Clinical features and natural history of pelvic organ prolapse in South Kivu (Eastern DRC): a cross-sectional study.

Abstract

Introduction: pelvic organ prolapse, a common condition, is a real public health problem in developing countries. Its anamnestic and clinical features may present particularities in these environments. The objective of this study was to assess when women present for treatment and the reasons for delay in seeking care. The authors also describe the clinical particularities of prolapse in the East of the Democratic Republic of Congo.

Methods: a cross-sectional study conducted on 217 women with pelvic organ prolapse consulting for the first time. Descriptive statistics and logistic regression were performed to describe clinical features and determinants of delay in seeking care.

Results: the mean age was 46.38±14.12. Women under the age of 41 represents a third of the population or 36.4%. Young people (18-30 years old) represented 16.6%. Mechanical symptoms were the main reasons for consultation (63.1%) followed by sexual disorders (21.2%). Half of the population had a lateral cystocele (50.5%) followed by medio-lateral cystocele (32.1%). The average duration of symptoms was 6.67±6.85 years. The farming profession proved to be a determinant of consultation delays with adjusted Odds ratio « aOR » 3.10, 95% Confidence interval « CI », 1.055-3.481 (aOR: 3.10, 95% CI 1.055-3.481; p=0.017) and urban residence a protective factor (aOR: 0.48, 95% CI 0.24-0.97; p=0.04).

Conclusion: prolapse affects women of all ages but especially a large proportion of young people in genital activity. The clinic of pelvic organ prolapse in our environment can present particularities and the time is long between the first symptoms occurrence and the decision to consult. Delays in consulting are essentially linked to the profession of farmer and the fact of residing in town is a protective factor for late consultations.