Hypothesis / aims of study
Although there are known factors associated with pelvic organ prolapse (POP), it is uncertain if patients in Ghana diagnosed with POP have similar characteristics, due to the dearth of data on the incidence and factors associated with pelvic organ prolapse (POP) in Ghana. This study retrospectively investigated the incidence of Pelvic organ prolapse in the Obstetric and Gynecology unit of a municipal hospital between January 2023 and December, 2024
Study design, materials and methods
Electronic health records of the Obstetrics and Gynecology unit were searched to investigate the incidence of pelvic organ prolapse among patients who visited a government hospital from January 2023 to December 2024. A data extraction tool was designed to capture patient demographics, health profile, and treatment received. Descriptive statistics were used to present results on patient demographics, the incidence of POP, the health profile of patients, and the treatment prescribed to patients (Table 1). The chi-square test was used to determine the association between patient demographics and POP incidence, patient health profile, and POP incidence.
Results
A total of 1,114 new patients visited the obstetrics and gynaecology unit of the hospital from January 2023 to December 2024. In 2023, 469 new patient visits were recorded, while in 2024, 645 new patient visits were recorded. The mean age of patients was 43.78±12.813 years. The majority of patients (n=21, 33.3%) were within the 40–49 years group. Most participants were married (n=45, 71.4%), self-employed (n=49, 77.8%), and had attained primary education (n=28, 44%).
A total of 63 patients (5.66%) were diagnosed with POP within the period under review. In 2023, 30 (6.40%) out of the 469 cases were diagnosed with POP, while in 2024, 33 (5.12%) out of the 645 cases were diagnosed with POP.
Spontaneous vaginal delivery (SVD) was the most (n=46, 73.0%) recorded mode of child delivery, while 16(25.4%) underwent both caesarean section and SVD. More than half of the patients (n=34, 54.0%) had had 4-6 deliveries, and 27 (42.9%) had 1-3 deliveries (Table 1).
There was a statistically significant association between age and POP, Marital status and POP, and number of deliveries and POP (Table 2). The most common treatment prescribed for patients was physiotherapy (n=38, 60.3%), whereas both physiotherapy and surgery were prescribed to 13 (20.6%) patients.
Interpretation of results
The recorded pelvic organ prolapse incidence rate is quite high in our setting, despite the socio-cultural barriers that hinder the reporting of this condition. Women in their 3rd and 4th decades of life, which are the reproductive years, had the highest incidence. This indicates there might be more middle-aged women living with pelvic organ prolapse. Age, parity, and marital status were factors that were associated with the incidence of POP. Although, mode of delivery had no significant association with POP, it is worth noting that most of the patients delivered via SVD, which is the most preferred and a known risk factor(1). Physiotherapy, being the most prescribed intervention, indicates the confidence the medical team has in conservative management of POP. Thus, efforts should be put into training and equipping physiotherapists in the accurate conservative management of POP.
Limitations of the study include: incorrect classification of POP, making it difficult to obtain accurate data on the types of POP that were diagnosed. Also, there were challenges in accessing data from previous years due to the transition from manual to electronic record-keeping.