The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study
Introduction and hypothesis Vaginal bulging is considered the key symptom for genital organ prolapse. The aim was to investigate the age-related prevalence and frequency of symptomatic pelvic organ prolapse (sPOP) and other pelvic floor symptoms in nonpregnant nullipara aged 25–64 years. Methods Thi...
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| Veröffentlicht in: | International Urogynecology Journal 2019-04, Vol.30 (4), p.639-647 |
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| creator | Gyhagen, Maria Al-Mukhtar Othman, Jwan Åkervall, Sigvard Nilsson, Ida Milsom, Ian |
| description | Introduction and hypothesis
Vaginal bulging is considered the key symptom for genital organ prolapse. The aim was to investigate the age-related prevalence and frequency of symptomatic pelvic organ prolapse (sPOP) and other pelvic floor symptoms in nonpregnant nullipara aged 25–64 years.
Methods
This national postal and web-based questionnaire survey was conducted in 2014 and included four independent random samples of women aged 25–34, 35–44, 45–54, and 55–64 years. The association of sPOP with demographics and with other pelvic floor conditions and with clustering to other pelvic floor conditions, was presented in women with and without sPOP. Logistic regression was used to identify and rank variables associated with symptomatic prolapse.
Results
The response rate was 52% (
n
= 10,187) and 726 nullipara confirmed sPOP. Women with sPOP were younger (
p
|
| doi_str_mv | 10.1007/s00192-018-3684-5 |
| format | Article |
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Vaginal bulging is considered the key symptom for genital organ prolapse. The aim was to investigate the age-related prevalence and frequency of symptomatic pelvic organ prolapse (sPOP) and other pelvic floor symptoms in nonpregnant nullipara aged 25–64 years.
Methods
This national postal and web-based questionnaire survey was conducted in 2014 and included four independent random samples of women aged 25–34, 35–44, 45–54, and 55–64 years. The association of sPOP with demographics and with other pelvic floor conditions and with clustering to other pelvic floor conditions, was presented in women with and without sPOP. Logistic regression was used to identify and rank variables associated with symptomatic prolapse.
Results
The response rate was 52% (
n
= 10,187) and 726 nullipara confirmed sPOP. Women with sPOP were younger (
p
< 0.001), shorter (
p
< 0.001), and more often overweight and obese (
p
< 0.01) compared with asymptomatic women. Previous surgery for prolapse was reported by 15 women only (0.16%). Symptomatic POP decreased from 9.8% in the youngest age group (25–34 years) to 6.1% in the oldest (55–64 years) (
p
< 0.0001). Symptomatic POP was more often experienced as bothersome (
p
= 0.012), and aggravated by straining and heavy lifting (
p
= 0.003), in older women. Vaginal/vulval chafing/rubbing feeling was most prevalent among the youngest 14.2%, decreasing to 7.8% among the oldest (<0.0001). This symptom occurred three to five times more often in those with sPOP (
p
< 0.0001). Clustering of pelvic floor symptoms was four times more prevalent in women with sPOP (23.2% versus 6.1%) (
p
< 0.0001).
Conclusions
The high prevalence of sPOP in this study was contradictory to most earlier reports, which have shown that genital prolapse is rare in nullipara. The explanation of our results may be the low probability of the clinical condition, the dominance of weak and infrequent symptoms, and not least clustering of alternative conditions mimicking sPOP.]]></description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-018-3684-5</identifier><identifier>PMID: 29934770</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Age ; Age Factors ; Asymptomatic Diseases - epidemiology ; Body Height ; Childbirth & labor ; Cohort analysis ; Epidemiology ; Female ; Gynecology ; Health risk assessment ; Humans ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity - epidemiology ; Obstetrics ; Original ; Original Article ; Parity ; Pelvic organ prolapse ; Pelvic Organ Prolapse - complications ; Pelvic Organ Prolapse - epidemiology ; Population ; Prevalence ; Studies ; Sweden - epidemiology ; Symptom Assessment ; Urinary incontinence ; Urology ; Vagina - pathology ; Womens health</subject><ispartof>International Urogynecology Journal, 2019-04, Vol.30 (4), p.639-647</ispartof><rights>The Author(s) 2018</rights><rights>International Urogynecology Journal is a copyright of Springer, (2018). All Rights Reserved. © 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3855-90a3e05f0317dcf92f0ba2e9b810bbd3fb19950b0bee3a9c50c77ce6cbdf96f03</citedby><cites>FETCH-LOGICAL-c3855-90a3e05f0317dcf92f0ba2e9b810bbd3fb19950b0bee3a9c50c77ce6cbdf96f03</cites><orcidid>0000-0001-7355-8644</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-018-3684-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-018-3684-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29934770$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gyhagen, Maria</creatorcontrib><creatorcontrib>Al-Mukhtar Othman, Jwan</creatorcontrib><creatorcontrib>Åkervall, Sigvard</creatorcontrib><creatorcontrib>Nilsson, Ida</creatorcontrib><creatorcontrib>Milsom, Ian</creatorcontrib><title>The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description><![CDATA[Introduction and hypothesis
Vaginal bulging is considered the key symptom for genital organ prolapse. The aim was to investigate the age-related prevalence and frequency of symptomatic pelvic organ prolapse (sPOP) and other pelvic floor symptoms in nonpregnant nullipara aged 25–64 years.
