Pelvic organ prolapse (POP) is a prevalent condition affecting women globally, with

significant morbidity implications (Masenga et al., 2018). The weakening of pelvic

floor connective tissue and collagen is a key factor contributing to the
development of POP (Weintraub et al., 2020).
The prevalence of POP varies worldwide, with rates ranging from about 14% in the
general population to almost 68% in the elderly (Spinu et al., 2019). It is
estimated that POP affects about half of women worldwide and becomes more common
with age (Gressler et al., 2021).
Ethnicity has been found to be a risk factor for pelvic floor dysfunction including
POP and urinary incontinence5. Possible anatomical and genetic differences between
women of different racial backgrounds may contribute to the etiology of pelvic
floor dysfunction. A prospective observational study conducted among more than 200
of each East Asian and Caucasian women comparing pelvic organ descent between both
races showed significant differences between East Asian and Caucasian women
presenting with symptoms of POP. Posterior compartment prolapse was more common in
Caucasians while uterine prolapse was more common in East Asians, after controlling
for multiple confounders.
While there is no exact number of POP prevalence rates in Indonesia, a study
conducted among 343 women in Kepulauan Riau found that there were as many as 63.75%
subjects diagnosed with POP and most of the subject diagnosed with POP is more
than 44 years old (27,5%). Another study conducted in Polikinik Uroginekologi RSUPN
Cipto Mangunkusumo found that there were 252 cases of POP in 2016-2018, with a
prevalence of 15.96%. According to a study conducted in Gynecology Outpatient
Clinic Dr. Soetomo General Academic Hospital Surabaya in 2017 involving 82 patients
of uterine prolapse, most of the uterine prolapse patients were older than 65 years
old (45.1%) and multiparous (62.2%). More than half of the patients (61%) have had
more than three vaginal deliveries and have gone through menopause (91.5%).

Various risk factors such as obesity, menopause, and trauma to the levator ani have
been associated with an increased risk of POP (Haylen et al., 2016). Additionally,
studies have shown associations between metabolic syndrome and the severity of POP,
indicating a complex interplay between metabolic health and pelvic floor disorders
(Rogowski et al., 2014; Gava et al., 2018). Vitamin D deficiency has also been
linked to POP in postmenopausal women (Legan et al., 2022).

Masenga G., Shayo B., & Rasch V. Prevalence and risk factors for pelvic organ
prolapse in kilimanjaro, tanzania: a population based study in tanzanian rural
community. Plos One 2018;13(4):e0195910.
Weintraub A., Glinter H., & Marcus-Braun N. Narrative review of the epidemiology,
diagnosis and pathophysiology of pelvic organ prolapse. International Braz J Urol
2020;46(1):5-14.
Spinu D., Bratu O., Bumbu A., Stanescu A., Marcu D., Cherciu A.et al. Renal failure
in pelvic organ prolapse. Revista De Chimie 2019;70(9):3354-3356.
Gressler L., dosReis S., & Chughtai B. Opioid prescribing and risks among
commercially insured women undergoing pelvic organ prolapse repair.
Pharmacoepidemiology and Drug Safety 2021;30(8):993-1002.

Haylen B., Maher C., Barber M., Camargo S., Dandolu V., Digesu A.et al. An
international urogynecological association (iuga) / international continence
society (ics) joint report on the terminology for female pelvic organ prolapse
(pop). Neurourology and Urodynamics 2016;35(2):137-168.
Rogowski A., Bienkowski P., Tarwacki D., Dziech E., Samochowiec J., Jerzak M.et al.
Association between metabolic syndrome and pelvic organ prolapse severity.
International Urogynecology Journal 2014;26(4):563-568.
Gava G., Alvisi S., Mancini I., Seracchioli R., & Meriggiola M. Prevalence of
metabolic syndrome and its components in women with and without pelvic organ
prolapse and its association with prolapse severity according to the pelvic organ
prolapse quantification system. International Urogynecology Journal
2018;30(11):1911-1917.
Legan M., Barbič M., Osredkar J., & Blaganje M. Association of vitamin d deficiency
and pelvic organ prolapse in postmenopausal women: a cross-sectional study. Women S
Midlife Health 2022;8(1).