Risk Factors for Pelvic Organ Prolapse, a Case-Control Study in a Tertiary Hospital in Iran Publisher



Sharifiaghdas F¹ ; Narouie B^{1, 2} ; Hanafi Bojd H³ ; Dadpour M¹ ; Rostaminejad N¹ ; Motevalli Amini SK¹ ; Torabinavid P⁴ ; Rouientan H¹ ; Momeni H¹ ; Radpour N¹ ; Matin MH¹ ; Saygin S⁵
Source: Urologia Journal Published:2025

Abstract

Background: Pelvic organ descent is a common gynecological disorder called pelvic organ prolapse (POP). Conservative care and surgical repair are women’s primary treatments for pelvic organ prolapse. Modifying risk factors is a crucial keystone to reducing its prevalence. Methods: This unmatched case-control study was conducted at a Tehran referral hospital (June 15 to September 10, 2020) and involved 287 participants (139 cases, 148 controls). Structured questionnaires gathered socio-demographic, obstetric, health, and lifestyle data. Analyses encompassed univariate and multivariate logistic regression. Results: Among cases, 69 (49.6%) had anterior prolapse, 46 (33.1%) had posterior prolapse, and 24 (17.3%) experienced complete prolapse. The mean age of participants with POP was 62.7 ± 10.7 years compared to 44.5 ± 12.7 years for controls. Risk factors significantly associated with POP included higher BMI (28.01 ± 4.7 vs 26.18 ± 4.6; p = 0.002), gravidity (4.49 ± 2.89 vs 2.18 ± 1.63; p < 0.001), vaginal deliveries (3.60 ± 2.07 vs 1.03 ± 1.57; p < 0.001), prolonged labor (12.2% vs 2.7%; OR: 4.91, 95% CI: 1.61–14.99), and comorbidities such as diabetes mellitus (30.2% vs 8.8%; OR: 4.49, 95% CI: 2.29–8.83) and hypertension (34.5% vs 6.8%; OR: 7.28, 95% CI: 3.50–15.12). Protective factors included higher education levels and a history of cesarean delivery (mean cesarean count: 0.31 ± 0.72 vs 0.78 ± 0.88; p < 0.001). Conclusions: This study highlights key risk factors for POP among Iranian women, emphasizing the need for targeted preventive strategies. Public health interventions addressing these factors may reduce the burden of POP in developing regions. © The Author(s) 2025.