title: Pelvic organ prolapse and stress urinary incontinence, do they share the same risk factors?
abstract: OBJECTIVE
  To determine whether there are differences in the etiologies of two of the most common pelvic floor disorders (PFD), pelvic organ prolapse (POP) and stress urinary incontinence (SUI).
  
  
  METHODS
  This cross-sectional descriptive study included 1042 women, referred to a pelvic floor unit in a tertiary Spanish hospital, between 2008 and 2012. Subjects at their fist visit were interviewed and examined generally and specifically (medical and urogynecological history). Collected parameters included: age, weight, height, medical and surgical background (including in-depth obstetrical and gynecological characteristics). The participants were classified into 3 different groups (POP, SUI, and mixed pathology). Descriptive analyses of each variable and multinomial logistic regression were performed to determine factors associated with POP and SUI.
  
  
  RESULTS
  Patients with POP were older, thinner, with greater parity and their newborns tended to be heavier. Furthermore, forceps, vaginal tears and vaginal surgeries were more common in the POP group. In contrast, family history was an important factor for the development of SUI, with a 6.45-fold increase (95% CI: 3.69-11.24). Two protective factors were identified for POP, cesarean section reduces the risk by 3 fold (OR=0.33) (95% CI: 0.13-0.85) whereas pelvic floor rehabilitation produces a 2 fold reduction (OR=0.49) (95% CI: 0.31-0.76).
  
  
  CONCLUSIONS
  Our data study demonstrates differences in potential triggers and risk factors for POP and SUI. Cesarean section and pelvic floor rehabilitation have a protective effect on preventing the development of POP. Bringing up that a personal medical care and a specific urogynecological follow-up should be developed for those who are more susceptible or at risk of PFD.
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital Sant Joan de Déu, University of Barcelona, Spain. Electronic address: nuromi@gmail.com.
authors.forename: Núria L
authors.initials: NL
authors.lastname: Rodríguez-Mias
authors.affiliation: Department of Obstetrics and Gynaecology, Parc Sanitari Sant Joan de Déu, Sant Boi del Llobregat, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Martínez-Franco
authors.affiliation: Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi del Llobregat, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Aguado
authors.affiliation: Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain.
authors.forename: Emilia
authors.initials: E
authors.lastname: Sánchez
authors.affiliation: Department of Obstetrics and Gynaecology, Hospital Sant Joan de Déu, University of Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Amat-Tardiu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001724:Birth Weight; D001835:Body Weight; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D005113:Extraction, Obstetrical; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D010298:Parity; D059952:Pelvic Floor Disorders / Q000534:rehabilitation; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000209:etiology; D065840:Protective Factors; D012307:Risk Factors; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D014621:Vagina / Q000293:injuries / Q000601:surgery
keywords: Epidemiology; Pelvic floor dysfunction; Pelvic organ prolapse; Risk factor; Urinary incontinence