title: Prevalence, risk factors, and predictors of pelvic organ prolapse:  a community-based study.
abstract: OBJECTIVE
  This study aimed to determine the prevalence of pelvic organ prolapse (POP) in a village in East Lebanon and to evaluate related risk factors and clinical predictors.
  
  
  METHODS
  Five hundred four ever-married women, aged 15 to 60 years, were interviewed and underwent physical and pelvic examinations and laboratory testing. Prolapse was determined according to a simplified version of the POP quantification system.
  
  
  RESULTS
  Two hundred fifty-one (49.8%) women had clinically significant POP. When stratified by life decade, POP prevalence was 20.4% for women aged 20 to 29 years, 50.3% for women aged 30 to 39 years, 77.2% for women aged 40 to 49 years, and 74.6% for women aged 50 to 59 years, suggesting a plateau in prevalence in the decade after menopause. Clinically significant POP was found in 3.6% of nulliparous, 6.5% of primiparous, 22.7% of secondiparous, 32.9% of triparous, and 46.8% of tetraparous women. Increasing age, increasing vaginal parity, and a body mass index higher than 24 kg/m were found to be significant risk factors for POP, with relative risks of 1.09 (P < 0.001), 2.31 (P < 0.0001), and 1.62 (P = 0.048) respectively. Combined clinical symptoms of pelvic heaviness, urinary disturbances, and a feeling of bulge in the vagina were predictive of POP.
  
  
  CONCLUSIONS
  Our findings suggest that cost-efficient interventions to reduce the burden of POP in this and similar remote communities include the following: family planning awareness campaigns focusing on the risks of grand multiparity; nutritional education and weight management programs to help reduce the progression of POP before the age of menopause; and consideration of symptom-based screening to identify affected women who might benefit from a referral to specialty care at a tertiary care center.
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon. jawwad@aub.edu.lb
authors.forename: Johnny
authors.initials: J
authors.lastname: Awwad
authors.forename: Raja
authors.initials: R
authors.lastname: Sayegh
authors.forename: Joumana
authors.initials: J
authors.lastname: Yeretzian
authors.forename: Mary E
authors.initials: ME
authors.lastname: Deeb
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight; D005193:Family Planning Services; D005260:Female; D006266:Health Education; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D010298:Parity; D056887:Pelvic Organ Prolapse / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D011247:Pregnancy; D012307:Risk Factors; D012424:Rural Population