Global burden and trends of pelvic organ prolapse: an observational trend study from 1990 to 2021

This study aimed to estimate the global trend of age-standardised incidence rates (ASIR) and age-standardised disability-adjusted life years (AS-DALYs) of pelvic organ prolapse from 1990 to 2021, and analyse the separate effects of age, period and birth cohort.

Data of pelvic organ prolapse's ASIR and AS-DALYs were obtained from the Global Burden of Disease (GBD) 2021. The regions were classified by the socio-demographic index (SDI). An age-period-cohort (APC) model was employed to analyse the effect of every age, period and birth cohort on pelvic organ prolapse's ASIR.

In 2021, the global ASIR and AS-DALY were 317.51 (95% UI, 267.67-378.25) and 8.68 (95% UI, 4.26-16.38) per 100,000 population, respectively. The rates decreased globally and in five SDI regions from 1990 to 2021. APC analysis demonstrated that ASIR significantly increased with advancing age, exhibiting a bi-peak curve, with one peak appearing around 50 years and the other around 70 years.

Over the past 32 years, the global ASIR and AS-DALY of pelvic organ prolapse have continued to decrease significantly, while in low SDI regions, the rates remain high. These findings highlight the need for targeted pelvic organ prolapse prevention programs and proper investment in pelvic floor care in low SDI regions.