Baseline questionnaires ascertained demographics and personal habits. A baseline pelvic examination assessed uterine prolapse, cystocele, and rectocele. Descriptive statistics and logistic regression models were used to investigate factors that were associated with pelvic organ prolapse.


RESULTS
In the 16,616 women with a uterus, the rate of uterine prolapse was 14.2%; the rate of cystocele was 34.3%; and the rate of rectocele was 18.6%. For the 10,727 women who had undergone hysterectomy, the prevalence of cystocele was 32.9% and of rectocele was 18.3%. After controlling for age, body mass index, and other health/physical variables, African American women demonstrated the lowest risk for prolapse. Hispanic women had the highest risk for uterine prolapse. Parity and obesity were strongly associated with increased risk for uterine prolapse, cystocele, and rectocele.


CONCLUSIONS
Pelvic organ prolapse is a common condition in older women. The risk for prolapse differs between ethnic groups, which suggests that the approaches to risk-factor modification and prevention may also differ. These data will help address the gynecologic needs of diverse populations.
Hendrix
Susan L
SL
Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA. shendrix@med.wayne.edu
Clark
Amanda
A
Nygaard
Ingrid
I
Aragaki
Aaron
A
Barnabei
Vanessa
V
McTiernan
Anne
A
D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010298:Parity; D015995:Prevalence; D020047:Rectocele / Q000453:epidemiology* / Q000209:etiology; D001745:Urinary Bladder Diseases / Q000453:epidemiology* / Q000209:etiology; D014596:Uterine Prolapse / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D016387:Women's Health