Racial differences in pelvic organ prolapse.
OBJECTIVE
To compare the estimated prevalence of, risk factors for, and level of bother associated with subjectively reported and objectively measured pelvic organ prolapse in a racially diverse cohort.


METHODS
The Reproductive Risks for Incontinence Study at Kaiser 2 is a population-based cohort study of 2,270 middle-aged and older women. Symptomatic prolapse was self-reported, and bother was assessed on a five-point scale. In 1,137 women, prolapse was measured with the Pelvic Organ Prolapse Quantification (POP-Q) system. Multivariable logistic regression analysis was used to identify the independent association of prolapse and race while controlling for risk factors.


RESULTS
The participants' mean (standard deviation) age was 55 (9) years, and 44% were white, 20% were African American, 18% were Asian American, and 18% were Latina or other race. Seventy-four women (3%) reported symptomatic prolapse. In multivariable analysis, the risk of symptomatic prolapse was higher in white (prevalence ratio 5.35, 95% confidence interval [CI] 1.89-15.12) and Latina (prevalence ratio 4.89, 95% CI 1.64-14.58) compared with African-American women. Race was not associated with report of moderate to severe bother. Degree of prolapse by POP-Q stage was similar across all racial groups; however, the risk of the leading edge of prolapse at or beyond the hymen was higher in white (prevalence ratio 1.40, 95% CI 1.02-1.92) compared with African-American women.


CONCLUSIONS
Compared with African-American women, Latina and white women had four to five times higher risk of symptomatic prolapse, and white women had 1.4-fold higher risk of objective prolapse with leading edge of prolapse at or beyond the hymen.


METHODS
II.
Whitcomb
Emily L
EL
From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Reproductive Medicine, University of California, San Diego, California; Department of Public Health and Primary Health Care, University of Bergen, Norway; Research Unit for General Practice, Unifob Health, Bergen, Norway; Department of Obstetrics, Gynecology and Reproductive Sciences, Department of Epidemiology and Biostatistics, and Department of Family and Community Medicine, University of California, San Francisco, California; and Kaiser Permanente Division of Research, Oakland, California.
Rortveit
Guri
G
Brown
Jeanette S
JS
Creasman
Jennifer M
JM
Thom
David H
DH
Van Den Eeden
Stephen K
SK
Subak
Leslee L
LL
D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000208:ethnology* / Q000523:psychology; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors