Characteristics of Symptomatic Pelvic Organ Prolapse in a Population of Racially and Ethnically Diverse Women
Drs. A. Korn, T. Duong, R. Jackson
San Francisco General Hospital
San Francisco, California

Objective:   To investigate whether symptomatic pelvic organ prolapse (POP) differs in frequency or clinical presentation among African American, Asian, Latina, or White women.
Materials and Methods:   We performed a retrospective study of a convenience sample of women referred for evaluation of POP between 1/1/91 and 6/1/00 in the San Francisco Community Health Network (CHN). We abstracted the details of a structured pelvic examination and demographic information from medical records. We examined association of several variables with the degree of prolapse first in univariate analyses using Fisher’s exact tests for categorical variables and student t-tests for continuous variables. We then performed multivariate logistic regression analyses using age, race, weight, parity and prior hysterectomy in the regression model. Results are presented as odds ratios (OR) for Stage 3 or Stage 4 prolapse and 95% confidence intervals (CI). All statistical calculations were performed with STATA software.
Results:   662 of 42,162 women (1.57%) in the CHN were referred for evaluation of POP over the study period. The self-identified racial/ethnic groups of these women were Latina (321), Asian (130), White (122) and African American (89). Latinas between the ages of 25 and 74, were more frequently referred for POP than were similar age women of any of the other ethnic/racial groups (OR= 2.8, 95% CI: 2.4-3.3, p<.0001). In the multiple logistic regression analyses, age was associated with stage 3 or 4 prolapse of the anterior vaginal wall (OR= 1.03/yr, 95%CI:1.01-1.06, p=.02), vaginal cuff (OR= 1.06/yr, 95%CI:1.01-1.11, p=.03), and posterior vaginal wall (OR=1.04/yr, 95%CI: 1.00-1.08, p=.03).
Conclusions:   Latinas were nearly three times more likely to seek care for symptomatic POP than were women of other ethnic/racial groups. Stage 3 and 4 prolapse was associated with increasing age but not with racial/ethnic group, prior hysterectomy, parity or weight.
Key Words:   Pelvic organ prolapse, race, epidemiology.