Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/8075
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Type: Journal article
Title: The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery
Author: MacLennan, A.
Taylor, A.
Wilson, D.
Wilson, D.
Citation: British journal of obstetrics and gynaecology, 2000; 107(12):1460-1470
Publisher: British Journal of Obstetrics and Gynaecology
Issue Date: 2000
ISSN: 0306-5456
1471-0528
Abstract: <h4>Objective</h4>To define the prevalence of pelvic floor disorders in a non-institutionalised community and to determine the relationship to gender, age, parity and mode of delivery.<h4>Design</h4>A representative population survey using the 1998 South Australian Health Omnibus Survey.<h4>Sample</h4>Random selection of 4400 households; 3010 interviews were conducted in the respondents' homes by trained female interviewers. This cross sectional survey included men and women aged 15-97 years.<h4>Results</h4>The prevalence of all types of self-reported urinary incontinence in men was 4.4% and in women was 35.3% (P<0.001). Urinary incontinence was more commonly reported in nulliparous women than men and increased after pregnancy according to parity and age. The highest prevalence (51.9%) was reported in women aged 70-74 years. The prevalence of flatus and faecal incontinence was 6.8% and 2.3% in men and 10.9% and 3.5% in women, respectively. Pregnancy (> 20 weeks), regardless of the mode of delivery, greatly increased the prevalence of major pelvic floor dysfunction, defined as any type of incontinence, symptoms of prolapse or previous pelvic floor surgery. Multivariate logistic regression showed that, compared with nulliparity, pelvic floor dysfunction was significantly associated with caesarean section (OR 2.5, 95% CI 1.5-4.3), spontaneous vaginal delivery (OR 3.4, 95% CI 2.4-4.9) and at least one instrumental delivery (OR 4.3, 95% CI 2.8-6.6). The difference between caesarean and instrumental delivery was significant (P<0.03) but was not for caesarean and spontaneous delivery. Other associations with pelvic floor morbidity were age, body mass index, coughing, osteoporosis, arthritis and reduced quality of life scores. Symptoms of haemorrhoids also increased with age and parity and were reported in 19.9% of men and 30.2% of women.<h4>Conclusion</h4>Pelvic floor disorders are very common and are strongly associated with female gender, ageing, pregnancy, parity and instrumental delivery. Caesarean delivery is not associated with a significant reduction in long term pelvic floor morbidity compared with spontaneous vaginal delivery.
Keywords: Pelvic Floor
Humans
Fecal Incontinence
Urinary Incontinence
Uterine Prolapse
Delivery, Obstetric
Cross-Sectional Studies
Parity
Age Distribution
Pregnancy
Sex
Adolescent
Adult
Aged
Aged, 80 and over
Middle Aged
Female
Obstetric Labor Complications
Male
DOI: 10.1111/j.1471-0528.2000.tb11669.x
Appears in Collections:Aurora harvest
Obstetrics and Gynaecology publications

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