Prevalence and Trends of Symptomatic Pelvic Floor Disorders in U.S. Women

Wu, Jennifer M. MD, MPH; Vaughan, Camille P. MD, MS; Goode, Patricia S. MD; Redden, David T. PhD; Burgio, Kathryn L. PhD; Richter, Holly E. PhD, MD; Markland, Alayne D. DO, MSc

Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000057
Contents: Original Research
Abstract

OBJECTIVE: To estimate the prevalence and trends of these pelvic floor disorders in U.S. women from 2005 to 2010.

METHODS: We used the National Health and Nutritional Examination Survey from 2005–2006, 2007–2008, and 2009–2010. A total of 7,924 nonpregnant women (aged 20 years or older) were categorized as having: urinary incontinence (UI)—moderate to severe (3 or higher on a validated UI severity index, range 0–12); fecal incontinence—at least monthly (solid, liquid, or mucus stool); and pelvic organ prolapse—seeing or feeling a bulge. Potential risk factors included age, race and ethnicity, parity, education, poverty income ratio, body mass index ([BMI] less than 25, 25-29, 30 or greater), comorbidity count, and reproductive factors. Using appropriate sampling weights, weighted χ analysis and multivariable logistic regression models with odds ratios and 95% confidence intervals (95% CIs) were reported.

RESULTS: The weighted prevalence rate of one or more pelvic floor disorders was 25.0% (95% CI 23.6–26.3), including 17.1% (95% CI 15.8–18.4) of women with moderate-to-severe UI, 9.4% (95% CI 8.6–10.2) with fecal incontinence, and 2.9% (95% CI 2.5–3.4) with prolapse. From 2005 to 2010, no significant differences were found in the prevalence rates of any individual disorder or for all disorders combined (P>.05). After adjusting for potential confounders, higher BMI, greater parity, and hysterectomy were associated with higher odds of one or more pelvic floor disorders.

CONCLUSION: Although rates of pelvic floor disorders did not change from 2005 to 2010, these conditions remain common, with one fourth of adult U.S. women reporting at least one disorder.

LEVEL OF EVIDENCE: III

In Brief

Population-based data show that pelvic floor disorders are common, with one fourth of adult women reporting symptoms and prevalence rates remaining constant from 2005 to 2010.

Author Information

Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham Department of Veterans Affairs Medical Center, and the Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, the School of Public Health, and the Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama; and the Division of General Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia.

Corresponding author: Jennifer M. Wu, MD, MPH, UNC Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, 3032 Old Clinic Building, CB#7570, Chapel Hill, NC 27599-7570; e-mail: Jennifer_wu@med.unc.edu.

Supported in part by Veterans Health Administration Career Development Awards (CDA-2) to Drs. Markland (B6126W) and Vaughan (1 IK2 RX000747-01). Dr. Wu is supported by K23HD068404, Eunice Kennedy Shriver National Institute of Child Health & Human Development.

Financial Disclosure Dr. Wu has been a consultant for Proctor and Gamble. Dr. Vaughan has received research grants support from Astellas. Dr. Richter has received research grants from Astellas, Pelvalon, and the University of California San Francisco/Pfizer. She has served as a consultant for Pelvalon and Astellas. The other authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.