University of Virginia Health System

Study Finds Incontinence in Women Somewhat Common

Almost 25 percent of American women have a pelvic floor disorder, such as urinary incontinence, fecal incontinence or pelvic organ prolapse, according to a study in the Journal of the American Medical Association (JAMA).

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

"I don't think there's any question that pelvic floor disorders are underreported," adds Dr. Victor Nitti of New York University. "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."

Pelvic Floor Disorders Defined

The new study reviewed data from almost 2,000 women older than 20 who had participated in the 2005-2006 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 exam 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 one monthly leakage of stool.

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, loses support and comes outside of 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 points out that this study looked at moderate to severe incontinence. She says it is quite common for women to leak small amounts of urine while laughing or sneezing, but that is not what was studied.

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 with 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. Similarly, being overweight or obese also increased the risk of pelvic floor disorders, according to the study.

Effective Treatments Available

"The most important thing women should know about pelvic floor disorders is that they are common and they are largely treatable," says Elisa Trowbridge, M.D., a urogynecologist at the University of Virginia Health System who specializes in female pelvic medicine.

Trowbridge and Kathie Hullfish, M.D., are both fellowship-trained in female pelvic medicine and provide comprehensive non-surgical and surgical options for women with pelvic floor disorders.

"Our approach to care is personalized. We first and foremost take into account the patient's goals and expectations in treating their condition," Trowbridge says. "Both Dr. Hullfish and I are among a handful of physicians in the state of Virginia with training in the treatment of pelvic floor disorders. We offer a wide array of treatment options ranging from conservative lifestyle modification (including exercise programs and physical therapy) to state-of-the-art, minimally invasive surgery such as robotic surgery."

For more information about pelvic floor disorders or other women's health topics, visit www.uvahealth.com.

Always consult your physician for more information.