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Pelvic Organ Prolapse Symptoms in American Samoan Women

Cohen, Kathleen E., MD*; McGarvey, Stephen T., PhD; Has, Phinnara, MS*; Hampton, Brittany S., MD*

Female Pelvic Medicine & Reconstructive Surgery: November 27, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000673
Original Article: PDF Only

Objectives American Samoa has one of the highest rates of obesity worldwide, making it a population at high risk for pelvic organ prolapse (POP). The primary objective of this study was to describe the presence of POP symptoms and associated degree of bother in American Samoan women. The secondary objective was to determine which characteristics are associated with POP symptoms in this cohort.

Methods We performed a cross-sectional survey of women presenting to the waiting room of the emergency department of the Lyndon B. Johnson Tropical Medical Center in Faga'alu, American Samoa from February to March 2017. Questions included self-described characteristics and the Pelvic Organ Prolapse Distress Inventory 6. Univariate distributions were described and comparisons of social and health characteristics were made between women without POP symptoms and those with at least 1 POP symptom.

Results Two hundred eighty-four women were approached and 225 women completed the survey (79% response rate). The mean (SD) age was 40.5 (14.7), the mean (SD) body mass index was 36.4 (8.7), and the median (range) number of vaginal births was 2 (0–14). A total of 44.2% endorsed at least 1 POP symptom, most commonly pelvic pressure (29.9%) and feeling of incomplete bladder emptying (26.7%). The number of vaginal births was associated with lower abdominal pressure (P = 0.04) and hysterectomy was associated with pelvic heaviness (P = 0.05).

Conclusions This is the first study investigating POP in American Samoa. Almost half of women reported at least 1 pelvic floor symptom, demonstrating the need for further research on pelvic floor disorders within this high-risk population.

From the *Women and Infants' Hospital/Brown University; and

International Health Institute, and Department of Epidemiology, Brown University School of Public Health, Providence RI.

Correspondence: Kathleen Cohen, MD, 50 Biltmore Ave, Providence RI 02908. E-mail:

The authors have declared they have no conflicts of interest.

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