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      Prevalence of pelvic floor dysfunction in women in Riyadh, Kingdom of Saudi Arabia: A cross-sectional study

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          Abstract

          Objective:

          Pelvic floor dysfunction has a high prevalence among women worldwide. However, in the Kingdom of Saudi Arabia, it is underreported. Thus, we aimed to estimate the prevalence and risk factors of pelvic floor dysfunction in women in the Kingdom of Saudi Arabia.

          Methods:

          We conducted a cross-sectional study on literate non-pregnant women aged ⩾18 years who agreed to participate in our survey. We used the validated and translated Australian pelvic floor questionnaire and conducted a multivariate logistic regression analysis to assess the risk factors of pelvic floor dysfunction.

          Results:

          A total of 824 participants completed the questionnaire. While 60.2% of the participants had pelvic floor dysfunction, 67.7% reported signs of bowel dysfunction. Urinary dysfunction, prolapse, and sexual dysfunction were present in 44.1%, 67.7%, and 55.4% of the participants, respectively. Age, high body mass index, chronic medical illness, heavy weight lifting, and multiparity were found as the risk factors of bladder function problems. Meanwhile, chronic medical illness, heavy weight lifting, and multiparity were found as the risk factors of bowel dysfunction and prolapse. Age group and marital status were the independent factors associated with sexual dysfunction.

          Conclusion:

          We noted a high rate of pelvic floor dysfunction in the Kingdom of Saudi Arabia, which calls for the need to provide holistic approaches for the prevention and management of pelvic floor dysfunction among women.

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          The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

          Erik von Elm, Douglas G. Altman, Matthias Egger … (2014)
          Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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            Prevalence of symptomatic pelvic floor disorders in US women.

            Susan Meikle, Kimberly Kenton, William E Whitehead … (2008)
            Pelvic floor disorders (urinary incontinence, fecal incontinence, and pelvic organ prolapse) affect many women. No national prevalence estimates derived from the same population-based sample exists for multiple pelvic floor disorders in women in the United States. To provide national prevalence estimates of symptomatic pelvic floor disorders in US women. A cross-sectional analysis of 1961 nonpregnant women (>or=20 years) who participated in the 2005-2006 National Health and Nutrition Examination Survey, a nationally representative survey of the US noninstitutionalized population. Women were interviewed in their homes and then underwent standardized physical examinations in a mobile examination center. Urinary incontinence (score of >or=3 on a validated incontinence severity index, constituting moderate to severe leakage), fecal incontinence (at least monthly leakage of solid, liquid, or mucous stool), and pelvic organ prolapse (seeing/feeling a bulge in or outside the vagina) symptoms were assessed. Weighted prevalence estimates of urinary incontinence, fecal incontinence, and pelvic organ prolapse symptoms. The weighted prevalence of at least 1 pelvic floor disorder was 23.7% (95% confidence interval [CI], 21.2%-26.2%), with 15.7% of women (95% CI, 13.2%-18.2%) experiencing urinary incontinence, 9.0% of women (95% CI, 7.3%-10.7%) experiencing fecal incontinence, and 2.9% of women (95% CI, 2.1%-3.7%) experiencing pelvic organ prolapse. The proportion of women reporting at least 1 disorder increased incrementally with age, ranging from 9.7% (95% CI, 7.8%-11.7%) in women between ages 20 and 39 years to 49.7% (95% CI, 40.3%-59.1%) in those aged 80 years or older (P < .001), and parity (12.8% [95% CI, 9.0%-16.6%], 18.4% [95% CI, 12.9%-23.9%], 24.6% [95% CI, 19.5%-29.8%], and 32.4% [95% CI, 27.8%-37.1%] for 0, 1, 2, and 3 or more deliveries, respectively; P < .001). Overweight and obese women were more likely to report at least 1 pelvic floor disorder than normal weight women (26.3% [95% CI, 21.7%-30.9%], 30.4% [95% CI, 25.8%-35.0%], and 15.1% [95% CI, 11.6%-18.7%], respectively; P < .001). We detected no differences in prevalence by racial/ethnic group. Pelvic floor disorders affect a substantial proportion of women and increase with age.
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              Sexual dysfunction in the United States: prevalence and predictors.