Methods
This national postal and web-based questionnaire survey was conducted in 2014 and included four independent random samples of women aged 25–34, 35–44, 45–54, and 55–64 years. The association of sPOP with demographics and with other pelvic floor conditions and with clustering to other pelvic floor conditions, was presented in women with and without sPOP. Logistic regression was used to identify and rank variables associated with symptomatic prolapse.
Results
The response rate was 52% (
n
= 10,187) and 726 nullipara confirmed sPOP. Women with sPOP were younger (
p
< 0.001), shorter (
p
< 0.001), and more often overweight and obese (
p
< 0.01) compared with asymptomatic women. Previous surgery for prolapse was reported by 15 women only (0.16%). Symptomatic POP decreased from 9.8% in the youngest age group (25–34 years) to 6.1% in the oldest (55–64 years) (
p
< 0.0001). Symptomatic POP was more often experienced as bothersome (
p
= 0.012), and aggravated by straining and heavy lifting (
p
= 0.003), in older women. Vaginal/vulval chafing/rubbing feeling was most prevalent among the youngest 14.2%, decreasing to 7.8% among the oldest (<0.0001). This symptom occurred three to five times more often in those with sPOP (
p
< 0.0001). Clustering of pelvic floor symptoms was four times more prevalent in women with sPOP (23.2% versus 6.1%) (
p
< 0.0001).
Conclusions
The high prevalence of sPOP in this study was contradictory to most earlier reports, which have shown that genital prolapse is rare in nullipara. The explanation of our results may be the low probability of the clinical condition, the dominance of weak and infrequent symptoms, and not least clustering of alternative conditions mimicking sPOP.]]></description><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Asymptomatic Diseases - epidemiology</subject><subject>Body Height</subject><subject>Childbirth & labor</subject><subject>Cohort analysis</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gynecology</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity - epidemiology</subject><subject>Obstetrics</subject><subject>Original</subject><subject>Original Article</subject><subject>Parity</subject><subject>Pelvic organ prolapse</subject><subject>Pelvic Organ Prolapse - complications</subject><subject>Pelvic Organ Prolapse - epidemiology</subject><subject>Population</subject><subject>Prevalence</subject><subject>Studies</subject><subject>Sweden - epidemiology</subject><subject>Symptom Assessment</subject><subject>Urinary incontinence</subject><subject>Urology</subject><subject>Vagina - pathology</subject><subject>Womens health</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1u1TAUhS1ERR8tC2CCLDHpJPT6L4kZIKEKWqRKnZSxaztOXqrEfthJ0Zt1D2yAtbCUrqR-Slt-JEbX0v3OuT46CL0m8I4AVMcJgEhaAKkLVta8EM_QinDGCgaUPUcrkKwqGC_pPnqZ0jUAcBDwAu1TKRmvKlihq8u1w2k7bqYw4tDiG931Xg_YzEN-dLj32M_D0G90DHPC38PoPNadazAVd7c_Sv7r59bpmN5jjb2e-rAT27AOccJpmpvtIdpr9ZDcq4d5gL5-_nR5clacX5x-Ofl4XlhWC1FI0MyBaIGRqrGtpC0YTZ00NQFjGtYaIqUAA8Y5pqUVYKvKutKappVllh2gD4vvZjaja6zzU9SD2sR-1HGrgu7V3xvfr1UXblTJBQFKs8HRg0EM32aXJjX2ybph0N7l6IqCqAVwWZOMvv0HvQ5zzMkXioDktMoUWSgbQ0rRtU-fIaB2_amlP5X7U7v-lMiaN3-meFI8FpYBugApr3zn4u_T_3e9B_G8qIw</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Gyhagen, Maria</creator><creator>Al-Mukhtar Othman, Jwan</creator><creator>Åkervall, Sigvard</creator><creator>Nilsson, Ida</creator><creator>Milsom, Ian</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7355-8644</orcidid></search><sort><creationdate>201904</creationdate><title>The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study</title><author>Gyhagen, Maria ; Al-Mukhtar Othman, Jwan ; Åkervall, Sigvard ; Nilsson, Ida ; Milsom, Ian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3855-90a3e05f0317dcf92f0ba2e9b810bbd3fb19950b0bee3a9c50c77ce6cbdf96f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Asymptomatic Diseases - epidemiology</topic><topic>Body Height</topic><topic>Childbirth & labor</topic><topic>Cohort analysis</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gynecology</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity - epidemiology</topic><topic>Obstetrics</topic><topic>Original</topic><topic>Original