title: Are hypertension and diabetes mellitus risk factors for pelvic organ prolapse?
abstract: OBJECTIVE
  Pelvic organ prolapse (POP) is an important problem for women with multifactorial etiology. This study aims to determine the role of hypertension (HT) and diabetes mellitus (DM) in POP.
  
  
  METHODS
  The study included 586 women admitted to Bulent Ecevit University Hospital between September 2013 and April 2015 for hysterectomy, comprising 186 patients with POP and 400 patients without. The demographic characteristics, age, body mass index (BMI), obstetrical history, type of delivery, associated medical diseases, and benign gynecological diseases were recorded. HT, DM, or both together were particularly considered as coexisting medical diseases.
  
  
  RESULTS
  Median gravida, parity, and live birth numbers were significantly higher in POP patients (4 vs. 3, 3 vs. 2, and 3 vs. 2 respectively, p<0.001). POP patients were more obese than POP-absent patients (p<0.001). Vaginal history of birth increased POP frequency to 25.8% with statistical significance (p<0.001). There was no significant difference between groups regarding coexisting endometritis, endometrial polyp, endometriosis, endometrial hyperplasia (p>0.05). There was a significant difference between groups regarding comorbid diseases (p<0.001). Logistic regression analysis for risk factors of POP revealed age, BMI, vaginal parturition, and co-morbidity with HT+DM together significantly increased POP risk (p<0.05). HT+DM together significantly increased risks with OR of 1.9 (1.1-3.16).
  
  
  CONCLUSIONS
  In addition to multiple factors increasing POP risk, comorbidities as HT+DM together should be considered as risk factors. Patients with these comorbidities should be encouraged to change their lifestyles to prevent POP.
authors.affiliation: Bulent Ecevit University School of Medicine, Department of Obstetrics and Gynecology, Zonguldak, Turkey. Electronic address: k.hgonbe@gmail.com.
authors.forename: Hatice
authors.initials: H
authors.lastname: Isık
authors.affiliation: Bulent Ecevit University School of Medicine, Department of Obstetrics and Gynecology, Zonguldak, Turkey.
authors.forename: Oner
authors.initials: O
authors.lastname: Aynıoglu
authors.affiliation: Bulent Ecevit University School of Medicine, Department of Obstetrics and Gynecology, Zonguldak, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sahbaz
authors.affiliation: Mevlana University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: Refika
authors.initials: R
authors.lastname: Selimoglu
authors.affiliation: Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Timur
authors.affiliation: Bulent Ecevit University School of Medicine, Department of Obstetrics and Gynecology, Zonguldak, Turkey.
authors.forename: Muge
authors.initials: M
authors.lastname: Harma
mesh_terms: D000367:Age Factors; D016022:Case-Control Studies; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004714:Endometrial Hyperplasia / Q000453:epidemiology; D004715:Endometriosis / Q000453:epidemiology; D004716:Endometritis / Q000453:epidemiology; D005260:Female; D020073:Gravidity; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007044:Hysterectomy; D007889:Leiomyoma / Q000453:epidemiology; D050498:Live Birth / Q000453:epidemiology*; D016015:Logistic Models; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D010298:Parity; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000601:surgery; D011127:Polyps / Q000453:epidemiology; D017584:Reproductive History; D012189:Retrospective Studies; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000453:epidemiology
keywords: Diabetes mellitus; Hypertension; Pelvic organ prolapse; Risk factor