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      Validation of the Pelvic Organ Prolapse Simple Screening Inventory (POPSSI) in a population of Ethiopian women

      research-article
      1 , , 1 , 2
      BMC Women's Health
      BioMed Central
      POP, POPSSI, Ethiopian women

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          Abstract

          Background

          The incidence of Pelvic Organ Prolapse (POP) in the developing world is not known. A nonclinical screening tool for prolapse is needed in the resource poor setting. In this study, we aim to determine the validity of the Pelvic Organ Prolapse Simple Screening Inventory (POPSSI) for detection of POP in a population of women at two academic hospitals in Addis Ababa, Ethiopia.

          Methods

          Women from two teaching hospitals in Addis Ababa, Ethiopia were recruited to complete the POPSSI questionnaire as well as a Pelvic Organ Prolapse Quantification (POP-Q) exam. Descriptive data on exam findings were collected. Questionnaire responses were then correlated to exam findings and data analyzed to determine the validity of this test as a screening tool for prolapse in our patient population.

          Results

          Majority of the women with POP had advanced stage. The sensitivity and specificity of the POPSSI for identifying pelvic organ prolapse in our study patient population was 91.7 and 60.6% respectively.

          Conclusion

          The POPSSI has a high sensitivity for detecting women with POP. “Feeling or seeing bulge” had a higher sensitivity and specificity.

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          Most cited references7

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          Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery.

          To estimate the lifetime risk of stress urinary incontinence (SUI) surgery, pelvic organ prolapse (POP) surgery, or both using current, population-based surgical rates from 2007 to 2011.
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            Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors.

            Information on the prevalence, risk factors and social consequences of pelvic floor dysfunction (PFD) affecting women in 16 low-income and lower middle-income countries is reviewed. Medline searches were performed for articles dealing with prevalence of PFD. Thirty studies were identified. The mean prevalence for pelvic organ prolapse was 19.7% (range 3.4-56.4%), urinary incontinence (UI) was 28.7% (range 5.2-70.8%) and faecal incontinence (FI) was 6.9% (range 5.3-41.0%). Risk factors for PFD are similar to those in more affluent countries particularly increased age and parity, but additionally, PFD is associated with other factors including poor nutrition and heavy work. The social consequences of PFD conditions can be devastating. Pelvic organ prolapse and urinary and faecal incontinence are significant problems in developing countries. Access to health care to manage these conditions is often limited, and women usually have to live with the consequences for the rest of their lives.
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              Depression among women with obstetric fistula, and pelvic organ prolapse in northwest Ethiopia

              Background The prevalence of depression is not well studied among women with pelvic floor disorders. Hence, this study aimed to determine the prevalence of depression and its associated factors among women with pelvic floor disorders. Methods A cross-sectional study was conducted among 306 women with one or more of the advanced pelvic floor disorders who attended at the gynaecologic outpatient clinic of Gondar university referral hospital in the six months data collection period. Women who complained of urinary or faecal incontinence or protruding mass per vagina were assessed and staged accordingly. Eligible women i.e. those with advanced pelvic organ prolapse or obstetric fistula were included consecutively. A structured questionnaire was used to obtain socio-demographic data and medical histories for all consenting women. Interviews were done by a female midwife nurse. Depression measures were obtained using the Beck’s Depression Inventory (BDI) tool administered by the midwife nurse after intensive training. Data were entered into a computer using Epi Info version 3. 5.3, and then exported to SPSS version 20 for analysis. Multiple logistic regressions were fitted and Odds ratios with 95% confidence intervals were calculated to identify associated factors. Results Of the 306 women interviewed, 269 had advanced pelvic organ prolapse (stages 3 and 4), 37 had obstetric fistula. All four women (100%) with both faecal and urinary incontinence, 97.0% those with urinary incontinence due to obstetric fistula and 67.7% of those with advanced pelvic organ prolapse (stages 3 and 4) had symptoms of depression. Depression was significantly associated with age 50 years or older (P < 0.01), marital status (P < 0.05), history of divorce (p < 0.01), self perception of severe problem (P < 0.05), and having stage 3 pelvic organ prolapse (P < 0.01). Conclusion Women with advanced pelvic organ prolapse, and obstetric fistula had high prevalence of depressive symptoms. A holistic management approach, including mental health care is recommended for women having such severe forms of pelvic floor disorders.
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                Author and article information

                Contributors
                davworku@yahoo.com
                yirgug@yahoo.com
                padvolo@emory.com
                Journal
                BMC Womens Health
                BMC Womens Health
                BMC Women's Health
                BioMed Central (London )
                1472-6874
                3 April 2019
                3 April 2019
                2019
                : 19
                : 52
                Affiliations
                [1 ]ISNI 0000 0001 1250 5688, GRID grid.7123.7, Addis Ababa University School of Medicine, ; Addis Ababa, Ethiopia
                [2 ]ISNI 0000 0001 0941 6502, GRID grid.189967.8, Emory university school of medicine, ; Atlanta, USA
                Author information
                http://orcid.org/0000-0001-5448-7078
                Article
                746
                10.1186/s12905-019-0746-x
                6448209
                30943950
                f821c5e3-c8bf-48ae-886b-968488c54b11
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 2 December 2017
                : 21 March 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Obstetrics & Gynecology
                pop,popssi,ethiopian women
                Obstetrics & Gynecology
                pop, popssi, ethiopian women

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