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      A systematic review of clinical studies on hereditary factors in pelvic organ prolapse

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          Abstract

          Introduction and hypothesis

          There is growing evidence that pelvic organ prolapse (POP) is at least partly caused by underlying hereditary risk factors. The aim of our study was to provide a systematic literature review and meta-analysis of clinical studies on family history of POP as a risk factor for POP in individual women.

          Methods

          The databases PubMed and Embase were searched. Clinical studies reporting on family history of POP in relation to POP in individual women were included.

          Results

          Sixteen studies were included, of which eight enabled us to calculate a pooled odds ratio (OR). The pooled OR of POP in case of a positive family history of POP was 2.58 (95 % confidence interval 2.12–3.15).

          Conclusions

          Women with POP are substantially more likely to have family members with the same condition compared to women without POP. This strengthens the hypothesis that genetic predisposition plays an important role in the development of POP.

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          Most cited references46

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          Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects.

          P Woodman, Jeremy Kahn, Jesse S. Swift … (2005)
          The purpose of this study was to describe the distribution of pelvic organ support in a gynecologic clinic population to define the clinical disease state of pelvic organ prolapse and to analyze its epidemiologic condition. This was a multicenter observational study. Subjects who were seen at outpatient gynecology clinics who required an annual gynecologic examination underwent a pelvic organ prolapse quantification examination and completed a prolapse symptom questionnaire. Receiver operator characteristic curves were used to define pelvic organ prolapse with the use of symptoms and pelvic organ prolapse quantification examination measures. Standard age-adjusted univariate and multivariate logistic regression analysis were used to evaluate various relationships. The population consisted of 1004 women who were aged 18 to 83 years. The prevalence of pelvic organ prolapse quantification stages was 24% (stage 0), 38% (stage 1), 35% (stage 2), and 2% (stage 3). The definition of pelvic organ prolapse that was determined by the receiver operator characteristic curve was the leading edge of their vaginal wall that was -0.5 cm above the hymenal remnants. Multivariate analysis revealed age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus as risk factors for pelvic organ prolapse, as defined in this population. The results from this population suggest that there is a bell-shaped distribution of pelvic organ support in a gynecologic clinic population. Advancing age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus have the strongest correlations with prolapse.
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            Epidemiology and natural history of pelvic floor dysfunction.

            P Norton, Richard C. Bump (1998)
            Pelvic floor dysfunction, including urinary incontinence, anal incontinence, and pelvic organ prolapse, is extremely common, affecting at least one-third of adult women. A minority of patients sustaining these conditions volunteer their symptoms. Risk factor identification and the development of tactics for prevention are significant priorities for future research. Understanding both the specific predisposing factors that place an individual woman at risk and the precise events of the labor and delivery process that initiate injury and dysfunction is important for primary prevention. Defining the relative importance of various promoting and decompensating factors is essential for secondary prevention.
            Article 0 comments Cited 86 times – based on 0 reviews     Review now
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              Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors.

              Eva Samuelsson, F.T. Arne Victor, Gösta Tibblin … (1999)
              Our objective was to study the prevalence of genital prolapse and possible related factors in a general population of women 20 to 59 years of age. Of 641 eligible women in a primary health care district, 487 (76%) answered a questionnaire and accepted an invitation to a gynecologic health examination. The prevalence of any degree of prolapse was 30.8%. Only 2% of all women had a prolapse that reached the introitus. In a set of multivariate analyses, age (P <.0001), parity (P <.0001), and pelvic floor muscle strength (P <.01)-and among parous women, the maximum birth weight (P <.01)-were significantly and independently associated with presence of prolapse, whereas the woman's weight and sustained hysterectomy were not. Signs of genital prolapse are frequently found in the female general population but are seldom symptomatic. Of factors associated with genital prolapse found in this study, pelvic floor muscle strength appears to be the only one that could be affected.
              Article 0 comments Cited 72 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                : +31-24-3614726 , +31-24-3668597 , sabrinalince@yahoo.com
                Journal
                Journal ID (nlm-ta): Int Urogynecol J
                Journal ID (iso-abbrev): Int Urogynecol J
                Title: International Urogynecology Journal
                Publisher: Springer-Verlag (London )
                ISSN (Print): 0937-3462
                ISSN (Electronic): 1433-3023
                Publication date (Electronic): 16 March 2012
                Publication date PMC-release: 16 March 2012
                Publication date (Print): October 2012
                Volume: 23
                Issue: 10
                Pages: 1327-1336
                Affiliations
                [1 ]Department of Obstetrics and Gynecology (791), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
                [2 ]Department of Pathology, McGill University, Montreal, QC Canada
                [3 ]Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC Canada
                Article
                Publisher ID: 1704
                DOI: 10.1007/s00192-012-1704-4
                PMC ID: 3448053
                PubMed ID: 22422218
                SO-VID: 65554f2a-7d12-4c0c-bcd9-8f4955cc4c94
                Copyright © © The Author(s) 2012
                History
                Date received : 23 August 2011
                Date accepted : 9 February 2012
                Categories
                Subject: Review Article
                Custom metadata
                issue-copyright-statement © The International Urogynecological Association 2012

                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: family,review,genetics,inheritance,pelvic organ prolapse
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: family, review, genetics, inheritance, pelvic organ prolapse

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