title: Determinants of pelvic organ prolapse among gynecologic patients in Bahir Dar, North West Ethiopia: a case-control study.
abstract: BACKGROUND
  Pelvic organ prolapse (POP) is a significant public health problem in developing countries including Ethiopia. However, less has been documented on risk factors of POP. Therefore, the aim of this study was to identify the determinants factors of POP.
  
  
  METHODS
  An unmatched case-control study was conducted among gynecologic patients in Bahir Dar city, North West Ethiopia, from July to October 2014. A total of 370 women (selected from outpatient departments) were included in the study. Cases (clients with stage III or IV POP) and controls (who declared free of any stages of POP) were identified by physicians using the Pelvic Organ Prolapse Quantitative Examination tool. Data analysis was carried out by SPSS version 20.0. Descriptive, bivariate, and multivariable logistic regression analyses were performed. Statistical differences were considered atP<0.05, and the strength of association was assessed by odds ratio (OR) and respective confidence intervals (CIs).
  
  
  RESULTS
  This study revealed that determinants such as age of women (>40 years) (adjusted OR [AOR] =3.0 [95% CI: 1.59-5.89]), sphincter damage (AOR =8.1 [95% CI: 1.67-39.7]), family history of POP (AOR =4.9 [95% CI: 1.94-12.63]), parity (≥4) (AOR =4.5 [95% CI: 2.26-9.10]), nonattendance of formal education (AOR =4.3 [95% CI: 1.25-14.8]), carrying heavy objects (AOR =3.1 [95% CI: 1.56-6.30]), body mass index (BMI) <18.5 kg/m2(AOR =3.1 [95% CI: 1.22-7.82]), and delivery assisted by nonhealth professionals (AOR =2.6 [95% CI: 1.24-5.56]) were significantly associated with POP.
  
  
  CONCLUSIONS
  In our study, sphincter damage, family history of POP, being uneducated, having ≥4 vaginal deliveries, carrying heavy objects, BMI <18.5 kg/m2, age ≥40 years, and having delivery assisted by nonhealth professional were the independent determinants of POP. Therefore, skilled delivery, further promoting family planning and girls' education, early pelvic floor assessment, and counseling on avoidance of carrying heavy objects are recommended.
authors.affiliation: Hamlin Fistula Center, Amhara National Regional State, Bahir Dar, Ethiopia.
authors.forename: Ayalnesh
authors.initials: A
authors.lastname: Asresie
authors.affiliation: Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Reproductive Health Department, Amhara National Regional State, Bahir Dar, Ethiopia.
authors.forename: Eleni
authors.initials: E
authors.lastname: Admassu
authors.affiliation: Bahir Dar University, College of Medicine and Health Sciences, School of Public Health, Reproductive Health Department, Amhara National Regional State, Bahir Dar, Ethiopia.
authors.forename: Tesfaye
authors.initials: T
authors.lastname: Setegn
keywords: case–control; counseling; determinant; education; pelvic organ; prolapse