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Pelvic Organ Prolapse in Nulliparous Women and Their Parous Sisters

From the Departments of ¹Obstetrics and Gynecology, ²Urology, and ³Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York; ⁴Department of Urology, University of Utah, Salt Lake City, Utah.

OBJECTIVE: To investigate the role of vaginal delivery and familial factors in the development of pelvic organ prolapse by comparing the prevalence of this condition in nulliparous women and their parous sisters.

METHODS: Pairs of nulliparous and parous postmenopausal sisters were recruited for assessment of pelvic organ prolapse. One hundred one sister pairs underwent clinical evaluation. Pelvic organ prolapse was recorded using the Pelvic Organ Prolapse Quantification System.

RESULTS: The majority of women had no pelvic organ prolapse. By compartment there was a 74.3% to 91.1% concordance in prolapse stage within sister pairs. In discordant sister pairs, the parous sister was found to have the more advanced prolapse 88% of the time.

CONCLUSION: High concordance of pelvic organ prolapse in nulliparous and parous sister pairs suggests a familial predisposition toward developing this condition. However, vaginal delivery does appear to confer a risk for more advanced pelvic organ prolapse.

LEVEL OF EVIDENCE: II-2

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