Analysis of epidemiological factors for pelvic floor defects in Indian women


  • Maitreyee S. Parulekar Department of Obstetrics and Gynecology, Seth G. S. Medical College and K. E. M. Hospital, Mumbai, Maharashtra, India
  • Shashank V. Parulekar Department of Obstetrics and Gynecology, Seth G. S. Medical College and K. E. M. Hospital, Mumbai, Maharashtra, India



Epidemiology, Pelvic floor defects, Pelvic organ prolapse


Background: Pelvic floor defects is one of the commonest conditions requiring gynecological reference. This study was aimed at evaluation of epidemiology which would help us in having a better understanding regarding the prevalence, risk factors, the natural course and associated complications of the disease in Indian women where the number of women presenting with pelvic floor defects is on a rise but there is a considerable lack of research in literature as compared to the western population.

Methods: It was an observational, non-interventional, prospective type of study including 88 patients over a period of 3 years at the department of obstetrics and gynecology at a tertiary hospital in Mumbai, Maharashtra, India.

Results: The mean age of the patients was 52.38±11.35 years, 54 (61.36%) of the patients were of postmenopausal age group. The mean duration for which the complaints were present were 48±6.73 months. Seventy-six patients (86.83%) presented with complaints of mass per vagina, 22 patients (25%) had history of prolonged labor and 9 patients (10.2%) had history of instrumental delivery. Eighty-six women (97.72%) had history of all vaginal deliveries and only 4 (4.54%) patients had history of a caesarean section. Forty-four patients (55.69%) of patients had grade 3 utero-vaginal descent, 74 patients (84.09%) presented with cystocele and 79 (89.77%) of the patients presented with rectocele.

Conclusions: This paper provides an insight into the factors affecting the prevalence of this disease in Indian women and the unique differences from other populations.


Maldonado PA, Wai CY. Pelvic organ prolapse. new concepts in pelvic floor anatomy. Obstet Gynecol Clin North Am. 2016;43(1):15-26.

Roberts EH. Uterine prolapse. Br Med J. 1932;2(3756):1209.

Dietz HP, Scoti F, Subramaniam N, Friedman T, Shek KL. Impact of subsequent pregnancies on pelvic floor functional anatomy. Int Urogynecol J. 2018;29(10):1517-22.

Ashton-Miller JA, DeLancey JOL. On the biomechanics of vaginal birth and common sequelae. Annu Rev Biomed Eng. 2009;11(1):163-76.

Dietz HP. Prolapse worsens with age, doesn’t it? Aust N Zeal J Obstet Gynaecol. 2008;48(6):587-91.

Vergeldt TFM, Weemhoff M, IntHout J, Kluivers KB. Risk factors for pelvic organ prolapse and its recurrence: a systematic review. Int Urogynecol J. 2015;26(11):1559-73.

AUGS. 26th Annu Sci Meet Am Urogynecologic Soc. 2005;11:1-55.

Carley ME, Schaffer J. Urinary incontinence and pelvic organ prolapse in women with Marfan or Ehlers-Danlos syndrome. Am J Obstet Gynecol. 2000;182(5):1021-3.

Herschorn S. Female pelvic floor anatomy: the pelvic floor, supporting structures, and pelvic organs. Rev Urol. 2004;6(Suppl 5):S2.

Wu JM, Vaughan CP, Goode PS, Redden DT, Burgio KL, Richter HE, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol. 2014;123(1):141-8.

Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, et al. Prevalence of Symptomatic Pelvic Floor. JAMA. 2014;300(11):1311-6.

Rortveit G, Brown JS, Thom DH, Van Den Eeden SK, Creasman JM, Subak LL. Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol. 2007;109(6):1396-403.

Swift SE, Tate SB, Nicholas J. Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol. 2003;189(2):372-7.

Vergeldt TF, Notten KJ, Kluivers KB, Weemhoff M. Recurrence risk is associated with preoperatively advanced prolapse stage: Is there a difference between women with stage 2 and those with stage 3 or 4 cystocele? Int Urogynecol J. 2017;28(7):983-7.

Moalli PA, Talarico LC, Sung VW, Klingensmith WL, Shand SH, Meyn LA, et al. Impact of menopause on collagen subtypes in the arcus tendineous fasciae pelvis. Am J Obstet Gynecol. 2004;190(3)620-7.

Durnea CM, Khashan AS, Kenny LC, Durnea UA, Smyth MM, O’Reilly BA. Prevalence, etiology and risk factors of pelvic organ prolapse in premenopausal primiparous women. Int Urogynecol J Pelvic Floor Dysfunct. 2014;25(11):1463-70.

Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC. Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. Am J Obstet Gynecol. 2000;183(6):1402-11.

Rortveit G, Subak LL, Thom DH, Creasman JM, Vittinghoff E, Van Den Eeden SK, et al. Urinary incontinence, fecal incontinence and pelvic organ prolapse in a population-based, racially diverse cohort: Prevalence and risk factors. Female Pelvic Med Reconstr Surg. 2010;16(5):278-83.

Miedel A, Tegerstedt G, Maehle-Schmidt M, Nyren O, Hammarstrom M. Nonobstetric risk factors for symptomatic pelvic organ prolapse. Obstet Gynecol. 2009;113(5):1089-97.






Original Research Articles