Prevalence of Pelvic Floor Disorders in the Female Population and the Impact of Age, Mode of Delivery, and Parity

Abstract

The study data demonstrate that pelvic floor dysfunction is a common problem among women and it is strongly linked to childbirth and aging.

Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

“…However, rectocele grade II or grade III, rectal intussusception, rectocele grade II or III associated with rectal intussusception and occult sphincter injury were more prevalent in group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001, respectively). The groups did not differ significantly with regard to anismus, anismus associated with rectocele grade II or III, or entero/ sigmoidocele grade III ( (8,14,15,17,20,27) . Thus, while some reports have correlated pelvic floor abnormalities with obstetric trauma (4,10,12,23) , others have failed to identify an association between the incidence of such dysfunctions and vaginal delivery (17,20,27) .…”

“…Different techniques and imaging methods have been used to evaluate pelvic floor dysfunctions in the anterior, middle and posterior compartment (2,3,7,8,9,12,14,15,16,17,18,19,20,24,25,27) . Because of differences in measurement techniques and anatomical landmarks, some authors describe rectocele as a descent of the rectal ampulla, quantified by correlation with the inferoposterior margin of the symphysis pubis (8,12) , while others consider rectocele a herniation of the anterior rectal wall into the posterior vagina, the size of which determines the grade of rectocele (2,3,9,13,15,17,19,20,23,27,29) .…”

“…However, tissue atrophy in women over 50y (post-menopausal) can lead to reduced distensibility (11) and, consequently, increased risk of pelvic floor dysfunctions. Results vary between studies due to differences in population profile, study variables, techniques and tests performed during evaluation (8,14,17,20,27,30) . In an analysis of the demographic variables of post-menopausal women and assessment of pelvic prolapse (uterine, cystocele and rectocele) by baseline pelvic examination, Hendrix et al (12) found that pelvic prolapse, especially cystocele, is common in older women and strongly associated with parity and obesity.…”

“…Anatomical and functional changes of the pelvic floor (anterior compartment) have also been described (12,16,24,25) . However, the relation between vaginal delivery, age (post-menopause) and posterior pelvic floor dysfunctions involving obstructed defecation syndrome (ODS) is still a matter of controversy (8,14,17,19,27) . Pelvic floor dysfunctions are best evaluated with dynamic techniques such as magnetic resonance (9,15) and ultrasonography using endorectal (2,18,19) or transperineal (3,7) probes to view the anal canal and pelvis anatomy.…”

An interview study of the experiences of middle-aged women living with constipation

“…[13] The prevalence of pelvic floor dysfunction and constipation increases in relation to delivery and number of children after adjusting for age. [13,14] Childbirth can be one factor that contributes to the difference in constipation rates among men and women.…”