title: Determinants of pelvic organ prolapse among the women of the western part of Nepal: a case-control study.
abstract: OBJECTIVE
  This study was carried out in order to identify the determinants of pelvic organ prolapse (POP) among the women of the western part of Nepal.
  
  
  METHODS
  This was a matched case-control study. Cases were defined as women diagnosed with third and fourth degree POP, and the control group consisted of women who were screened and confirmed of not having any degree of POP. Cases (n = 183) and controls (n = 183) were randomly selected and for each case, one control was selected, matched by age and place of residence. A semistructured interview was carried out to obtain the information for both groups. Bivariate analysis along with conditional logistic regression analysis was carried out to identify the association between selected variables with POP.
  
  
  RESULTS
  The results showed the significant association between number of vaginal deliveries, tear of vagina in the last childbirth, sphincter damage in the last childbirth and duration of labor in the last childbirth with POP, after adjusting for educational status of the women, carrying heavy loads, type of usual work and incidence of diarrhea.
  
  
  CONCLUSIONS
  The results suggest that prolonged labor along with vaginal delivery having sphincter and vaginal tear are the determinants of POP and program managers should strongly consider these factors to develop interventions targeting the prevention of POP.
authors.affiliation: Department of Public Health, Nepal Institute of Health Sciences, Kathmandu, Bagmati, Nepal.
authors.forename: Subash
authors.initials: S
authors.lastname: Thapa
authors.forename: Mangesh
authors.initials: M
authors.lastname: Angdembe
authors.forename: Deepak
authors.initials: D
authors.lastname: Chauhan
authors.forename: Ranjila
authors.initials: R
authors.lastname: Joshi
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D009390:Nepal / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D036801:Parturition; D056887:Pelvic Organ Prolapse / Q000453:epidemiology*; D011247:Pregnancy; D012307:Risk Factors; D014621:Vagina / Q000293:injuries
keywords: case-control study; conditional logistic regression; determinants; matching; pelvic organ prolapse