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      Pelvic floor dysfunction: prevalence and associated factors

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          Abstract

          Background

          Pelvic floor dysfunction in women encompasses a wide range of clinical disorders: urinary incontinence, pelvic organ prolapse, fecal incontinence, and pelvic-perineal region pain syndrome. A literature review did not identify any articles addressing the prevalence of all pelvic floor dysfunctions.

          Objective

          Determine the prevalence of the group of pelvic floor disorders and the factors associated with the development of these disorders in women.

          Material and methods

          This observational study was conducted with women during 2021 and 2022 in Spain. Sociodemographic and employment data, previous medical history and health status, lifestyle and habits, obstetric history, and health problems were collected through a self-developed questionnaire. The Pelvic Floor Distress Inventory (PFDI-20) was used to assess the presence and impact of pelvic floor disorders. Pearson's Chi-Square, Odds Ratio (OR) and adjusted Odds Ratio (aOR) with their respective 95% confidence intervals (CI) were calculated.

          Results

          One thousand four hundred forty-six women participated. Urinary incontinence occurred in 55.8% (807) of the women, fecal incontinence in 10.4% (150), symptomatic uterine prolapse in 14.0% (203), and 18.7% (271) reported pain in the pelvic area. The following were identified as factors that increase the probability of urinary incontinence: menopausal status. For fecal incontinence: having had instrumental births. Factors for pelvic organ prolapse: number of vaginal births, one, two or more. Factors for pelvic pain: the existence of fetal macrosomia.

          Conclusions

          The prevalence of pelvic floor dysfunction in women is high. Various sociodemographic factors such as age, having a gastrointestinal disease, having had vaginal births, and instrumental vaginal births are associated with a greater probability of having pelvic floor dysfunction. Health personnel must take these factors into account to prevent the appearance of these dysfunctions.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-023-16901-3.

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          Most cited references40

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          Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects.

          P Woodman, Jeremy Kahn, Jesse S. Swift … (2005)
          The purpose of this study was to describe the distribution of pelvic organ support in a gynecologic clinic population to define the clinical disease state of pelvic organ prolapse and to analyze its epidemiologic condition. This was a multicenter observational study. Subjects who were seen at outpatient gynecology clinics who required an annual gynecologic examination underwent a pelvic organ prolapse quantification examination and completed a prolapse symptom questionnaire. Receiver operator characteristic curves were used to define pelvic organ prolapse with the use of symptoms and pelvic organ prolapse quantification examination measures. Standard age-adjusted univariate and multivariate logistic regression analysis were used to evaluate various relationships. The population consisted of 1004 women who were aged 18 to 83 years. The prevalence of pelvic organ prolapse quantification stages was 24% (stage 0), 38% (stage 1), 35% (stage 2), and 2% (stage 3). The definition of pelvic organ prolapse that was determined by the receiver operator characteristic curve was the leading edge of their vaginal wall that was -0.5 cm above the hymenal remnants. Multivariate analysis revealed age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus as risk factors for pelvic organ prolapse, as defined in this population. The results from this population suggest that there is a bell-shaped distribution of pelvic organ support in a gynecologic clinic population. Advancing age, Hispanic race, increasing body mass index, and the increasing weight of the vaginally delivered fetus have the strongest correlations with prolapse.
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            Prevalence and trends of symptomatic pelvic floor disorders in U.S. women.

            Jennifer Wu, Camille P Vaughan, Patricia S Goode … (2014)
            To estimate the prevalence and trends of these pelvic floor disorders in U.S. women from 2005 to 2010. 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. 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. 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. III.
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              Fecal Incontinence: Community Prevalence and Associated Factors--A Systematic Review.

              Kheng-Seong Ng, Yogeesan Sivakumaran, Natasha Nassar … (2015)
              Fecal incontinence is a chronic and debilitating condition with significant health burden. Despite its clinical relevance, the prevalence of fecal incontinence remains inconsistently described.
              Article 0 comments Cited 40 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Sergio Martínez-Vázquez: svazquez@ujaen.es
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 14 October 2023
                Publication date PMC-release: 14 October 2023
                Publication date Collection: 2023
                Volume: 23
                Electronic Location Identifier: 2005
                Affiliations
                [1 ]Department of Nursing, University of Jaen, ( https://ror.org/0122p5f64) Jaen, Spain
                [2 ]Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real, Faculty of Nursing, University of Castilla-La Mancha, ( https://ror.org/05r78ng12) Ciudad Real, Spain
                [3 ]GRID grid.466571.7, ISNI 0000 0004 1756 6246, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), ; Madrid, Spain
                Author information
                http://orcid.org/0000-0003-3543-5170
                Article
                Publisher ID: 16901
                DOI: 10.1186/s12889-023-16901-3
                PMC ID: 10576367
                PubMed ID: 37838661
                SO-VID: a1364213-5f30-42d8-8129-13d90e242e3b
                Copyright © © BioMed Central Ltd., part of Springer Nature 2023
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 22 February 2023
                Date accepted : 4 October 2023
                Funding
                Funded by: Ministry of Economics and Knowledge of the Government of Andalucia
                Award ID: Operative Program FEDER 2014-2020 (Code 1380358)
                Award Recipient :
                Funded by: Program University Teacher Training, financed by the Ministry of Universities Government of Spain
                Award ID: (ref. FPU20/01567)
                Award Recipient :
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © BioMed Central Ltd., part of Springer Nature 2023

                ScienceOpen disciplines: Public health
                Keywords: pelvic floor dysfunction,associated factors,women´s health,pelvic floor
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: pelvic floor dysfunction, associated factors, women´s health, pelvic floor

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