Magnitude, Presentation, and Management of Pelvic Organ Prolapse at a Tertiary Referral Hospital in Southwestern Uganda: Retrospective Medical Records Review (2014–2018)

Abstract

Purpose: This study sought to determine the burden, clinical characteristics, and management approaches of pelvic organ prolapse (POP) among women admitted to the gynecology unit at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. Methods: A retrospective review was conducted of medical records for women treated for pelvic floor disorders (PFDs) at the gynecology unit of MRRH between January 2014 and December 2018. The PFDs evaluated included POP, genitourinary fistulas, anosphincter injuries, and other forms of urinary incontinence. For women diagnosed with POP, additional information regarding the type, stage, treatment modality, and postoperative complications was extracted. Descriptive statistics were summarized using frequencies, and comparisons were made using the chi-square test, with statistical significance set at p < 0.05. Results: During the study period, 9,109 women were admitted to the gynecology unit, of whom 674 (7.4%) were diagnosed with PFDs. POP accounted for 210 (31.2%) of these cases, yielding a POP prevalence of 2.3% (95% CI: 2.0-2.61%). Uterine prolapse was the predominant type, observed in 77.1% of cases. The majority of patients (86.2%) presented with advanced disease (stage III or IV), and most (94.2%) received surgical treatment. Early postoperative complications occurred in 7.1% (14/198) of surgically managed patients, with vaginal cuff sepsis being the most frequent complication (5.1%; 10/198). Conclusion: POP represents a significant proportion of gynecological admissions at MRRH and is predominantly treated surgically with a low rate of early postoperative complications. Preventive strategies should be strengthened to reduce the occurrence of POP, and greater emphasis should be placed on promoting less invasive treatment options, including the use of pessaries.