Pelvic organ prolapse and Japanese lifestyle: prevalence and risk factors in Japan

Introduction and hypothesis Little is known about the prevalence of pelvic organ prolapse (POP). We aimed to evaluate the prevalence of POP and identify its risk factors in Japan. Methods This was a single-centre, cross-sectional study. We recruited Japanese women seen for a Pap smear from July 2018 through May 2019. After providing their informed consent, subjects were asked to complete questionnaires. Pelvic organ support was assessed using the POP quantification (POP-Q) system by an examiner. Logistic regression analyses were conducted to identify risk factors for POP. Results There were 1032 women aged 21 to 84 years. The distribution of POP-Q stage was stage 0, 38.0%; stage I, 45.0%; stage II, 16.4%; stage III, 0.6%; and stage IV, 0%. Rates (95% confidence interval [CI]) of stage II or greater in each age group were 6.6% (2.4-10.8) in 20 s-30 s; 17.6% (13.3-21.9) in 40 s; 17.1% (12.9-21.3) in 50 s; 18.0% (12.6-23.4) in 60 s; and 28.7% (19.6-37.9) in 70 s and over. Multivariate analysis revealed the following risk factors for POP, with odds ratio (95% CI): body mass index [BMI] >= 25 kg/m(2), 1.63 (1.05-2.51); BMI < 18.5 kg/m(2), 0.40 (0.17-0.94); hysterectomy, 4.09 (1.55-10.80); >= 3 vaginal deliveries, 2.26 (1.19-4.28); and >= 1 cup of coffee per day, 0.63 (0.43-0.92). Conclusion Among Japanese women undergoing routine gynaecological examinations, 17.1% (14.7-19.5) had POP-Q stage II or greater. Overweight, hysterectomy and >= 3 vaginal deliveries increased the risk for POP, whereas underweight and daily coffee consumption decreased it.