Article</topic><topic>Parity</topic><topic>Pelvic organ prolapse</topic><topic>Pelvic Organ Prolapse - complications</topic><topic>Pelvic Organ Prolapse - epidemiology</topic><topic>Population</topic><topic>Prevalence</topic><topic>Studies</topic><topic>Sweden - epidemiology</topic><topic>Symptom Assessment</topic><topic>Urinary incontinence</topic><topic>Urology</topic><topic>Vagina - pathology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gyhagen, Maria</creatorcontrib><creatorcontrib>Al-Mukhtar Othman, Jwan</creatorcontrib><creatorcontrib>Åkervall, Sigvard</creatorcontrib><creatorcontrib>Nilsson, Ida</creatorcontrib><creatorcontrib>Milsom, Ian</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gyhagen, Maria</au><au>Al-Mukhtar Othman, Jwan</au><au>Åkervall, Sigvard</au><au>Nilsson, Ida</au><au>Milsom, Ian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2019-04</date><risdate>2019</risdate><volume>30</volume><issue>4</issue><spage>639</spage><epage>647</epage><pages>639-647</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract><![CDATA[Introduction and hypothesis
Vaginal bulging is considered the key symptom for genital organ prolapse. The aim was to investigate the age-related prevalence and frequency of symptomatic pelvic organ prolapse (sPOP) and other pelvic floor symptoms in nonpregnant nullipara aged 25–64 years.
Methods
This national postal and web-based questionnaire survey was conducted in 2014 and included four independent random samples of women aged 25–34, 35–44, 45–54, and 55–64 years. The association of sPOP with demographics and with other pelvic floor conditions and with clustering to other pelvic floor conditions, was presented in women with and without sPOP. Logistic regression was used to identify and rank variables associated with symptomatic prolapse.
Results
The response rate was 52% (
n
= 10,187) and 726 nullipara confirmed sPOP. Women with sPOP were younger (
p
< 0.001), shorter (
p
< 0.001), and more often overweight and obese (
p
< 0.01) compared with asymptomatic women. Previous surgery for prolapse was reported by 15 women only (0.16%). Symptomatic POP decreased from 9.8% in the youngest age group (25–34 years) to 6.1% in the oldest (55–64 years) (
p
< 0.0001). Symptomatic POP was more often experienced as bothersome (
p
= 0.012), and aggravated by straining and heavy lifting (
p
= 0.003), in older women. Vaginal/vulval chafing/rubbing feeling was most prevalent among the youngest 14.2%, decreasing to 7.8% among the oldest (<0.0001). This symptom occurred three to five times more often in those with sPOP (
p
< 0.0001). Clustering of pelvic floor symptoms was four times more prevalent in women with sPOP (23.2% versus 6.1%) (
p
< 0.0001).
Conclusions
The high prevalence of sPOP in this study was contradictory to most earlier reports, which have shown that genital prolapse is rare in nullipara. The explanation of our results may be the low probability of the clinical condition, the dominance of weak and infrequent symptoms, and not least clustering of alternative conditions mimicking sPOP.]]></abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>29934770</pmid><doi>10.1007/s00192-018-3684-5</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-7355-8644</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | International Urogynecology Journal, 2019-04, Vol.30 (4), p.639-647 |
| issn | 0937-3462 1433-3023 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6451022 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Age Age Factors Asymptomatic Diseases - epidemiology Body Height Childbirth & labor Cohort analysis Epidemiology Female Gynecology Health risk assessment Humans Medicine Medicine & Public Health Middle Aged Obesity - epidemiology Obstetrics Original Original Article Parity Pelvic organ prolapse Pelvic Organ Prolapse - complications Pelvic Organ Prolapse - epidemiology Population Prevalence Studies Sweden - epidemiology Symptom Assessment Urinary incontinence Urology Vagina - pathology Womens health |
| title | The symptom of vaginal bulging in nulliparous women aged 25–64 years: a national cohort study |
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