title: [Risk factors of pelvic organ prolapsed in women qualified to reconstructive surgery--the Polish multicenter study].
abstract: OBJECTIVE
  To evaluate the prevalence rate of various pelvic floor disorders among patients treated in 8 academic centers in Poland due to pelvic organ prolapse (POP).
  
  
  METHODS
  The study group consisted of 717 women scheduled for reconstructive surgery due to POP. Risk factors, functional abnormalities along with symptoms affecting quality of life, were assessed by means of disease specific questionnaire. The stage of the disease was assessed after gynecological examination using POP-Q score.
  
  
  RESULTS
  The mean age of affected women with POP was 61,25 years (median 61), and mean BMI--27.62 (median--27.29). 80% of women were menopausal. Mean time of symptoms related to disease was 65,6 months; whereas the time relapsed from first doctor diagnosis of POP to hospital admission was 50.6 months. 97.4% affected women were multiparous. Only 1.21% women with POP were nulliparous. Family history of prolapse was found in 13.4% of patients, whereas familial positive history of urinary incontinence was 10%. Lower urinary tract symptoms (LUTS) among the analyzed group were as follows: frequency--almost 50%, urgency 32.2%, feeling of improper voiding -29,6% and voiding difficulty -17.7%. Functional disorders of lower bowel were found in 43% of patients and the most prevalent symptom was constipation (31%), followed by empting difficulty (12%), dyschesia (9%), and urge stool empting (7.7%). Cardiovascular diseases were found among 43% of respondents, whereas pulmonary diseases with chronic coughing were present in 20% of the analyzed population. Subjective POP symptoms reported by women were as follows: feeling of heaviness in lower abdomen--378%, perineal pain--27.8%, lumbosacral pain-34.2%, and abdominal pain--28.4%. Female sexual disorders were reported by 9,8% women and dyspareunia was found in 7.6% of responders. POP was the main reason for sexual abstinence only in 1 out of 10 patients. More than 30% of patients from the study group underwent previously pelvic surgery due to various reasons. POP related quality of life measured by VAS (Visual Analogue Scale) was 61.4 points (median--60). The most common finding during gynecological examination was cystocele--96.5%, followed by rectoenterocele--92.7%, and central defect--79%. Mean POP quantification was stage III in POP-Q scale. LUTS symptoms (urinary incontinence, urgency and voiding difficulties) were present among 81% of patients whereas lower gastrointestinal disorders (constipation, fecal incontinence, dyschesia) were found in 43% of women affected by POP.
  
  
  CONCLUSIONS
  Mean delay time from objective POP diagnosis until decision concerning surgical treatment was more than 5 years. The most common risk factors associated with POP were: multiparity with vaginal deliveries, obesity and aging. The most common defect found among patients with POP was cystocele, followed by rectoenterocele and central defect however most patients presented with advanced combined defects.
authors.affiliation: II Katedra i Klinika Ginekologii UM w Lublinie. rechbergt@yahoo.com
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rechberger
authors.forename: Paweł
authors.initials: P
authors.lastname: Miotła
authors.forename: Konrad
authors.initials: K
authors.lastname: Futyma
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Bartuzi
authors.forename: Antoni
authors.initials: A
authors.lastname: Basta
authors.forename: Marcin
authors.initials: M
authors.lastname: Opławski
authors.forename: Klaudia
authors.initials: K
authors.lastname: Stangel-Wójcikiewicz
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Baranowski
authors.forename: Jacek
authors.initials: J
authors.lastname: Doniec
authors.forename: Artur
authors.initials: A
authors.lastname: Rogowski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Starczewski
authors.forename: Jolanta
authors.initials: J
authors.lastname: Nawrocka-Rutkowska
authors.forename: Joanna
authors.initials: J
authors.lastname: Borowiak
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sikora
authors.forename: Igor
authors.initials: I
authors.lastname: Bakon
authors.forename: Jacek
authors.initials: J
authors.lastname: Magnucki
authors.forename: Andrzej
authors.initials: A
authors.lastname: Witek
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Drosdol
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Solecka
authors.forename: Andrzej
authors.initials: A
authors.lastname: Malinowski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Ordon
authors.forename: Artur
authors.initials: A
authors.lastname: Jakimiuk
authors.forename: Wojciech
authors.initials: W
authors.lastname: Borucki
authors.forename: Radosław
authors.initials: R
authors.lastname: Rodzoch
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D052858:Cystocele / Q000453:epidemiology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010147:Pain Measurement; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000601:surgery*; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology; D016387:Women's Health