Study of Incidence and Etiology of Prolapse at Rural Based Teaching Hospital

The International Journal Of Engineering And Science (IJES)
|| Volume || 4 || Issue || 9 || Pages || PP -59-61 || 2015 ||
ISSN (e): 2319 – 1813 ISSN (p): 2319 – 1805
www.theijes.com The IJES Page 59
“Study of Incidence and Etiology of Prolapse at Rural Based
Teaching Hospital.”
Dr. Vidya M. Jadhav1
, Dr. R. D. Shrivastav2
, Dr. Taklikar J M3
Dr. Sanjay S. Patil4
1
Professor, Dept of Obestetrics and Gynaecology Bharatividyapeeth Deemed University Medical
College, Hospital, Sangli, Maharashtra, India
2
Associate Professor, Dept of Obestetrics and Gynaecology Bharatividyapeeth Deemed University
Medical College, Hospital, Sangli, Maharashtra, India
3
Professor and HOD L R P A M C, P. G. Institute, Islampur, Sangli.
4
Associate Professor and HOD L R P A M C, P. G. Institute, Islampur,Sangli.
-------------------------------------------------------ABSTRACT---------------------------------------------------------------
In our country as large number of woman deliver at home, usually conducted by untrained dias,
incidence of prolapse is higher. The etiology of prolapse was discussed by ARETAEUS, a Greek physician who
believed procedentiato be result of weakness of ligaments of the uterus.
There are multiple etiological factors in the developed of prolapse. Diagnosis of prolapse at the
earliest will help to reduce the complications of prolapse as well as continue child bearing function of the young
woman.
Key words: Prolapse, Parity, delivery
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Date of Submission: 05 September 2015 Date of Accepted: 20 September 2015
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I. Introduction
Prolapse or procedencia (from Latin word procidere, to fall) or downward descent of the vagina and the
uterus is one of the leading complaints of the patients attending OPD. Though there is tendency of smaller
family size, now a day in India prolapse remain a common gynecological problem in middle and old age groups.
Various etiological factors lead to development of prolapse. E.g. poor obstetric during delivery, improper
puerperal rehabilitation and manual work irrespective of age and parity.
The obstetrician- gynecologist can understand the cause of prolapse which helps to early diagnosis and
treatment.
Aim and objectives:
1. To study the incidence of genital prolapse at general hospital, Sangli. Period Jan 1997 to Dec 1997.
2. To know the etiology of prolapse.
II. Material and Methods
This study was carried out at general hospital, Sangli, Maharashtraduring the period of Jan 1977 to Dec
1977. Total 66 patients were selected and diagnosed. The delivery and type of delivery assessment was done
according to age parity, degree of prolapse, symptomatology desire to retain further reproductive function or
menstruation. General, local and systemic examinations of patients were done.
Observation and results:
Table No 1:Review of Incidence of prolapse.
Sr.no. Author Incidence in %
1 Satur and Chakravarty1995 19.4
2 KaminiNaik et al 1980 19.8
3 Institute of Obst. And Gynaec, Madras 13.0
4 Govt. Rajaji Hospital, Madurai 11.0
5 Present study 11.0

