Association between grade 3 and 4 pelvic organ prolaps and anxiety based on cortisol levels

Abstract

Introduction: Higher degrees of Pelvic organ prolapse (POP) (grades 3 and 4) are often associated with anxiety, which can reduce quality of life. The aim of this study was to determine the association between grades 3 and 4 pelvic organ prolapse and anxiety symptoms, as assessed by serum cortisol levels. Material and methods: A cross-sectional study involved women diagnosed with grade 3 or 4 POP; it was conducted at Dr. Wahidin Sudirohusodo General Hospital and other teaching hospitals from January to December 2023. Anxiety levels were assessed using the Hamilton Anxiety Rating Scale (HARS) questionnaire, and blood cortisol samples were collected to evaluate physiological stress. The correlation between POP severity and cortisol levels was analyzed using Statistical Package for the Social Sciences (SPSS) version 27. Results: This study consisted of 97 individuals (48 in the anxiety group and 49 in the non-anxiety group). Preliminary findings showed that patients with grade 4 POP showed significantly higher anxiety scores (41 subjects vs. 11 subjects) and higher cortisol levels (21.96±18.31 vs. 15.81±12.12) compared to patients with grade 3 POP. A positive correlation was found between the degree of POP and cortisol concentrations (p<0.05), indicating a potential psychophysiological impact of prolapse severity. Conclusion: There is a significant association between the severity of pelvic organ prolapse and anxiety symptoms, as evidenced by elevated cortisol levels. A holistic approach to POP management, encompassing both physical and psychological aspects of patient care, is essential.

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