To describe the care pathway of patients with pelvic organ prolapse in a high-volume resource-limited setting and characterize patients undergoing surgery.
The patient care pathway at a large referral hospital in Eastern Democratic Republic of Congo was determined through interviews with key personnel. Patients with apical prolapse (with or without anterior/posterior prolapse) who underwent surgery between January-December 2018 were included. Demographics and outcomes were characterized. Data were presented as means (standard deviation), medians (interquartile range), or percentages.
A holistic care model was described. During the study period, 772 patients underwent prolapse repairs, 235 met inclusion criteria. Mean age was 55 (14), and 75% were post-menopausal. Median parity was 7 (5-9). A majority had BMI <18.5 kg/m (56%). Most were farmers (77%) and had no formal education (76%). Postmenopausal patients underwent hysterectomy, while premenopausal patients were treated with uterine-preserving techniques. Most repairs were performed vaginally (96%), and 40% had concurrent multicompartment repairs. Most common complications were hemorrhage (4%, intraoperative) and urinary tract infection (5%, postoperative).
High-volume surgical services for treating prolapse can be integrated into existing healthcare delivery models. Our demographic of patients differs from studies in high-income countries. The degree to which these studies can be generalized to patients in settings similar to ours represents an opportunity for further research.

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