Risk Factors & Outcome of Operative Procedures of Genital Prolapse in Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh
Authors: Siddika Ayesha , Akter Taslima , Akter Mosst. Khadiga , Akhter Sabina , Mariana Nafisa Anwar , Akther Nasima 
Published: October 2022

Background: Genital prolapse is a very common gynaecological disorder in Bangladesh but women do not admit this problem due to shame, ignorance, social taboo and insolvency. The rural scenario is much more disastrous. Objective: To determine the risk factors & outcome of operative procedures of genital prolapse. Material & Methods: It was a cross sectional study. The research work had been carried out from July, 2019 to December, 2019 in the department of Obstetrics and Gynaecology at Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur. Hospital women patients had been caring with genital prolapse were considered in this study and asked for proper history. Data was collected by using pre-design questionnaire. All the patients included in the study were evaluated by detailed history, through physical examination and relevant laboratory investigations. The maximum extend of the prolapse was clinically measured during a valsalva maneuver or coughing and was confirmed by the patient as being the most severe protrusion. Written informed consent to participate in this study was taken. Result: The mean age was found 59±5.4 years with range from 50 to 70 years. Educational status of the patients, 85(85%) patients were illiterate & marital status more than half 52 (52%) Patients were living with husband and 47 (47%) patients were widow. Regarding occupational status, Three forth 72 (72%) Patients were housewives, 18(18%) were day laborer and 10 (10%) were worker. 23% patients were underweight, 67% patients had average body weight and 10 % were obese. Primi para were found 2(2%) multipara were 53 (53%) and grand multi para were 45 (45%). Number of living child of the patients. 1-2 child were found 10(10%) patients, 3-4 child were 48 (48%) and ≥5 child were 42 (42%) patients. History of abdominal surgery was found in 6(6%) patients, vaginal delivery was found in 100 (100%) Patients, home delivery was in 90 (90%), majority 44(44%) patients had prolong labour during delivery and 2% had instrumental delivery. 60% patients did heavy work during puerperium, 32% did moderate work and only 8% did light work. 31% patients were engaged in heavy physical activities, 20% suffered from chronic cough and 15 % suffered from chronic constipation. 85% patients were delivered by untrained birth attendant. 100(100%) patients had felling of something coming down, 20(20%) had retention of urine, 92(92%) had frequency of micturition, 51(51%) had backache, 53(53%) had difficulty in emptying bladder, 41(41%) had burning during micturition, 45(45%) had constipation, 38(38%) had stress incontinence, 25(25%) had dragging pain in lower abdomen, 22 (22.0%) had white discharge and 5 (5%) had irreducible prolapse. 80(80%) patients had 2nd degree of uterine prolapses, 15(15%) patients had 1st degree & only 5(5%) patients had 3rd degree of uterine prolapses. 90 (90%) patients had moderate cystocele, 69(69%) patients had moderate rectocele, 27(27%) patients had urethrocele, 36(36%) had decubitus ulcer, 40(40%) had stress incontinence and 17 (17%) had elongation of cervix. management of the study population by vaginal hysterectomy with anterior colporrhaphy and posterior colpoperineorrhaphy 70(70%), anterior colporrhaphy 15(15%), posterior colpoperineorrhaphy 5(5%), pelvic floor repair 10(10%).20(20%) had pyrexia, 5(5%) had hemorrhage, 15(15%) had urinary infection, 4 (4%) had local sepsis and 3(3%) had urinary retention. complete relief was found 93(93%) and 7 (7%) had partial relief. Conclusion: Genital Prolapse has a very high prevelance in multiparous women. There is a significant association between genital prolapse, history of collagen disease and childbirth-related pelvic floor trauma. Pyrexia and urinary infection were more common complication after surgical procedures of genital prolapse. Complete relief was found 93.0% of the patients.