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Female Incontinence Problems


(HealthDay News) -- Almost 25 percent of American women have a pelvic floor disorder, such as urinary incontinence, fecal incontinence or pelvic organ prolapse, according to new research.


"This study showed that pelvic floor disorders are exceedingly common in women in the United States," said the study's lead author, Dr. Ingrid Nygaard, a professor in the division of urogynecology and pelvic reconstructive surgery in the department of obstetrics and gynecology at the University of Utah School of Medicine.

And, though these disorders are prevalent, women don't always bring them up with their doctors, said Nygaard. "Pelvic floor disorders are not talked about often, and women are often too embarrassed to bring them up" with their doctors.


Dr. Victor Nitti, vice chairman of urology at New York University Langone Medical Center: "I don't think there's any question that pelvic floor disorders are underreported. Some women are embarrassed, and some think they're a normal part of aging. Either way, it's not something women will often report spontaneously."

The new study, published in the Sept. 17 issue of the Journal of the American Medical Association, reviewed data from almost 2,000 women over the age of 20 who had participated in the 2005-06 National Health and Nutrition Examination Survey. This study group is considered to be representative of the U.S. population. None of the women included in the data analysis was pregnant at the time of the study.


The women were interviewed at home and underwent a physical in a mobile examination center. Urinary incontinence was diagnosed based on scoring more than "three" on an incontinence severity index. Fecal incontinence was diagnosed if women reported having at least once monthly leakage of stool. And pelvic organ prolapse was diagnosed if women reported feeling a bulge inside or outside of the vagina. (Pelvic organ prolapse occurs when one of the pelvic organs, such as the uterus, drops and presses on the vagina.)


Overall, the researchers found that 23.7 percent of women experienced at least one pelvic floor disorder. Almost 16 percent of the women reported urinary incontinence, 9 percent experienced fecal incontinence, and 2.9 percent reported pelvic organ prolapse.

Nygaard pointed out that this study looked at moderate to severe incontinence. She said it's quite common for women to leak small amounts of urine while laughing or sneezing, but that's not what was studied here.


Older women were most likely to report a pelvic floor disorder, with almost 50 percent of those 80 and older reporting at least one pelvic floor disorder, compared to just 10 percent of women between 20 and 39 years old.


Having been pregnant increased the odds of pelvic floor disorders, and, with each pregnancy, the likelihood of incontinence or prolapse rose. Being overweight or obese also increased the risk of pelvic floor disorders, according to the study.


Both Nygaard and Nitti said that effective treatments are available for women with pelvic floor disorders. Nygaard recommended that women start with the most conservative treatment options, such as pelvic muscle strengthening and behavioral therapy. Surgery, which can be effective for certain problems, is usually reserved as a last option, she said.


"The most important thing women need to realize is that they're not alone. Pelvic floor disorders aren't dangerous and are treatable," said Nygaard.


Nitti added: "If you have any symptoms related to any of these problems, and they bother you, you shouldn't be embarrassed to bring it to the attention of your health-care providers. All are, in one way or another, treatable, particularly at the early stages."