The Clinical Epidemiological Study Of Female Pelvic Organ Prolapse In Ningxia Hui Region

ObjectiveThis study is retrospectively analyzed the clinical features and disease risk factors of pelvic organ prolapse (POP) of female population in Ningxia Hui region, providing the theoretical basis to early diagnosis and timely treatment and prevention of POP for the high-risk group.MethodsThis is a case-control study,329 cases of hospitalization POP patients were randomly selected as case group, at the same time 332 cases of hospitalization non-POP patients as control group, in gynaecology department of Ningxia medical university hospital from January 2006 to January 2012. These factors of two group, such as age, body mass index (BMI), nationality, occupation, first childbirth age, pregnancy time, parity time, delivery way, menopausal status, hormone replacement therapy, familial history, presence of chronic diseases such as hypertension, diabetes, lung disease, constipation, and history of hysterectomy are investigated. Single factor and multi-factor non-conditional Logistic regression analysis calculate odds ratio (OR) values and 95% confidence interval (CI), to identify risk factors for POP-related. Chi-square or t test is used for different ethnic(Hui and Han)comparison analysis of risk factors. At the same, time, the relationship between the factors and the severity of female pelvic organ prolapse is analysed using Mann Whitney or Kruskal-Wallis test. All the data analysis use statistical software SPSS17.0.Results1 Among all the factors, these factors such as patients’ age, occupation, body mass index, familial history, first childbirth age, pregnancy time, parity time, vaginal birth, menopause status, hypertension, diabetes, chronic pneumonosis, constipation, history of hysterectomy are POP risk factors (OR> 1). Ill age, first childbirth age, parity time, vaginal birth, menopause, constipation are the independent risk factors for POP illness.2 Comparing risk factor from Hui to Han Chinese POP patients, ill age, body mass index, first childbirth age, these three factors have significant difference (P< 0.05). Ill age of Hui nationality is less than Han nationality, body mass index is higher than Han nationality, first childbirth age is less than Han nationality.3 Along with increasing of the age, duration of menopause, body mass index, pregnancy time, parity time, severe pelvic organ prolapse patients increased significantly (P< 0.001).Severe pelvic organ prolapse increased significantly for patients whose first childbirth age less than 20 years, patients of labourer, patients with hypertension, diabetes, constipation, and hysterectomy history, compared with patients whose first childbirth age more than 20 years, patients of headworker, patients without hypertension, diabetes, constipation, and hysterectomy history respectively (P<0.001). Severe pelvic organ prolapse increased obviously for patients of vaginal birth, patients without hormone replace treatment than patients of Caesarean birth patients with hormone replace treatment respectively (P<0.05) 。Conclusion1 POP prevalence is associated with pelvic floor tissues atrophy because of menopause and aging and chronic disease, pelvic nerve and muscle damage caused by vaginal delivery and surgery, increased intra-abdominal pressure for a long time.2 Ningxia Hui nationality POP illness associated with early marriage and childbirth and high body mass index.3 The ill age of POP for Ningxia Hui nationality is younger than the Han nationality.4 Avoiding early marriage and early childbearing and multiple vaginal delivery is of great immportance for the prevention of POP of ethnic minorities in Ningxia area. Maintaining a healthy weight, avoiding long-term constipation, is necessary measure to prevent the POP. For the women in the menopausal transition period, a timely appropriate hormone replacement therapy has a positive effect in prevention and treatment of POP. Active prevention and treatment of chronic diseases, such as high blood pressure, diabetes and chronic lung disease is an important way in preventing POP. Avoiding unnecessary hysterectomy is also necessary in preventing POP leading by postoperative pelvic support tissue injury. postpartum pelvic floor rehabilitation training is a good way in preventing and treating POP by repairing the damaged tissue in pelvic floor.