Predictors of advanced pelvic organ prolapse in Asian women.

OBJECTIVE: To investigate risk factors for advanced pelvic organ prolapse (POP) in Asian women. STUDY DESIGN: This was a case-control study of Asian women referred for POP or incontinence over a 10-year period at San Francisco General Hospital. Details of a structured pelvic examination and demographic information were abstracted from medical records. Cases were women with advanced (beyond the hymenal remnant) POP, while patients with a lesser degree of prolapse served as controls. Categorical variables were analyzed using chi2 or Fisher's exact test (where appropriate), while continuous variables were analyzed with Student's t test. Logistic regression was used for multivariate analysis. RESULTS: One hundred thirty Asian women were identified. Sixty-six women had advanced prolapse of some portion of their vagina. Increasing parity was associated with advanced prolapse of the anterior compartment of the vagina (adjusted OR 1.56, 95% CI 1.22-2.00). Previous hysterectomy appears to be protective of advanced prolapse of the anterior vagina (adjusted OR 0.09, 95% CI 0.01-0.81). CONCLUSION: Similar to the Caucasian population, Asian women with higher parity are at increased risk for prolapse of the anterior compartment of the vagina. However, previous hysterectomy appears to be protective of future prolapse in Asian women.