Did you know? Basic Facts about Urogynecology

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Prolapse

  • Vaginal prolapse is common, affecting up to half of adult women [1]
  • Lifetime risk of undergoing 1st time POP surgery 11-12%, up to 19% in an Australian study [2,3]
  • The presence of prolapse doesn't necessarily mean it needs treatment - it depends on how much it is affecting the woman's quality of life.
  • In severe cases of prolapse, obstruction of the ureters (the tubes which connect the kidneys to the baldder) and kidney function impairment can offer. In these cases, treatment is required [4]
  • Vaginal prolapse is divided into 3 compartments: anterior (bladder), posterior (rectum), and apical (uterine or vault).

Urinary Incontinence

  • It is estimated that nearly 50% of adult women experience urinary incontinence, and only 20-61% of symptomatic community-dwelling women seek care. [5-7]
  • Stress urinary incontinence and urge incontinence are the 2 most common types of incontinence that women present with.
  • Stress urinary incontinence is urine leakage with any activities that increase intra-abdominal pressure e.g. coughing, laughing, sneezing - this is most common in younger women especially 45-49 years old [5,8-9]
  • Urge incontinence is urine leakage preceded by a sudden and strong need to urinate.
  • "Overactive bladder" is a term that describes a syndrome of urinary urgency with or without incontinence, which is often accompanies by nocturia and urinary frequency.
  • Overall prevalence of urinary incontinence in non-pregnant women >20 years = 10-17% [10-11]
  • Compared with no treatment, women treated with pelvic muscle exercises were more likely to report improvement or cure of any urinary incontinence (67% vs 29%; RR 2.39) [13]. Outcomes are better with regular exercise that has been supervised.
  • Urinary incontinence only needs treatment if it is significantly affecting the woman's quality of life.

Additional Information:

Looking for more detailed information about urogynecology? Check out our patient leaflets covering more than 35 topics in more than 15 languages available on our patient website, YourPelvicFloor.org.

References:

  1. Hendrix SL, et al. Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol. 2002;186(6):1160.
  2. Olsen AL, et al. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501.
  3. Smith FJ, Holman CDJ, Moorin RE, Tsokos N, Obstet Gynecol 2010; 116,5:1096-1100
  4. Australian Commission on Safety and Quality in Healthcare. Treatment Options for pelvic organ prolapse. Accessed 26 Aug 2019 at: https://www.safetyandquality.gov.au/sites/default/files/migrated/Treatment-Options-POP-Consumer-Info.pdf
  5. Hannestad YS, Rortveit G, Hunskaar S. Help-seeking and associated factors in female urinary incontinence. The Norwegian EPINCONT Study. Epidemiology of Incontinence in the County of Nord-Trøndelag. Scand J Prim Health Care. 2002 Jun;20(2):102-7.
  6. Minassian VA, et al. The iceberg of health care utilization in women with urinary incontinence. Int Urogynecol J. 2012;23(8):1087. Epub 2012 Apr 12
  7. Morrill M, et al. Seeking healthcare for pelvic floor disorders: a population-based study. Am J Obstet Gynecol. 2007 Jul;197(1):86.e1-6.
  8. Wood LN, Anger JT. Urinary incontinence in women. BMJ. 2014;349:g4531. Epub 2014 Sep 15.
  9. Minassian VA, et al. Clinical epidemiological insights into urinary incontinence. Int Urogynecol J. 2017;28(5):687. Epub 2017 Mar 20.
  10. O'Halloran T, et al. Urinary incontinence in young nulligravid women: a cross-sectional analysis. Ann Intern Med. 2012;157(2):87.
  11. Wu JM, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol. 2014 Jan;123(1):141-8.
  12. Urinary Incontinence: An inevitable part of aging? National Poll on Health Aging. University of Michigan. November 2018 www.healthyagingpoll.org/sites/default/files/2018-11/NPHA_Incontinence-Report_FINAL-110118.pdf (Accessed on November 02, 2018).
  13. Dumoulin C, et al. Cochrane Database Syst Rev. 2018;10:CD005654. Epub 2018 Oct 4

 

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IUGA volunteers are active and engaged members of our urogynecology community working to create and disseminate knowledge that not only advances the field of urogynecology, but results in improved patient care. From students, trainees, and fellows at the beginning of their careers to seasoned practitioners with years of experience, our volunteer force is strong and productive.

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