Knowledge, prevalence and treatment practices of uterine prolapse among women of reproductive age in the Jhaukhel- Duwakot Health Demographic Surveillance Site, Bhaktapur, Nepal

Background: Uterine prolapse (UP) is a main contributor to reproductive health problems that infl uence women’s quality of life. In Nepal, the UP prevalence ranges from 7-27%. Women experience various diffi culties and symptoms due to UP, which are determined by the type as well as thestage of UP. Objectives: This study aimed to explore the knowledge, prevalence and treatment practices of uterine prolapse among women of reproductive age in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) in the Bhaktapur district of Nepal. Methods: This cross-sectional study collected data in two stages. A structured survey of 3,124 households in JD-HDSS, incorporating 60% of all women of reproductive age, assessed knowledge of uterine prolapse and identifi ed self-reported disease prevalence (symptomatic). Next, we organised a fi ve day clinical screening camp at JD-HDSS to identify the prevalence of uterine prolapse in attendees.The household survey was conducted on September-December 2012 and the UP screening camp on May-June 2013. Descriptive statistics was used to analyse the proportion of comprehensive knowledge regarding UP and the prevalence of UP. Results: Ninety-three percent of womenin JD-HDSS had heard of uterine prolapse and 55% of those had comprehensive knowledge. Self-reported (symptomatic) prevalence was 2.11% (8.5% including women who had undergone hysterectomy for uterine prolapse). Among these, 52.6% had received no treatment. The most common reported treatments of uterine prolapse included surgery (53.2%), exercise and medicine (35.5%) and pessary (11.3%). Among women attending the outreach camp (N=303), UP prevalence was 15.18%. Conclusion: Knowledge of uterine prolapse among women in JD-HDSS is almost double that reported in a national survey. Similarly, the prevalence of self-reported uterine prolapse in JD-HDSS is almost three fold less than the national prevalence. Knowledge,early healthcare practices and availability of surgical care for uterine prolapse might have contributed to these fi ndings.