An estimated 25% of women in the United States have pelvic floor disorders including urinary incontinence, pelvic organ prolapse, and fecal incontinence, according to national survey results.
The prevalence of these disorders rises with increasing age and parity, so that as many as one-third of older women may be affected, said Dr. Ingrid Nygaard of the University of Utah, Salt Lake City, and associates.
The results are based on responses of a nationally representative sample of 1,961 nonpregnant women aged 20 years and older, included in the 2005–2006 National Health and Nutrition Examination Survey. The survey is conducted by the Centers for Disease Control and Prevention. Until now, no national survey has assessed the prevalence of moderate to severe pelvic floor disorders in these patients. Only moderate to severe symptoms were included in this analysis: at least weekly urinary leakage or leakage of substantial urinary volumes; at least monthly leakage of solid, liquid, or mucous stool; and/or seeing or feeling a bulge or “something falling out” in the vaginal area.
Overall, 24% of women reported at least one such symptom. Approximately 16% reported urinary incontinence, 9% reported fecal incontinence, and 3% reported pelvic organ prolapse, the investigators said (JAMA 2008;300:1311-6). Participants were interviewed in their homes and then were given standardized physical examinations in a mobile examination center.
The proportion of affected women rose with age. The prevalence was approximately 10% among women in their 20s and 30s, 27% among those in their 40s and 50s, 37% among women in their 60s and 70s, and 50% among women aged 80 years and older.
Women with more body mass and higher parity were more likely to have pelvic floor disorders than were women of less body mass and lower parity.
These prevalences are likely to be underestimates because the analysis excluded women who already had been treated for pelvic floor disorders. The analysis also used conservative definitions of leakage. Moreover, physical examination of a study subset showed that the prevalence of physically diagnosed pelvic organ prolapse was greater than that diagnosed by symptoms only.
The study findings indicate that as the population of older women increases, “the national burden related to pelvic floor disorders in terms of health care costs, lost productivity, and decreased quality of life will be substantial,” Dr. Nygaard and her associates noted.
This study was funded by a variety of grants from public institutions.