Prevalence, Bother, and Risk Factors Associated With Occurrence of Pelvic Floor Dysfunctions in Young Women: A Cross-Sectional Survey

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Abstract

Purpose:

Pelvic floor dysfunctions (PFD) have been increasingly reported in young female athletes, but it is likely that young women, not specific to athletes, might also experience symptoms of PFD. This study investigated the occurrence of PFD symptoms in young women from the general population, their degree of bother and functional and clinical factors associated with these occurrences.

Methods:

Online survey was conducted with young women from the general population, not specific to athletes. Sociodemographic and clinical data, symptoms of urinary (UI) and anal incontinence (AI), pelvic organ prolapse, dyspareunia, chronic pelvic pain, and functional constipation, as well as their degree of bother were collected using validated questionnaires. Fisher exact and χ ² tests, Student t tests, and logistic regression models were applied ( α = .05).

Results:

A total of 337 women aged 18 to 25 years were investigated. The overall occurrence of PFD was 60.0%. Dyspareunia was the most prevalent symptom (49.2%), followed by UI (44.2%) and constipation (21.7%). Higher degree of bother was reported for UI, AI, and chronic pelvic pain, respectively. Constipation ( P < .001) and anxiety ( P = .004) were associated with occurrence of PFD, increasing the chances of PFD by 4 and 2 times, respectively.

Discussion:

The high occurrence, co-occurrence, and bother of PFD in young women suggest impairments in pelvic floor muscle functions that should be investigated by physical therapists. Educational programs including preventive strategies and the role of physical therapists in the treatment of PFD should be provided from early ages.

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Most cited references 28

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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 … (2008)

Much of 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 generalizability. 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. Eighteen 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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Adil Bharucha, Brian E. Lacy (2020)

With a worldwide prevalence of 15%, chronic constipation is one of the most frequent gastrointestinal diagnoses made in ambulatory medicine clinics, and is a common source cause for referrals to gastroenterologists and colorectal surgeons in the United States. Symptoms vary among patients; straining, incomplete evacuation, and a sense of anorectal blockage are just as important as decreased stool frequency. Chronic constipation is either a primary disorder (such as normal transit, slow transit, or defecatory disorders) or a secondary one (due to medications or, in rare cases, anatomic alterations). Colonic sensorimotor disturbances and pelvic floor dysfunction (such as defecatory disorders) are the most widely recognized pathogenic mechanisms. Guided by efficacy and cost, management of constipation should begin with dietary fiber supplementation and stimulant and/or osmotic laxatives, as appropriate, followed, if necessary, by intestinal secretagogues and/or prokinetic agents. Peripherally acting μ -opiate antagonists are another option for opioid-induced constipation. Anorectal tests to evaluate for defecatory disorders should be performed in patients who do not respond to over-the-counter agents. Colonic transit, followed if necessary with assessment of colonic motility with manometry and/or a barostat, can identify colonic dysmotility. Defecatory disorders often respond to biofeedback therapy. For specific patients, slow-transit constipation may necessitate a colectomy. No studies have compared inexpensive laxatives with newer drugs with different mechanisms. We review the mechanisms, evaluation, and management of chronic constipation. We discuss the importance of meticulous analyses of patient history and physical examination, advantages and disadvantages of diagnostic testing, guidance for individualized treatment, and management of medically refractory patients.

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Pelvic floor dysfunction, including urinary incontinence, anal incontinence, and pelvic organ prolapse, is extremely common, affecting at least one-third of adult women. A minority of patients sustaining these conditions volunteer their symptoms. Risk factor identification and the development of tactics for prevention are significant priorities for future research. Understanding both the specific predisposing factors that place an individual woman at risk and the precise events of the labor and delivery process that initiate injury and dysfunction is important for primary prevention. Defining the relative importance of various promoting and decompensating factors is essential for secondary prevention.

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Author and article information

Journal

Title: Journal of Women's & Pelvic Health Physical Therapy

Publisher: Ovid Technologies (Wolters Kluwer Health)

ISSN (Electronic): 2833-3659

Publication date Created: 2024

Publication date (Print): July 2024

Publication date (Electronic): July 18 2024

Volume: 48

Issue: 3

Pages: 194-201

Article

DOI: 10.1097/JWH.0000000000000305

SO-VID: ec6b30f2-65ec-4d9a-89e7-4d0a2338dc5d

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