Genitourinary prolapse and joint hypermobility in Ethiopian women
AbstractObjectives: To assess the relationship between genitourinary prolapse (GUP) and joint hyper-mobility (JHM).
Design: Double-blind cross-sectional survey.
Setting: Adigrat hospital, northern Ethiopia, which serves as a referral centre for about one million people.
Patients: Two hundred and nine women were examined for joint hyper-mobility using the modified Carter-Wilkinson criteria. In addition, each patient was examined for genitourinary prolapse by a gynaecologist who was blind to the evaluation of JHM.
Results: Joint hyper-mobility was found in 78 out of 209 women (37%). Subjects with joint hyper-mobility had a high prevalence of second and third degree genitourinary prolapse (58/78 versus 75/131 with odds ratio of 2.17 and 95% confidence interval of 1.12 - 4.23). Those subjects with age above 35 years were significantly more likely to have GUP than those less than or equal to age 35 years (102/133 versus
31/76 with odds ratio of 4.78 and 95% confidence interval of 2.47 - 9.27). In addition, a significant number of women with GUP had stress incontinence (68/133 versus 8/76 with odds ratio of 8.89 and 95% confidence interval of 3.73 - 211.94).
Conclusion: The high prevalence of GUP in women with JHM suggests connective tissue abnormalities which may explain the unusually high prevalence of GUP in relatively young and low parity Ethiopian women besides the socio-economic and cultural factors. This implies that joint hyper-mobility may serve as a clinical marker for patients at risk of developing GUP.