Prevalence of symptomatic pelvic floor disorders in US women.
BACKGROUND
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.


METHODS
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.


METHODS
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.


CONCLUSIONS
Pelvic floor disorders affect a substantial proportion of women and increase with age.
Nygaard
Ingrid
I
Department of Obstetrics and Gynecology, University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT 84132-2209, USA. ingrid.nygaard@hsc.utah.edu
Barber
Matthew D
MD
Burgio
Kathryn L
KL
Kenton
Kimberly
K
Meikle
Susan
S
Schaffer
Joseph
J
Spino
Cathie
C
Whitehead
William E
WE
Wu
Jennifer
J
Brody
Debra J
DJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor; D020047:Rectocele / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology*; D014596:Uterine Prolapse / Q000453:epidemiology*
Br J Obstet Gynaecol. 1997 May;104(5):579-85
9166201
Gastroenterology. 2005 Jul;129(1):42-9
16012933
Eur J Obstet Gynecol Reprod Biol. 2000 Dec;93(2):135-40
11074133
Am J Obstet Gynecol. 2006 Oct;195(4):942-8
16681989
Obstet Gynecol. 2005 Oct;106(4):726-32
16199628
JAMA. 1995 Aug 16;274(7):559-61
7629985
Am J Obstet Gynecol. 2001 Jul;185(1):116-20
11483914
J Clin Epidemiol. 2000 Nov;53(11):1150-7
11106889
Am J Epidemiol. 2007 Feb 1;165(3):309-18
17132698
Obstet Gynecol. 2005 Oct;106(4):759-66
16199633
Can J Aging. 2004 Winter;23(4):319-31
15838815
Dis Colon Rectum. 1999 Dec;42(12):1525-32
10613469
Am J Obstet Gynecol. 2001 Dec;185(6):1388-95
11744914
Obstet Gynecol. 1997 Apr;89(4):501-6
9083302
Acta Obstet Gynecol Scand. 2003 Mar;82(3):280-6
12694126
J Urol. 2006 Feb;175(2):601-4
16407004
Int Urogynecol J Pelvic Floor Dysfunct. 2006 Sep;17(5):520-4
16547687
Am J Obstet Gynecol. 2003 Aug;189(2):372-7; discussion 377-9
14520198
Am J Obstet Gynecol. 2001 Jun;184(7):1496-501; discussion 1501-3
11408873
Int Urogynecol J Pelvic Floor Dysfunct. 2004 Jan-Feb;15(1):10-3; discussion 13
14752592
Am J Obstet Gynecol. 2005 Jul;193(1):53-7
16021058
Obstet Gynecol. 2006 Jun;107(6):1253-60
16738149
World J Urol. 1999 Aug;17(4):225-9
10460405
Am J Obstet Gynecol. 2005 May;192(5):1637-42
15902170
Am J Obstet Gynecol. 2005 Mar;192(3):795-806
15746674
BJOG. 2000 Dec;107(12):1460-70
11192101
Obstet Gynecol. 2005 Sep;106(3):585-92
16135592
J Urol. 2008 Feb;179(2):656-61
18082211
Obstet Gynecol. 2001 Dec;98(6):1004-10
11755545
J Urol. 2006 Jan;175(1):259-64
16406923
Am J Obstet Gynecol. 2001 Dec;185(6):1332-7; discussion 1337-8
11744905
Dis Colon Rectum. 2006 Jun;49(6):841-51
16741640
Am J Gastroenterol. 2005 Apr;100(4):905-9
15784039
J Am Geriatr Soc. 2005 Apr;53(4):629-35
15817009
Am J Obstet Gynecol. 2007 Jul;197(1):70.e1-8
17618763
Dis Colon Rectum. 2000 Jan;43(1):9-16; discussion 16-7
10813117
Am J Obstet Gynecol. 2002 Jun;186(6):1160-6
12066091
Neurourol Urodyn. 2000;19(2):137-45
10679830
Am J Obstet Gynecol. 1999 Feb;180(2 Pt 1):299-305
9988790