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Incontinence affects a substantial proportion of women
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CHICAGO—Nearly one-quarter of women surveyed, and more than one-third of older women, report at least one pelvic floor disorder, which includes urinary and fecal incontinence and the shifting of a pelvic organ, according to a study in the September 17 issue of JAMA. These disorders become more prevalent with increasing age and weight.

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Pelvic floor disorders include urinary and fecal incontinence, pelvic organ prolapse (when a pelvic organ, such as the uterus, drops [prolapses] from its normal spot and pushes against the walls of the vagina), and other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts. Because no single national population-based survey has assessed the prevalence of major pelvic floor disorders in U.S. women, the national burden related to these diseases remains unknown, according to background information in the article.

Ingrid Nygaard, M.D., M.S., of the University of Utah School of Medicine, Salt Lake City, and colleagues conducted a study to provide prevalence estimates of symptomatic pelvic floor disorders in women. The study included 1,961 nonpregnant women (age 20 years or older) who participated in the 2005-2006 National Health and Nutrition Examination Survey, a nationally representative survey of the U.S. population. Women were interviewed in their homes and then underwent standardized physical examinations in a mobile examination center. Urinary and fecal incontinence and pelvic organ prolapse symptoms were assessed.

The researchers found that overall, 23.7 percent of women reported symptoms of at least 1 pelvic floor disorder. Of these, 15.7 percent experienced urinary incontinence, 9.0 percent experienced fecal incontinence and 2.9 percent experienced symptomatic pelvic organ prolapse. The proportion of women who reported at least 1 pelvic floor disorder increased with age (9.7 percent in women age 20 to 39 years, 26.5 percent in women age 40 to 59 years, 36.8 percent in women age 60 to 79 years, and 49.7 percent in women age 80 years or older).

Overweight and obese women were more likely to report at least 1 pelvic floor disorder than normal weight women: prevalence was 15.1 percent for underweight/normal weight, 26.3 percent for overweight, and 30.4 percent for obese women. Also, the more children a woman had given birth to increased the likelihood of at least 1 pelvic floor disorder. Race/ethnicity and education were not significantly associated with having a pelvic floor disorder.

“These data represent the first nationwide, population-based estimates of the 3 primary pelvic floor disorders in women in the United States derived from a single source,” the authors write. “By 2030, more than one-fifth of women will be 65 years or older. 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.”

“Given the burden pelvic floor disorders place on U.S. women and the health care system, research is needed to further understand their pathophysiology, prevention, and treatment.”
(JAMA. 2008;300[11]:1311-1316. Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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