The association between women's pelvic organ prolapse and joint hypermobility.

Objective: To determine whether joint hypermobility is associated with pelvic organ prolapse.

Methods: The case-control study was conducted from January to April 2011 and comprised 30 women with pelvic organ prolapse, stage > or = II and 30 controls with stages 0 and I with similar age and parity. They were recruited from the gynaecology clinic at Imam Reza Hospital in Mashhad, Iran. The condition was evaluated by a quantification system and, for the purposes of this study, pelvic organ prolapse was defined as stage > or = II. All the subjects were examined in the dorsal lithotomic position with an empty bladder. A separate investigator evaluated each subject for joint hypermobility by using Beighton score which was calculated by doing five simple manoeuvres. SPSS 11.5 was used for data analysis.

Results: The mean age of the 30 cases was 35.40 +/- 6.39 years, while for the controls it was 35.36 +/- 5.9 years. Overall clinical joint hypermobility was found in 24 of the 60 (40%) subjects. There were no significant difference in the prevalence of joint hypermobility between the two groups. The prevalence of hypermobility in the cases was 36.7% (n = 11) versus 43.3% (n=13) in the controls (p = 0.59). The prevalence of cystocele in subjects with joint hypermobility was 41.7% (n = 10) versus 38.9% (n=14), (p < 0.83); rectocele 33.3% (n = 8) versus 41.7% ( n =15), (p < 0.73) women with normal joint mobility. No Significant differences were found between the groups with regard to other markers of connective tissue weakness such as the presence of varicose veins (p < 0.37), easy bruising ( p < 0.43) and observed striae ( p < 0.42).

Conclusion: Joint hypermobility was not associated with pelvic organ prolapse in the study population. Further studies involving more patients with pelvic organ prolapse are recommended.