Prevalence and Trends of Symptomatic Pelvic Floor Disorders in U.S. Women

Abstract

OBJECTIVE: To estimate the prevalence and trends of these pelvic floor disorders in U.S. women from 2005 to 2010. METHODS: 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. RESULTS: 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. CONCLUSION: 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. LEVEL OF EVIDENCE: III