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Submitted by alemama on March 2, 2008 - 11:20am
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Study: Female Incontinence Is Common
Incontinence Not an Inevitable Part of Aging, Researchers Report
By Miranda Hitti
WebMD Medical NewsReviewed by Louise Chang, MDFeb. 29, 2008 -- Women often don't tell their doctors about incontinence, overactive bladder, and pelvic organ prolapse, but those problems are common, a new study shows.

The study urges women not to accept those problems as a normal part of aging.

"Rather, they should focus on modifiable risk factors such as weight loss and maintenance, and seek treatment for all conditions when they occur," the researchers write in the March edition of Obstetrics & Gynecology.

The study included 4,103 women aged 25 to 84 (average age: 56) who got their health care through Kaiser Permanente Southern California.

The women completed surveys about the following pelvic floor disorders:

Stress urinary incontinence: urine leakage when there is an increase in abdominal pressure, such as while exercising, laughing, sneezing, or coughing.
Overactive bladder: an urgent need to urinate.
Pelvic organ prolapse: the descent or drooping of the bladder, uterus, vagina, small bowel, or rectum.
Anal incontinence: defined in the study as leaking gas, as well as solid or liquid stool.
The survey's results:

15% reported stress urinary incontinence
13% reported overactive bladder
6% reported pelvic organ prolapse
25% reported anal incontinence
Many women had more than one pelvic floor disorder.

"Roughly 80% of women with stress urinary incontinence or overactive bladder, 69% with pelvic organ prolapse, and 48% with anal incontinence reported at least one other [pelvic floor] disorder," write the researchers, who included Jean Lawrence, ScD, MPH, of Kaiser Permanente Southern California.

Pelvic floor disorders were more common among older women. But age wasn't as important as other factors, such as the number of babies the women had had by vaginal birth, menopause, hysterectomy, smoking, and obesity.

It's not clear if the results apply to all women. Those with pelvic floor disorders may have been more likely than women without those problems to complete the survey.

ATS

March 2, 2008 - 11:40am

If I am reading that correct then out of over 4,000 women only 6% had POP - doesn't that mean that the estimated over 50% of women suffer this condition thing wrong?

granolamom

March 2, 2008 - 2:13pm

how many women with POP actually know they have it?
my guess is many women don't even know so they'd check the 'does not apply' box on a survey.

and interesting to note that hysterectomy is listed as a factor in POP, alongside vaginal birth and menopause.

ATS

March 2, 2008 - 2:25pm

I've actually been reading a lot of stories on the hystersisters website and they have talked about prolapse as being something that follows a hyster. One woman said her doctor was not happy when she saw him about her prolapes and mentioned she had a hyster. He asked why she had one and because it was for fibroids he was even less pleased stating that there are plenty of other things that can be done for fibroids instead of hyster and it was the hyster that had caused her prolapse.

Christine

March 2, 2008 - 3:17pm

Hi Alemama, Anita and gmom,

I totally agree, Anita…even the opening statement is questionable:

“Women often don't tell their doctors about incontinence, overactive bladder, and pelvic organ prolapse, but those problems are common, a new study shows.”

I’m doubtin’ that. The generations of women going to the doctor today are much more open and communicative than their mothers and grandmothers.

Obgyn has a huge vested interest in “treating” these conditions. Although awareness is growing around the hazards of pelvic floor surgery, and we are seeing more and more women being fitted with pessaries and referred to PT, there is no doubt that gynecology has zero interest in considering these chronic conditions to be largely the result of modifiable risk factors.

The numbers in this study are very suspect: 22% of women with urinary incontinence (stress and/or urge) and 12% of women with fecal incontinence reported at least one other pelvic floor disorder. Fecal incontinence was experienced more than four times as often as prolapse, urinary incontinence was experienced almost five times as often as prolapse. Only 35% of the total population reporting symptoms reported prolapse, yet almost three-quarters of these women also reported symptoms of urinary and/or fecal incontinence. Given these odds, it seems unlikely that the incontinence groups were almost exclusively reporting other forms of incontinence as their “other” pelvic floor disorder.

Even if the numbers are an accurate representation of the results of the questions asked, data central to the core issues of prolapse and incontinence have been once again omitted, making this just one more non-sensical study filling the gyn literature. Vaginal birth is mentioned as a criterion of the study, but what about episiotomy (25% fecal incontinence???), birthing position, and instrumental delivery? Hysterectomy is also mentioned, but what about the time factor? Were these women weeks and months out from surgery naively believing they would remain bulge free for the long term? These are some of the real questions to be included in any study of this kind. And that they are left out time and time again is an insult to the intelligence of women!

I thought the WebMD feed on the home page might give us useful things to consider, but have been outraged at the drivel passing for “news”.

Hope everyone is doing well,

Christine

louiseds

March 2, 2008 - 8:50pm

Hi All

I would never take material like this at face value. I cannot get a full text version of the original paper, so I have to rely on an article written by a journalist about *some* of the findings of a survey run by a health insurance company which stands to gain from more women being aware of conditions they *may* have, which will also bring business to the Obs and Gynos who are commenting on the results of the survey, and more policy holders for the health insurance company.

This is sales talk, and really doesn't tell women any more than we already know. What is the point of it, other than to drum up business?

The article also does not say who sponsored the research. Presumably the participants were members of the health insurance company, which makes it biased in the first place. I would have a couple of guesses at who sponsored it. These guesses would suggest to me that it is not genuine, unbiassed research. End of story.

Show me the full article and I may eat my hat.

Cheers

Louise