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Pelvic organ prolapse: Don't forget developing countries [letter]

Author: 
Gunasekera P; Sazaki J; Walker G
Source: 
Lancet. 2007 May 26; 369(9575):1789-1790.
Abstract: 

Although pelvic organ prolapse is a significant problem in affluent countries, the situation in developing countries is far worse. This is mainly a result of high fertility with early marriage and childbearing, many vaginal deliveries, and in certain countries such as Nepal, frequent heavy lifting. In Nepal, fertility until recently was very high and most deliveries take place at home, with only 14% in a health facility and less than 3% by caesarean section. In developing countries, the extent and effects of morbidity associated with pelvic organ prolapse are seldom acknowledged, because of patients' embarrassment. However, studies in Nepal, supported by the United Nations Population Fund (UNFPA), have begun to identify the suffering of women with this disorder. Findings indicate that 10% of women have pelvic organ prolapse, of whom about half require operative management (30.9% with stage II, 12.6% with stage III, and 1.4% with stage IV or procidentia). Women report difficulty in sitting (82%), walking (79%), and lifting (89%), all of which affect their acceptance as full family and community members. The social consequences of prolapse are substantial, and include physical and emotional isolation, abandonment, divorce, ridicule, low self esteem, abuse, lack of economic support, and domestic violence. In Nepal, UNFPA is supporting efforts to identify women with pelvic organ prolapse through reproductive health camps and to contract gynecologists to treat these women at district hospitals. We suggest that more attention should be given to acknowledging the profound consequences of uterine organ prolapse and establishing programmes in developing countries to prevent and manage this frequently severely debilitating condition. (full text)

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Year: 
Region / Country: 
Document Number: 
317189
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