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Obstetrics & Gynecology 2008;111:678-685
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Prevalence and Co-Occurrence of Pelvic Floor Disorders in Community-Dwelling Women

Jean M. Lawrence, ScD, MPH1, Emily S. Lukacz, MD, MAS2, Charles W. Nager, MD2, Jin-Wen Y. Hsu, PhD1 and Karl M. Luber, MD3

From 1Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California; 2Female Pelvic Medicine and Reconstructive Surgery, Department of Reproductive Medicine, University of California, San Diego, California; and 3Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente, San Diego, California.

OBJECTIVE: To assess the effect of age on prevalence of pelvic floor disorders and report the co-occurrence of these conditions in community-dwelling women.

METHODS: Stress urinary incontinence (SUI), overactive bladder (OAB), pelvic organ prolapse (POP), and anal incontinence were assessed using a validated questionnaire among 25- to 84-year-old women. Women screened positive for each disorder based on reported symptoms and their degree of bother. Covariates were assessed through self-report. Prevalence of each disorder was compared across four 15-year age groups using {chi}2 tests. Multiple logistic regression was used to adjust for confounders.

RESULTS: Among 4,103 women (mean age 56.5±15.8 years), the prevalence of SUI was 15%, OAB 13%, POP 6%, anal incontinence 25%, and 37% for any one or more disorder. Although the unadjusted prevalence of SUI, OAB, and anal incontinence increased with increasing age category, age was no longer significantly associated with the prevalence of any condition in most categories after adjustment for confounders, including obesity, birth history, menopause, and hormones. Co-occurrence of the disorders was high; roughly 80% of women with SUI or OAB, 69% with POP, and 48% with anal incontinence reported at least one other disorder.

CONCLUSION: Although the prevalence of pelvic floor disorders in a community-dwelling population is high, age was not a significant contributor after adjustment for confounders. The high co-occurrence of pelvic floor disorders suggests that physicians seeing women seeking care for one condition should inquire about symptoms of other disorders.

LEVEL OF EVIDENCE: II






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