Mar. 5, 2008 A new study by Kaiser Permanente found that one-third of women suffer from one or more pelvic floor disorders, which include symptoms such as the frequent urge to urinate, dropped pelvic organs, and incontinence. The study consists of the broadest age range of participants to date, of which 80 percent of the 4,000 women studied had given birth. Of those 4,000 women, 25 percent suffered from anal incontinence, 15 percent from stress urinary incontinence, 13 percent from overactive bladder and six percent experienced pelvic organ prolapse, the dropping of pelvic organs.
"These conditions really affect women's quality of life. Many women think this is just something they have to deal with as they age and that there isn't anything they can do about it, but that's not true," said lead author Jean M. Lawrence, ScD, MPH, MSSA, a research scientist at Kaiser Permanente's Department of Research and Evaluation in Southern California, where the study was conducted.
Published in the March issue of Obstetrics & Gynecology, the study surveyed women aged 25 to 84 in English and Spanish, making it the most extensive research on the subject to date across such a wide age range. Funded by the National Institutes of Health, the findings expand on research published two years ago by the same scientific team from Kaiser Permanente Southern California and the University of California, San Diego Medical Center that found that vaginal births double the rate of pelvic floor disorders compared to Cesarean deliveries and women who have never given birth.
"One of the myths surrounding pelvic floor disorder is that it affects only older women, but the truth is these conditions are extremely prevalent and extremely debilitating. But because the subject matter isn't cocktail conversation, women feel isolated and don't seek support and treatment," said study co-author Karl Luber, M.D., a uro-gynecologist in the Department of Obstetrics and Gynecology at Kaiser Permanente San Diego Medical Center.
Dr. Luber's advice for women with overactive bladders and urgency to urinate, involuntary leaking of urine during physical activity, anal incontinence or sagging pelvic organs is to get educated through internet research or books on the subject, and then find a physician who is trained in female pelvic medicine and reconstructive surgery to seek treatment.
"Among the available options for treatment for these common disorders are physical therapy to strengthen your pelvic floor muscles, devices that can be fit to support your vaginal walls, and surgery. Many of today's surgeries are very non-invasive and can be done as an outpatient." Luber said.
This research surveyed women in the general community, not just those seeking treatment for these conditions, and studied several different common pelvic floor disorders. Based on the findings of this study, clinicians have better clues about what else to ask women about when they have symptoms of one condition and what conditions may cluster together.
More than 15 million women in the U.S. have stress urinary incontinence and 16 million women have an overactive bladder. One in 10 women suffers from anal incontinence, with one in 15 experiencing moderate to severe symptoms. Over a woman's lifetime, 11 percent are likely to have pelvic surgery for urinary incontinence and/or prolapse while 29 percent will have multiple surgeries for pelvic floor disorders, according to previous studies published in Neurological Urodynamics and Urology.
With statistics like these, women need to know how to best protect their health by seeking out solutions to maintain and/or restore their quality of life and full functionality. "Women need to know how to find and gain access to experts like those at Kaiser Permanente who are committed both in their research and in clinical practice to delivering outstanding continence care. That's why consumer education and advocacy organizations like NAFC exist," said Nancy Muller, executive director of the National Association for Continence (NAFC).
Major contributions to this work were made by co-authors on the study included Emily S. Lukacz, M.D., MAS and Charles W. Nager, M.D, of UC-San Diego Medical Center and Jin-Wen Y. Hsu, Ph.D., of Kaiser Permanente's Department of Research and Evaluation.
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