Burden and Clinical Outcomes of Female Pelvic floor and Lower Genital Tract Disorders

Memoona Rehman, Omema Akhtar, Haleema Yasmin, Shigraf Iftikhar, Iqra Jam

Abstract

Objective

To determine the frequency, demographic and clinical profile, as well as clinical outcomes of urogynecological morbidities among women presenting to a tertiary care hospital in Karachi.

Study design

Retrospective cross-sectional study.

Place & Duration of study

Department of Obstetrics and Gynaecology, Ward-08, Jinnah Postgraduate Medical Centre, (JPMC) Karachi, from January 2022 to December 2024.

Methods

Data were extracted from the records of outpatient department, ward admissions and operation theaters. Women presenting with pelvic organ prolapse (POP), urinary incontinence, lower urinary tract symptoms, fistula, and perineal problems were included. Continuous variables were summarized as median (IQR) except age, which was reported as mean ± SD. Chi-square and Fisher’s Exact tests were applied to find out the association between urogynecological conditions and clinical outcomes.

Results

A total of 193 women were included. The mean age of the women was 43.9±13.6 years; median parity was 5 (IQR 3–6), median inter-pregnancy interval was 8-months (IQR 6–12), and median duration of symptoms was 18-months (IQR 16–32). POP was the most common morbidity (n=138 - 71.5%), followed by overactive bladder (n=23 - 11.9%) and stress urinary incontinence (n=15 - 7.8%). POP demonstrated significant associations with abnormal BMI (p=0.017), short inter-pregnancy interval (p=0.001), and chronic constipation (p=0.025). Fistulas were significantly associated with abnormal BMI (p=0.017) and instrumental delivery (p=0.041). A total of 148 (76.7%) women underwent surgical management. A total of 186 (96.4%) women reported improvement.

Conclusion

Urogynecological morbidities were common and often presented at an advanced stage. Modifiable risk factors contribute significantly to disease burden, while appropriate management yielded high improvement rates.

Key words

Urogynaecological morbidities, Pelvic organ prolapse, Vesicovaginal fistula, Overactive bladder, Stress urinary incontinence.