Pelvic Organ Prolapse in Lagos, Nigeria

Background Although not a life threatening condition, pelvic organ prolapse can affect a woman’s quality of life by limiting physical, social, psychological and sexual functions. There is paucity of publication on the subject in Nigeria. We determined the incidence, pattern of presentation, factors determining treatment modalities and complications associated with surgical management of pelvic organ prolapse at the Lagos State University Teaching Hospital. Methods Retrospective review of all cases of pelvic organ prolapse managed between 1st January 1999 and 31st December 2008 was done. Data was analyzed using the Epi info version 3.5 statistical software of the Centre for Disease Control and Prevention, Atlanta, USA. Results The incidence of pelvic organ prolapse in this study was 0.74 per 1000 gynaecological consultations. The majority of the subjects were above 40 years and 64% were grandmultipara. The commonest presenting symptom was protrusion from the vagina which occurred in 96% of the subjects. Vaginal hysterectomy and pelvic floor repair was the commonest mode of management and was associated with higher post operative morbidity than other procedures. Conclusion Older and grand multiparous women are the principal sufferers of pelvic organ prolapse. Prevention through modification of obstetric risk factors, provision of adequate maternity care and family planning services is recommended. Key Words: pelvic organ prolapse, Lagos, Vaginal Hysterectomy

Factors associated with acceptability of child adoption as a management option for infertility among women in a developing country

Adeniyi Abiodun Adewunmi,1 Elizabeth Arichi Etti,1 Adetokunbo Olufela Tayo,1 Kabiru Afolarin Rabiu,1 Raheem Akinwunmi Akindele,2 Tawakwalit Abimbola Ottun,1 Fatimat Motunrayo Akinlusi11Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Ikeja-Lagos, 2Department of Physiology, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu-Ogun State, NigeriaBackground: Adoption as a treatment option for infertility amongst those that cannot access and/or afford assisted reproduction is not well accepted in developing countries. This study sets out to determine the willingness of infertile women in developing countries to adopt a child and factors that influence women's attitude to adoption.Methods: We conducted a questionnaire survey of consecutive infertile patients who attended the gynecological clinic of a regional teaching hospital over a 2-month period. Information on demographics, fertility history, and attitude to adoption was obtained, and the data were analyzed using SPSS version 16.0. Tests of statistical significance were used where appropriate at the 95% confidence level.Results: The majority of respondents were aware of child adoption, and the most common source of information was friends (47.8%), followed by the media (39.7%); 42.6% of respondents were willing to adopt if their infertility became intractable. The main reasons given by those unwilling to adopt were culture (78.3%) and family constraints (13.45%). On univariate analysis of factors associated with a favorable or unfavorable attitude to adoption, awareness of adoption (P = 0.002), duration of infertility > 5 years (P = 0.015), no living child (P = 0.007), tertiary education (P < 0.001), pressure from parents (P = 0.041), household yearly income ≥ $650 (P < 0.001), and belief that treatment will bring about the desired results (P < 0.001) were significant, and all except awareness of adoption turned out to be significant on multiple logistic regression analysis.Conclusion: There was a high level of awareness about child adoption among all respondents. However, the acceptability of adoption was significantly lower among poor women and those with limited education. Community advocacy and mobilization, especially through the media as well as via health care providers, will go a long way towards enlightening and enhancing the uptake of adoption among women in Nigeria.Keywords: infertility, adoption, developing country, Nigeri