From Anatomy to Emotion: How Pelvic Organ Prolapse Reshapes Women’s Quality of Life

Background: Pelvic organ prolapse (POP) is a multifactorial condition characterized by the descent of pelvic organs from their normal anatomical position, significantly impacting women’s quality of life. In this study, the effects of POP on symptom burden and quality of life were evaluated using the locally validated and reliable Pelvic Floor Distress Inventory-20 (PFDI-20) and Pelvic Floor Impact Questionnaire-7 (PFIQ-7), with the aim of identifying modifiable risk factors. Methods: This study included 1506 women who met the inclusion criteria and were admitted to the obstetrics and gynecology outpatient clinics of two tertiary university hospitals. Patients were classified into prolapse (stage ≥II) and control (stage I) groups based on the Pelvic Organ Prolapse Quantification (POP-Q system). Symptom burden and quality of life were evaluated via the PFDI-20 and PFIQ-7 questionnaires. Results: The median age of the study cohort was 41 (18–70) years, and POP was diagnosed in 510 (33.8%) patients. Compared to women without POP, those with stage ≥II POP had significantly higher total and subscale scores on the PFDI-20 and PFIQ-7 (p < 0.001). According to multivariate logistic regression analysis, the following factors were significantly associated with an increased the risk of developing POP: age (≥35 years) (odds ratio [OR]: 1.18; 95% confidence interval [CI]: 1.161–1.202), body mass index (BMI) ≥25 kg/m2 (OR: 1.47; 95% CI: 1.410–1.552), waist-hip ratio (WHR) ≥0.8 (OR: 3.0; 95% CI: 2.130–4.233), parity ≥2 (OR: 3.38; 95% CI: 2.975–3.841), vaginal delivery (OR: 3.75; 95% CI: 2.859–4.941), comorbidity (OR: 2.97; 95% CI: 2.227–3.970), and menopause (OR: 6.85; 95% CI: 5.409–8.683) (p < 0.001). In contrast, smoking was associated with a significantly lower risk of developing POP (OR: 0.70; 95% CI: 0.531–0.895; p = 0.005). Conclusions: These findings emphasize the importance of early detection through regular gynecological examinations, particularly in high-risk populations, and highlight the need for preventive strategies at the community level to reduce the burden of POP and improve women’s overall quality of life.