Study Of Incidence And Etiology Of Prolapse…
Table No 2: Agewise distribution of 66 patients.
Sr.no. Age in years No. of patients %
1 15-25 3 4.54
2 26-36 21 31.82
3 36-45 10 15.15
4 46-55 15 22.72
5 56-65 12 18.18
6 66-above 5 7.57
Age wise distribution: The cases studied were ranging from 15 years to 80 yrs. Maximum number of
patients were from 26-35 yrsi.e. child bearing age group (31.82 % )
Table No 3:Residencewise distribution.
Sr.no. Residence No. of patients %
1 Rural 47 71.21
2 Urban 19 20.79
Maximum numbers of patients were from rural area where home deliveries by untrained dias are
common.
Table No 4: Distribution according to menstrual status.
Sr.no. Menstrual status No. of patients %
1 Premenopausal 34 51.52
2 Postmenopausal 32 48.48
According to menstrual status almost equal distribution observed in registered patients.
Table No 5: Distribution according to place of delivery.
Sr.no. Place of Delivery No. of patients %
1 Home 55 83.33
2 Hospital 11 16.67
Maximum number of patients i.e. 83.33 % had become delivered by untrained person while only
16.67% patients delivered in hospital.
Table No 6: Distribution according to parity.
Sr.no. Parity No. of patients %
1 0 2 3.03
2 0+1 5 7.57
3 0+2 12 18.18
4 0+3 & above 47 71.22
Incidence of prolapse increases in proportion with parity. In present study maximum number of
patients were Para 3 and above. (71.22 %)
Table No 7: Distribution according to degree of prolapse.
Sr.no. Degree of prolapse No. of patients %
1 I 2 3.03
2 II 10 15.15
3 III 52 78.79
4 Procedentia 2 3.03
The maximum number of patients i.e. 78.79% had III uterine prolapse, 15.15% had II, while I uterine
prolapse and procedentia were present in 3.03%.
Table No 8: Distribution according to Vaginal wall prolapse.
Sr.no. Vaginal wall prolapse No. of patients %
1 Urethrocoele - -
2 Cystocoele 65 98.48
3 Rectocoele 25 37.88
4 Enterocoele 24 36.36

Study Of Incidence And Etiology Of Prolapse…
In present study 98.48% patients were having Cystocoele while 37.88 and 36.36 were having
Rectocoele and Enterocoele respectively. None had Urethrocoele.
Table No 9: Distribution according to duration of prolapse.
Sr.no. Duration of prolapse No. of patients %
1 <1 year 17 25.76
2 1-2 year 28 42.42
3 3-5 year 12 18.18
4 >6 year 9 13.64
Maximum number of patients came within 1-2 year of their symptoms.
Table No 10: Paritywise distribution of degree of prolapse.
Sr.no.
Degree of
prolapse
Nullypara
Para 1 Para 2
Para 3 and above
1 I - 1 (1.51) - 1 (1.51)
2 II - - 3(4.54) 7(10.6)
3 III 2(3.03) 4(6.06) 9(13.60) 37(56.00)
4 Procedentia - 1(1.51) - 1(1.51)
Increase in parity leads to increase in degree of prolapse. In present study 56% patients were para 3 and
above showed III0
prolapse.
III. Discussion
1. In present study incidence of prolapse is 11 % of all gynecological admissions.
2. In present study 51.52% patients were premenopausal where injury during child birth was main etiological
factor. While 48.48% patients were postmenopausal, where oestrogen deficiency precipitated development
of prolapse.
3. Thus incidence of prolapse increases as parity increases. In these patients repeated child birth leads to
maximum stretching of supports of uterus and vagina as well as trauma to pelvis supporting tissue.
4. It was observed that degree of prolapse directly proportional to parity.
IV. Conclusion
Incidence of prolapse can be reduced by preventing early marriage and advising proper spacing of
pregnancies.
References:
[1] AH checkA. Diagnosis of enterocoele by negative intrarectaltransilluminationobst.Gynacol.26, 636-639, 1965.
[2] DaniSuhasMost conservative treatment of prolapse – a preliminary communication. J. Obst. Gyn. India 39, 725, 1989.
[3] Hawkins and Bourne, - Shaw’s text book of Gynaecology10th
edition 1991.
[4] Malpas P.Genital prolapse and allied conditions 1st
edition 1995.
[5] Masani K.M.Text book of Gynaecology 7th
edition 1973.
[6] NaikKamini, Ahuja M. Kaduskar N., Gaikwad S.Are the trends in genital prolapse changing J Obes.Gyn. India, 43, 426, 1993.
[7] Parulekar S. V Practical ObstreticsGynaecology 2nd
edition 255-266, 1993.
[8] Ratnam S. S., K. BhaskarRao, S. Arulkumaran. ObstreticsGynaecology for postgraduates.Vol 2 for 1st
edition 437, 1994.
[9] Shirodkar V. N. The problem of prolapse contribution to ObsGynaec Living stone, London, P-22, 1960.
[10] The OdoreCianfrani, A short history of Obst. Gyn. 1st
ed.

Study of Incidence and Etiology of Prolapse at Rural Based Teaching Hospital

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