Pelvic organ prolapse: epidemiological trends and economic burden in the context of global population aging

• Mekan R. Orazov
• Victor E. Radzinsky
• Farida F. Minnullina

Abstract

The prevalence of pelvic organ prolapse (POP) varies widely (up to 50%), which emphasizes the scale of the “hidden epidemic”. The key factors influencing patients’ seeking medical care include socio-economic factors.

With the aging of the population, the number of patients with POP is projected to increase by 50–70% by 2050, which will increase the financial burden due to direct treatment costs and loss of working capacity.

The aim of the work was to analyze and systematize modern data on the global and regional prevalence of POP and the financial costs of its treatment in order to predict the burden on the healthcare system and develop strategies for optimizing medical care for patients. This article analyzes the structure of surgical interventions for different clinical forms of POP in a single-center retrospective study based on the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan for the period 2013–2023.

Results. The prevalence of POP can reach 50%, but territorial differences are noted: in the USA, the frequency of this indicator is 25%, and in Japan – 46%. According to the analysis of the results of a retrospective single-center study based on the Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan for the period 2013–2023, surgeries for POP account for 28% of the structure of all surgical interventions on the reproductive organs. At the same time, surgeries for the correction of cystocele (33.1%) and uterine prolapse (56.4%) predominate, which reflects the need to adapt clinical protocols taking into account the local epidemiological picture and the availability of technologies.

Conclusions. The study substantiates the need for standardization of diagnostic criteria, analysis of cost-effectiveness taking into account the risk of relapse. Promising areas include optimization of surgical approaches (for example, apical support reduces the frequency of reoperations from 20 to 11%) and the development of epidemiological registers to formulate a healthcare development strategy. Reducing the burden of POP requires the integration of clinical, epidemiological and economic data for the effective allocation of resources in the context of global population aging. Reducing the financial burden of POP requires the integration of clinical, epidemiological and economic data to prioritize early intervention, effectively allocate resources in the context of an aging population.

Keywords: pelvic organ prolapse; epidemiology; cost-effectiveness; surgical treatment; pessary; rectocele; cystocele; apical prolapsed

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