(Research Hub Theater) Associated Prevalence of Self-reported Urogynecological Co-morbidities in Hypermobile Ehlers-Danlos Patients

Background and/or Objectives: Urogynecological complications in hypermobile-type Ehlers-Danlos Syndrome (hEDS) - including dyspareunia, dysmenorrhea, and menorrhagia - have been previously reported, yet few studies have investigated the prevalence and frequency of such symptoms in this patient population.The only urogynecological condition currently included in diagnostic criteria for hEDS is that of pelvic organ prolapse in children, men, and nulliparous women. We noticed a trend of patients within the Hypermobility and EDS clinic at Tulane that report urologic or gynecological symptoms. This study aims to identify the prevalence of urinary and reproductive issues in women with hEDS.

Design: We conducted a retrospective chart review of 132 female patients seen at the Tulane Hypermobility and EDS clinic between January 1, 2021 and February 26, 2022. Each patient met the 20 17 hEDS diagnostic criteria. Their self-reported intake forms were reviewed for urinary and reproductive complications, in addition to other co-morbidities. We calculated the frequency of urogynecological conditions in hEDS patients.

Setting: Tulane Hypermobility and EDS Clinic.

Participants: 132 female patients who came into the Tulane Hypermobility and EDS Clinic and were diagnosed with hEDS.

Interventions: not applicable

Main Outcome Measures: Self-reported co-morbidities.

Results: 97 female patients (73%) reported urinary tract or reproductive system issues. Out of the 132 patients, 24 (18%) reported frequent urinary tract infections, 22 (17%) reported bladder retention, 15 (11%) reported bladder spasms, 7 (5%) reported bladder prolapse, and 21 (16%) reported bladder retention. 49 (37%) patients reported having abnormal periods, 31 (23%) reported painful sex, 28 (21%) reported pregnancy complications, 17 (13%) reported delivery complications, 8 (6%) reported uterine prolapse, and 22 (17%) reported uterine fibroids. 22 (17%) reported having PCOS and 24 (18%) Endometriosis.

Conclusions: Urogynecological symptoms and conditions are highly prevalent in our hypermobility clinic population. Further studies should be conducted to better assess these conditions within the context of hypermobility and connective tissue fragility.