한국 여성의 골반 장기탈출 유병율과이와 관련된 위험 요인
Prevalence and related risk factor of pelvic organ prolapsein the general Korean population
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목적: 일반적인 부인과 진찰을 위해 내원한 여성을 대상으로 한국 여성의 골반 장기탈출 유병율과 이와 관련된 위험요소를 알아보고자 하였다. 연구 방법: 18세에서 72세까지의 여성들로서 자궁 세포진 검사 및 일반 부인과적 진찰을 위하여 내원한 713명의 여성을 대상으로 하였다. 임신한 여성이나 출산 후 6주 이내의 여성은 제외하였다. 대상 여성의 산과력, 내과적 질환, 수술력 등을 조사하였다. 골반지지 상태는 골반 장기분류법 (Pelvic Organ Prolapse Quantification staging system)에 따라서 기 결정 (Staging)을 하였다. 통계적인 분석은 χ2 테스트를 사용하였다. 결과: 평균 나이는 41.6세 (18-72), 몸무게 55.8 kg (40-83), 키 159.7 cm (138-177), 체질량지수 22.3 kg/m2 (15.7-32), 허리둘레 72.3 cm (58-91) 그리고 분만력의 중앙값은 2 (0-6)였다. 전질벽 탈출은 27.6%, 자궁 탈출은 2.0%, 후질벽 탈출은 25.4%였다. 전체적인 기는 0기 68.3%, 1기 19.9%, 2기 11.2%, 3기 0.6%였다. 나이, 분만력, 체질량지수, 허리둘레, 골반근육수축상태, 폐경 유무와 분만형태가 골반 장기탈출과 통계적으로 의의 있는 관계가 있다. 결론: 일반적인 한국 여성에서 POP-Q 1기 이상의 골반 장기탈출 유병율은 31.7%였다. 전질벽탈출과 후질벽탈출의 유병율이 자궁탈출보다 상대적으로 많았다. 이전에 알려진 골반 장기탈출의 위험요소들을 가진 여성들이 통계적으로 의의있게 골반 장기탈출의 진행정도와 관련이 있었다.
Abstract
Objective: The aim of our study is to evaluate the prevalence and related risk factor of pelvic organ prolapse in the general Korean population. Methods: The study population considered of 713 women who were seen for routine gynecologic health care. Pregnant or women within 6 weeks postpartum were excluded. General biographic data were collected regarding obstetric history, medical history, and surgical history. Pelvic organ support was measured and described according to the Pelvic Organ Prolapse Quantification (POP-Q) staging system. Univariate analyses of categorical data were performed with χ2 test. Results: The subjects had a mean age of 41.6 years (18-72), weight 55.8 kg (40-83), height 158.7 cm (138-177), body mass index (BMI) 22.3 kg/m2 (15.7-32), waist circumference (WC) 72.3 cm (58-91), and median parity was 2 (0-6). In the 713 women with a uterus, the rate of anterior vaginal prolapse was 27.6%, uterine prolapse 2.0%, and posterior vaginal prolapse 25.4%. The overall distribution of pelvic organ prolapse quantification system stages were as follows: stage 0, 68.3%; stage 1, 19.9%; stage 2, 11.2%; and stage 3, 0.6%. Age, parity, BMI, WC, pelvic floor muscle score, menopausal status and delivery mode were significantly associated with presence of prolapse. Conclusion: The prevalence of any degree of prolapse is 31.7%. Prevalence of anterior and posterior vaginal prolapse is higher than uterine prolapse. There was a statistically significant trend toward increased POP-Q system stage of support among women with many of the historically quoted etiologic factors for the development of pelvic organ prolapse.
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