Older And Heavier Women More Likely To Suffer Incontinence

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Main Category: Women's Health / Gynecology
Also Included In: Seniors / Aging;  GastroIntestinal / Gastroenterology
Article Date: 17 Sep 2008 - 0:00 PDT

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According to a study published in the September 17 issue of JAMA, about 25% of women and over 33% of older women reported at least one pelvic floor disorder in recent survey. Pelvic floor disorders, such as urinary and fecal incontinence and the shifting of a pelvic organ, were also found to become more prevalent as age and weight increased.

Pelvic floor disorders refer to a broad array of women's health issues. Some of these include:

• Urinary and fecal incontinence
• Pelvic organ prolapse - when the uterus or other pelvic organ drops (prolapses) from its normal position and pushes against the walls of the vagina
• Sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts.

The lack of a national, population-based survey that assesses the prevalence of major pelvic floor disorders in U.S. women has kept medical and public health professionals unaware of the national burden related to these diseases.

In order to compute estimates of symptomatic pelvic floor disorders in women, Ingrid Nygaard, M.D., M.S. (University of Utah School of Medicine, Salt Lake City) and colleagues conducted a study with a sample of 1,961 non-pregnant women who were 20 years of age or older. The women were participants in a nationally representative survey of the U.S. population called the 2005-2006 National Health and Nutrition Examination Survey. Data came from home-based interviews and standardized physical examinations in a mobile examination center. The researchers paid specific attention to symptoms of urinary and fecal incontinence and pelvic organ prolapse.

At least one pelvic floor disorder was reported by 23.7% of the women. About 16% of these women experienced urinary incontinence, 9.0% experienced fecal incontinence and 2.9% experienced symptomatic pelvic organ prolapse. Age was a major factor in the proportion of women who reported at least one pelvic floor disorder:

• 9.7% in women age 20 to 39 years
• 26.5% in women age 40 to 59 years
• 36.8% in women age 60 to 79 years
• 49.7% in women age 80 years or older

In addition, the researchers noted an association between weight and pelvic floor disorders as overweight and obese women were more likely to report at least one pelvic floor disorder compared to normal weight women. The prevalence of disorders was:

• 15.1% for underweight/normal weight women
• 26.3% for overweight women
• 30.4% for obese women

Though race and ethnicity were not linked to pelvic floor disorders, women who gave birth to more women had an increased likelihood of at least one 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," clarify the researchers. "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," they conclude.

Prevalence of Symptomatic Pelvic Floor Disorders in US Women
Ingrid Nygaard; Matthew D. Barber; Kathryn L. Burgio; Kimberly Kenton; Susan Meikle; Joseph Schaffer; Cathie Spino; William E. Whitehead; Jennifer Wu; Debra J. Brody; for the Pelvic Floor Disorders Network
JAMA (2008).300(11):1311-1316.
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Written by: Peter M Crosta
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