Uterovaginal prolapse at a University Teaching Hospital in South-East Nigeria

Abstract

Background: Uterovaginal Prolapse is a common gynaecological problem particularly in the grandmultipara. It is of considerable importance to the practising gynaecologist in the tropics because of its strong association with repeated child birth and poor conduct of labour.
Objective: To determine the hospitalprevalence and management pattern of this condition in Imo State University Teaching Hospital, Orlu and the attendant problems associated with the management.
Methodology: This was a retrospective study of all patients presenting with uterovaginal prolapse between 1^st January, 2004 and 31^st December, 2007. There were 1,075 gynaecological admissions during the period and 43 patients had genital prolapse out of which 42 (97.7%) case notes were retrieved from the medical records department. Relevant data were obtained from the case notes, which included age, parity, presenting symptoms, number of living children, types of delivery, types of surgical management and associated operative morbidity and mortality. The data were presented as simple percentages.
Results: The prevalence of uterovaginal prolapse in this study was 39.1 per 1000 gynaecological admissions making it 3.9% of total gynaecological admissions. The mean age of presentation was 51.4± 3.3 years. The mean parity was 4.2± 1.6. Grandmultiparity accounted for 81% of the cases. The most common symptom at presentation was the sensation of a protrusion down the vagina in 32 (76.2%) of the patients. Difficult labour was found to be the most common associated factor in 32 (76.2%) of the patients. The most common form of treatment offered was vaginal hysterectomy with pelvic floor repair, 37 (88.1%).
Conclusion: There is need to educate women on the importance of accessing skilled antenatal, delivery and postnatal services as these might reduce the prevalence of uterovaginal prolapse in our environment.

Keywords: Difficult labour, genital, hysterectomy, multiparity