Pelvic Disorders Affect Large Number of Women

Nearly one-quarter of all women suffer from pelvic-floor disorders, such as incontinence, at some point in their lives, a national study, including researchers from UT Southwestern Medical Center, has found.

The study of nearly 2,000 women in seven U.S. cities found that 23.7 percent of participants had experienced at least one pelvic-floor disorder, and the risk increased with age.

“This study is the first nationwide study to confirm what we consider a high prevalence of pelvic-floor disorders in the U.S.,” said Dr. Joseph Schaffer, professor of obstetrics and gynecology at UT Southwestern and an author of the study, which appears in today’s issue of the Journal of the American Medical Association.

“Nearly a quarter of all women suffer from at least one pelvic-floor disorder, and, with the aging of the population, this will become more prevalent,” he said.

The national rate of pelvic-floor disorders has not been well-studied, although several regional studies have found that almost 10 percent of women go through surgery for such conditions at some point in their lives, while one-third of those women have two or more surgeries.

The current study was designed to assess the national rate of such disorders. The participating women were interviewed in 2005 and 2006 at their homes or at a mobile interview center and did not undergo physical examination. The questions were part of the National Health and Nutrition Examination Survey.

For the current study, the researchers focused on three conditions: urinary incontinence, fecal incontinence and symptomatic pelvic organ prolapse, which occurs when women can feel or see an organ dropping or bulging in the vaginal area. This can indicate a dropping of the uterus, bladder or rectum as supporting structures weaken.

The researchers interviewed 1,961 nonpregnant women older than 20. Overall, 15.7 percent of women experienced urinary incontinence; 9 percent experienced fecal incontinence; and 2.9 percent reported symptomatic pelvic organ prolapse. In all, 23.7 percent reported one or more conditions.

The rates of the conditions went up substantially with the number of childbirths and with age. They were also were higher among the poor or less educated. Obesity also increased the risk. Race or ethnicity had no effect on the conditions.

“Physicians with expertise in caring for pelvic-floor disorders offer a variety of nonsurgical and surgical treatments that can significantly improve the quality of life for patients with these problems,” Dr. Schaffer said. “Patients with pelvic-floor disorders should be encouraged to seek care from health care providers, particularly those with expertise in pelvic-floor medicine and surgery.”

The study was funded by the National Institutes of Health.

The research was conducted by the Pelvic Floor Disorders Network, which, in addition to UT Southwestern, includes study authors from the NIH, University of Utah School of Medicine, Cleveland Clinic, University of Alabama at Birmingham, Loyola University Stritch School of Medicine, University of Michigan School of Public Health, University of North Carolina School of Medicine and Duke University School of Medicine.

Dr. Schaffer has reported receiving research support from Cook Medical Inc. and speaking fees from Astellas/GlaxoSmithKline.

Source: UT Southwestern Medical Center

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