Pelvic-floor disorders common in women

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The first study to document the prevalence of pelvic-floor disorders in women has found that one-quarter of all adult women have one or more of the disorders, such as urinary incontinence, fecal incontinence or pelvic-organ prolapse.

The study, published today in the Journal of the American Medical Assn., will add to the simmering debate about the pros and cons of vaginal childbirth versus planned Cesarean section. The study found that the more babies a woman had, the higher the rate of pelvic-floor disorders. The study did not distinguish between the types of birth, but vaginal birth is generally linked to more problems with incontinence and prolapse. Cesarean-section rates in the United States now stand at record highs.

The study showed that pelvic-floor disorders increased with age, affecting 40% of women 60 to 79 and half of all women 80 and older. Those who had never given birth had a rate of 13% compared with a rate of 32% among women who had three or more children. Overweight or obese women also had a higher rate of the disorders. Race and ethnicity, however, were not linked to the condition. The study only identified women with moderate or severe forms of pelvic floor disorders.

Pelvic-floor disorders are not trivial. Incontinence can severely limit activity in women. Organ prolapse is uncomfortable and may require surgery. ‘Given the burden pelvic floor disorders place on U.S. women and the health care system, research is needed to further understand their pathophysiology, prevention and treatment,’ the authors of the study, from the University of Utah School of Medicine, wrote.

The National Institute of Child Health and Human Development is funding several studies on pelvic-floor disorders. Meanwhile, treatment includes exercises to strengthen muscles, behavioral therapy, vaginal devices to hold up the bladder or other pelvic organs or surgery. Information on pelvic-floor disorders can be found at the National Institutes of Health, the National Assn. for Continence and the Simon Foundation for Continence. In addition, see this recent package of stories from the L.A .Times Health section on the disorders.

• The hidden epidemic of pelvic floor problems
• Ways to prevent pelvic floor problems
• How to do Kegel exercises

-- Shari Roan