Clinical Presentation and Management Outcome of Uterovaginal Prolapse at a Tertiary Health Facility in Port Harcourt: A Ten-Year Review

Abstract

Uterovaginal prolapse is a major cause of morbidity with negative impact on the quality of life.

Objective: The study was carried out to determine the clinical presentation and management outcome of uterovaginal prolapse. This was a ten-year retrospective study of cases of uterovaginal prolapse managed at the University of Port Harcourt Teaching Hospital. A well designed proforma was used to obtain relevant information from the case files of patients with uterovaginal prolapse. The prevalence of uterovaginal prolapse was 1.3% of all gynaecological admissions. There were 62 cases of uterovaginal prolapse analysed with a mean age of 59.9 ± 10.6 years. Majority (89%) of the patients were post-menopausal and majority were grandmultiparous (81%). The most common presenting symptom was sensation of something coming down from the vagina in 54 (87.1%) cases. The commonest diagnosis at presentation was uterovaginal prolapse with both cystocele and rectocele in 44(71%) patients. The most common risk factor identified was lifting of heavy load in 39(62.9%) cases. Vaginal hysterectomy with pelvic floor repair was carried out in 57(91.9%)while 1(1.6%) patient had Manchester repair and 4 (6.5%)patients were managed conservatively with vaginal pessaries. Intraoperative haemorrhage (30.6%) and post-operative anaemia (60.3%) were the most common complications. Multiparity, lifting of heavy loads, unsupervised deliveries and prolonged labour were significant predisposing factors. Life-style modification, skilled deliveries and limitation of family size may decrease the prevalence of uterovaginal prolapse amongst the studied population.

Key words: Uterovaginal prolapse, management outcome, Port Harcourt