This description of the epidemiology of hospital admission
for prolapse in a population of married British
women who attended family planning clinics in England
and Scotland between 1968 and 1974 is generally
in concordance with review articles in the gynaecology
literature'.'J8. By far the most striking association is
with increasing parity, with an eleven fold increase in
risk in mothers of four or more children compared with
nulliparous women. Most of this increase in risk has
occurred once a woman has had two children. Less than1% of prolapse occurred in nulliparous women in this
study, but this is likely to be an underestimate of the true
population rate since the study was restricted to married
women (who are more likely to be parous than the genera1
population). Age is a much less important risk factor
once parity and calendar period have been taken into
account. However, the population in the Oxford-FPA
study is relatively young, and it may be that this factor
is more important in women older than 60. Furthermore,
surgeons may have a higher threshold for operating
for prolapse on older women. Since this analysis
relies on inpatient admissions to capture the diagnosis
of prolapse, it may under-estimate the numbers of older
women who are referred with prolapse by their general