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Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Pelvic Organ Prolapse and Alpha-1 Antitrypsin Deficiency
Erika Fuchs1, Jennifer Cera2,3, Kristen E Holm4,5
1Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Journal of Women'S Health (2002)
|August 13, 2026
Summary
Women with Alpha-1 antitrypsin deficiency (AATD) have a higher prevalence of symptomatic pelvic organ prolapse (POP) than the general population. This suggests AATD patients may benefit from POP screening and pelvic floor therapy.
Area of Science:
- Pulmonary Medicine
- Genetics
- Urogynecology
Background:
- Alpha-1 antitrypsin deficiency (AATD) is a genetic disorder linked to emphysema and COPD.
- Chronic cough in COPD may increase intra-abdominal pressure, potentially leading to pelvic organ prolapse (POP).
- The general population prevalence of POP is estimated at 3-6%.
Purpose of the Study:
- To determine the prevalence of symptomatic POP in women diagnosed with AATD.
- To identify factors associated with POP in this patient group.
Main Methods:
- A survey was administered to women aged 18+ with AATD in 2025.
- The Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6) assessed POP symptoms.
- Logistic regression analyzed associations between POPDI-6 scores and participant characteristics.
Main Results:
- 22.1% of surveyed women with AATD reported significant POP symptoms (POPDI-6 > 17).
- Higher POP symptom scores were associated with increased age, sleep apnea, hysterectomy, prior surgeries, vaginal births, and specific AATD genotypes (MZ).
- Increased cough-related symptoms (CAAT scores) were linked to higher POP distress.
Conclusions:
- Symptomatic POP is more prevalent in women with AATD than in the general population.
- Further research is needed to confirm these findings.
- Screening women with AATD for POP could facilitate early intervention with pelvic floor therapy.
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