A silent burden-prolapse, incontinence, and infertility in Australian Aboriginal and Torres Strait Islander women: A systematic search and narrative review

Abstract

Background: Pelvic organ prolapse (POP), urinary incontinence, and infertility are all prevalent conditions associated with considerable reduction in quality of life. As a group, Aboriginal and Torres Strait Islander women may be at higher risk of these conditions, but studies are scarce.

Objective: To review the literature pertaining to the epidemiology, diagnosis, and management of these conditions in Indigenous Australian women.

Search strategy: Medline, Embase, and Scopus were searched for articles published between 1980 and 2021 pertaining to these conditions in Indigenous Australian women.

Selection criteria: Studies that did not directly address the epidemiology, diagnosis, and management of these conditions were excluded.

Main results: It was possible to identify only 11 papers dealing with these conditions in Indigenous Australian women. Only one dealt with POP and was a retrospective audit of a health outreach program in the Northern Territory concluding that there was significant underreporting of the condition. Five papers dealt with urinary incontinence and, again, described significant underreporting and poor referral pathways. Five papers reported small studies about infertility, one reporting poor engagement from clinical directors.

Conclusion: It was concluded that despite the importance of these conditions, there is almost no body of research and this is an urgent national problem.

Keywords: infertility; pelvic organ prolapse; racism; systematic review; urinary incontinence.