Author(s): Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S,
Abstract Share this page
Abstract CONTEXT: Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect many women. No national prevalence estimates derived from the same population-based sample exists for multiple pelvic floor disorders in women in the United States. OBJECTIVE: To provide national prevalence estimates of symptomatic pelvic floor disorders in US women. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional analysis of 1961 nonpregnant women (>or=20 years) who participated in the 2005-2006 National Health and Nutrition Examination Survey, a nationally representative survey of the US noninstitutionalized population. Women were interviewed in their homes and then underwent standardized physical examinations in a mobile examination center. Urinary incontinence (score of >or=3 on a validated incontinence severity index, constituting moderate to severe leakage), fecal incontinence (at least monthly leakage of solid, liquid, or mucous stool), and pelvic organ prolapse (seeing/feeling a bulge in or outside the vagina) symptoms were assessed. MAIN OUTCOME MEASURES: Weighted prevalence estimates of urinary incontinence, fecal incontinence, and pelvic organ prolapse symptoms. RESULTS: The weighted prevalence of at least 1 pelvic floor disorder was 23.7\% (95\% confidence interval [CI], 21.2\%-26.2\%), with 15.7\% of women (95\% CI, 13.2\%-18.2\%) experiencing urinary incontinence, 9.0\% of women (95\% CI, 7.3\%-10.7\%) experiencing fecal incontinence, and 2.9\% of women (95\% CI, 2.1\%-3.7\%) experiencing pelvic organ prolapse. The proportion of women reporting at least 1 disorder increased incrementally with age, ranging from 9.7\% (95\% CI, 7.8\%-11.7\%) in women between ages 20 and 39 years to 49.7\% (95\% CI, 40.3\%-59.1\%) in those aged 80 years or older (P < .001), and parity (12.8\% [95\% CI, 9.0\%-16.6\%], 18.4\% [95\% CI, 12.9\%-23.9\%], 24.6\% [95\% CI, 19.5\%-29.8\%], and 32.4\% [95\% CI, 27.8\%-37.1\%] for 0, 1, 2, and 3 or more deliveries, respectively; P < .001). Overweight and obese women were more likely to report at least 1 pelvic floor disorder than normal weight women (26.3\% [95\% CI, 21.7\%-30.9\%], 30.4\% [95\% CI, 25.8\%-35.0\%], and 15.1\% [95\% CI, 11.6\%-18.7\%], respectively; P < .001). We detected no differences in prevalence by racial/ethnic group. CONCLUSION: Pelvic floor disorders affect a substantial proportion of women and increase with age.
This article was published in JAMA
and referenced in Journal of Womens Health Care