title: Prevalence of and risk factors for pelvic organ prolapse and lower urinary tract symptoms among women in rural Nepal.
abstract: OBJECTIVE
  To evaluate the prevalence and associated risk factors of pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS) among women seeking healthcare services in 3 discrete rural areas in Nepal.
  
  
  METHODS
  A cross-sectional study was conducted using a Nepalese-specific questionnaire to obtain demographic and personal information. Urinary symptoms were examined using the Urogenital Distress Inventory Short form questionnaire, while POP severity was staged according to the POP-Q system. The χ(2) test and multivariate logistic regression analysis were used to determine POP risk factors.
  
  
  RESULTS
  Of the 174 women included in the analysis, 106 (60.9%) had stage II POP or greater. In all, 93 women (53.4%) had cystocele, 63 (36.2%) had rectocele, and 37 (21.3%) had uterine prolapse. Univariate analysis identified high parity; young age at first delivery; menopause; squatting or standing position during delivery; and early return to work after delivery as risk factors for POP. Multivariate logistic regression revealed that delivery in a lying position presented a lower risk for cystocele than squatting or standing (odds ratio 0.34; P<0.01).
  
  
  CONCLUSIONS
  Both LUTS and POP are common among women in rural Nepal. Cystocele is the most frequent, advanced, and symptomatic form of POP observed in this population.
authors.affiliation: Department of Anesthesiology, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Ying-Shuang
authors.initials: YS
authors.lastname: Lien
authors.forename: Gin-Den
authors.initials: GD
authors.lastname: Chen
authors.forename: Soo-Cheen
authors.initials: SC
authors.lastname: Ng
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D052858:Cystocele / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D059411:Lower Urinary Tract Symptoms / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D015999:Multivariate Analysis; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D020047:Rectocele / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D012424:Rural Population; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014596:Uterine Prolapse / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D055815:Young Adult