              E O Laumann, Paul A. Paik, R Rosen (1999)
              While recent pharmacological advances have generated increased public interest and demand for clinical services regarding erectile dysfunction, epidemiologic data on sexual dysfunction are relatively scant for both women and men. To assess the prevalence and risk of experiencing sexual dysfunction across various social groups and examine the determinants and health consequences of these disorders. Analysis of data from the National Health and Social Life Survey, a probability sample study of sexual behavior in a demographically representative, 1992 cohort of US adults. A national probability sample of 1749 women and 1410 men aged 18 to 59 years at the time of the survey. Risk of experiencing sexual dysfunction as well as negative concomitant outcomes. Sexual dysfunction is more prevalent for women (43%) than men (31%) and is associated with various demographic characteristics, including age and educational attainment. Women of different racial groups demonstrate different patterns of sexual dysfunction. Differences among men are not as marked but generally consistent with women. Experience of sexual dysfunction is more likely among women and men with poor physical and emotional health. Moreover, sexual dysfunction is highly associated with negative experiences in sexual relationships and overall well-being. The results indicate that sexual dysfunction is an important public health concern, and emotional problems likely contribute to the experience of these problems.
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                Author and article information

                Contributors
                Haifaa Malaekah: Role: ConceptualizationRole: Data curationRole: MethodologyRole: SupervisionRole: ValidationRole: Writing original draftRole: Writing review editing
                Haifaa Saud Al Medbel:
                ORCID: https://orcid.org/0000-0002-9705-4501
                Role: Data curationRole: MethodologyRole: Writing original draftRole: Writing review editing
                Sameerah Al Mowallad: Role: Data curationRole: MethodologyRole: Writing original draftRole: Writing review editing
                Zahra Al Asiri: Role: Data curationRole: Formal analysisRole: Writing original draftRole: Writing review editing
                Alhanouf Albadrani: Role: MethodologyRole: Writing original draftRole: Writing review editing
                Hussam Abdullah: Role: MethodologyRole: Writing original draftRole: Writing review editing
                Journal
                Journal ID (nlm-ta): Womens Health (Lond)
                Journal ID (iso-abbrev): Womens Health (Lond)
                Journal ID (publisher-id): WHE
                Journal ID (hwp): spwhe
                Title: Women's Health
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 1745-5057
                ISSN (Electronic): 1745-5065
                Publication date (Electronic): 31 January 2022
                Publication date Collection: 2022
                Volume: 18
                Electronic Location Identifier: 17455065211072252
                Affiliations
                [1 ]General Surgery Department, Dr. Soliman Fakeeh Hospital, Fakeeh College for Medical Sciences, Jeddah, Kingdom of Saudi Arabia
                [2 ]General Surgery Department, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia
                [3 ]King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
                Author notes
                [*]Haifaa Malaekah, General Surgery Department, Dr. Soliman Fakeeh Hospital, Fakeeh College for Medical Sciences, PO Box: 2537, Jeddah, 21461, Kingdom of Saudi Arabia. Email: h_malaika@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0002-9705-4501
                Article
                Publisher ID: 10.1177_17455065211072252
                DOI: 10.1177/17455065211072252
                PMC ID: 8811438
                PubMed ID: 35100887
                SO-VID: bbdb71c5-7d9a-4cef-8dc0-1cc2541db765
                Copyright © © The Author(s) 2022
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 4 June 2021
                Date revision received : 7 December 2021
                Date accepted : 15 December 2021
                Categories
                Subject: Original Research Article
                Custom metadata
                cover-date January-December 2022
                typesetter ts1

                Keywords: fecal incontinence,pelvic floor disorders,pelvic organ prolapse,prevalence,sexual dysfunction,urinary incontinence
                Data availability:
                Keywords: fecal incontinence, pelvic floor disorders, pelvic organ prolapse, prevalence, sexual dysfunction, urinary incontinence

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