n International Study of the Prevalence and Incidence of Symptoms Associated with Prolapse

Objectives: Our objective was to conduct a descriptive study to assess common symptoms associated with POP (prevalence),

Methods: Patients presenting to three international urogynecology centers with a chief complaint of POP were eligible to complete a questionnaire incorporating nine sets of questions drawn from validated quality of life questionnaires covering genitourinary, gastrointestinal, pelvic pain, back pain, and sexual dysfunction symptoms. Symptoms were reported as present if the participant reported they were “somewhat,” “a moderate amount,” or “a lot” bothered by the symptom. Additionally, participants were queried if the symptom’s onset concurred with the POP and whether they perceived the symptom was worsened by their POP. These additional questions were developed by the study team and were not validated. Basic demographic data was collected and POP-Q exams were then performed.

Results: 205 participants were recruited from three academic centers: 100 from the United States, 46 from the United Kingdom, and 59 from Chile. All subjects had POP as their presenting complaint and a leading edge on POP-Q exam at or beyond 0.

Table 1 summarizes our results. The most common symptoms associated with POP were vaginal bulge and irritative voiding (urinary frequency and urgency). Irritative voiding was noted in almost half of participants, but less than a quarter felt those symptoms were related to their POP. Approximately one third of participants reported urgency or stress incontinence, however, less than a quarter of participants felt their incontinence was associated with onset of prolapse or worsened by prolapse. Pelvic and low back pain were also reported by over 40% of subjects and more than a third of participants felt their pelvic pain was worsened by prolapse. Only 13% reported their back pain concurrent with the POP and only 20% felt the POP worsened their pin. Gastrointestinal complaints were less frequently reported and infrequently associated with POP. Sexual dysfunction (dyspareunia) was the least common symptom associated with POP.

Conclusions: Vaginal bulge, irritative voiding, and pelvic and low back pain are commonly reported symptoms associated with POP. More than a third of participants perceive that POP worsened their pelvic pain and a quarter their irritative voiding. Understanding how patient perception of common symptoms associated with POP may respond to treatment of POP can help clinicians better counsel patients and manage treatment expectations.