Uterine prolapse (UP), known as pelvic organ prolapse (POP) and genital prolapse; dropping of uterus from its anatomical confines to positions within or outside the vaginal introitus, occurs weakened pelvic muscles no longer support the appropriate positioning of pelvic organs, vagina and uterus in particular accompanied by different prolapse symptoms like heaviness or something coming down, and other sexual, urinary, and bowel [1].
UP is most common gynecological health problems contributing to maternal morbidity and mortality among women of reproductive age in developing countries; lead to severe degrees of physical disability; for instance, inability to work, difficulties in walking or standing up, difficulties in urinating or defecating, painful intercourse, increased social stigma, and economic deprivation also affects physical and mental health of women, and can be fatal if left untreated[1, 2, 4].
The worldwide prevalence of UP has been reported to be around 9%. However, in developing countries, it is estimated to be nearly 20%. The developing countries studies report an astounding variation in the prevalence of POP (3.4-56.4%)[6].
Prevalence based on symptoms is 3-6% and up to 50% when defined by vaginal examination[7]. The global estimate shows that 30% of all women who have delivered a child are affected by UP[8]. The severity of uterine prolapse is determined based on its degree; first degree when the uterine cervix protrudes into the lower third of the vagina, second degree when the cervix protrudes past the vaginal opening and the third degree(severe) when the entire uterus protrudes outside the vaginal opening[9].
The burden of UP in low-income countries is expected to be worse than that of developed countries given the low level of awareness of women in developing countries. [10-12].
Major risk factors associated with UP are adolescent pregnancy, lack of rest during and immediately after pregnancy, carrying heavy loads, delivery by unskilled birth attendants, poor nutrition, frequent pregnancies and pregnancies close together due to prolonged and obstructed labor as well as weakening of pelvic organ muscles as a result of aging or other medical problems [4] [5].
The treatment of UP depends on the severity of the prolapse, the woman's general health, age and desire to have children. First and second degree prolapse usually treated using ring pessaries which is inserted into the vagina in order to stretch the vaginal walls, often used in combination with pelvic floor exercises. The prolapse above second degree is often treated by surgery[9].
Uterine Prolapse is an important but one of the most neglected public health problems in developing countries including Ethiopia and less has been documented regarding the prevalence of UP[3, 9].
In Ethiopia, almost no population-based studies have been performed on UP. However, reports from hospitals suggest a high burden of POP among women at gynecological outpatient clinics and wards. [5, 6].
There is paucity of locally generated evidence on the magnitude and associated factors among women regarding UP to design appropriate prevention strategies[3, 13],
Women who are suffering from UP experience a protruding mass inside or outside vigina, accompanied by difficulty in sitting, standing up, walking, and lifting. In developing countries, this may affect women’s social acceptance and can lead to physical and emotional isolation. Due to stigma in low-income countries, women affected by POP often hide their situation, do not seek help and live with the disease and its complications for long period[11].
Regardless the report from different studies, the actual number of women affected by prolapse is unknown because many women don't seek medical help because of the shame from the condition which affects a sensitive part of the women's body[9].
According to a projection from 2007 national census, in 2019, Ethiopia has nearly 110 million inhabitants. The women in the reproductive age group constitute 23.4%. Thus, nearly 25.5 million Ethiopian women are between 15 and 49 years of age. These women, in one or other ways are affected by the burden of uterine prolapse.
To design appropriate intervention strategies on awareness creation, the prevalence and factors associated with uterine prolapse among women need to be well determined. However, in Ethiopia there is scarcity of research evidence concerning prevalence of, and factors associated with UP[3, 13].
There for aim of this study was assessing prevalence and associated factors with uterine prolapse among women of reproductive age group.