Pelvic organ prolapse and associated factors among women in Tigray region, northern Ethiopia: A penalized logistic regression

Background Pelvic organ prolapse is a gynecological problem of public interest that affects women's physical, socio-economical, and quality of life. Several studies have been conducted to measure the prevalence of pelvic organ prolapse in hospital settings. Objective This study was conducted to determine the burden of pelvic organ prolapse among women from Tigray, Northern Ethiopia communities. Methods A total of 2607 women of reproductive age group were included in the study. A standard questionnaire plus physical examination was carried out to estimate the proportion of women with pelvic organ prolapse. Data were analyzed using STATA version 16 software. Penalized logistic regression was used to describe the factors associated with pelvic organ prolapse as it was suitable in case of a low outcome prevalence and the result was described using Crude and Adjusted odds ratio (COR and AOR). A p-value less than 0.05 was used to declare statistical significance. Results The overall prevalence of pelvic organ prolapse was 1.19% (95% CI: 0.83%-1.68%). A high number of pelvic organ prolapse was observed among women who were married early before 18 years (p-value=0.006), and women who gave birth at home (p-value=0.004). There were 143 women with loss urine while straining, 141 women who suspected themselves of having stool loss out of their control, and 140 women who suspected themselves of having fistula. Out of the nine suspected cases of obstetric fistula and undergoing a physical examination, only three women were confirmed for having obstetric fistula. Overall, the prevalence of obstetric fistula was 0.1% (95% CI: 0.03%, 0.35%) with 3 cases per 2,114 live births, or in other words, it was 1.4 per 1000 live births. Conclusions The provision of labor-saving technologies, the prohibition of early marriage, and regular campaigns with a well-guided strategy for treating pelvic organ prolapse is recommended.