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Posted: September 23, 2008

Incontinence Affects a Third of Older Women, Quarter of All Women: Study

More than a third of older women – and nearly a quarter of all adult women -- suffer from a pelvic disorder that leaves them urinary or fecal incontinent, and the prevalence of this condition increases with age and added weight, according to a study published in the medical journal JAMA.

The technical name for the condition described is pelvic floor disorder. These include urinary and fecal incontinence, pelvic organ prolapse (when a pelvic organ, such as the uterus, drops [prolapses] from its normal spot and pushes against the walls of the vagina), and other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts. 

Because no single national population-based survey has assessed the prevalence of major pelvic floor disorders in US women, the national burden related to these diseases remains unknown, according to background information in the article.

Dr. Ingrid Nygaard, of the University of Utah School of Medicine in Salt Lake City, and colleagues studied the prevalence of pelvic floor disorders in women by surveying 1,961 non-pregnant women (age 20 years or older) who participated in the 2005-2006 National Health and Nutrition Examination Survey, a nationally representative survey of the US population. Women were interviewed in their homes and then underwent standardized physical examinations in a mobile examination center, during which urinary and fecal incontinence and pelvic organ prolapse symptoms were assessed.

The researchers found that overall, 23.7% of women reported symptoms of at least one pelvic floor disorder. Of these, 15.7% experienced urinary incontinence, 9% experienced fecal incontinence and 2.9% experienced symptomatic pelvic organ prolapse. 

The proportion of women who reported at least one pelvic floor disorder increased with age, from 9.7% in women age 20 to 39 years, to 26.5% in women age 40 to 59 years, 36.8% in women age 60 to 79 years, and 49.7% in women age 80 years or older.

Overweight and obese women were more likely than normal-weight women to report at least one pelvic floor disorder -- 15.1% for underweight or normal weight, 26.3% for overweight, and 30.4% for obese women. 

Also, the more children a woman had given birth to increased the likelihood of a pelvic floor disorder. Race/ethnicity and education were not significantly associated with having a pelvic floor disorder, the researchers said.

“These data represent the first nationwide, population-based estimates of the three primary pelvic floor disorders in women in the United States derived from a single source,” the authors write in the medical journal. “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.”

They added: “Given the burden pelvic floor disorders place on US women and the health care system, research is needed to further understand their pathophysiology, prevention, and treatment.”

JAMA is a journal of the American Medical Association.

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