The prevalence of symptomatic pelvic floor disorders in women in Bangladesh

Abstract

Objective: To investigate the prevalence of, and risk factors for, pelvic floor disorders (PFDs) in women in Bangladesh.

Methods: A nationally representative sample of 1590 Bangladeshi women, aged 30–59 years, was recruited using a multistage cluster sampling technique, between September 2013 and March 2014. Urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) were assessed using validated questionnaires. The weighted prevalence and the factors associated with each PFD were investigated using multivariable weighted logistic regression.

Results: The weighted prevalence of UI was 23.7% (95% confidence interval (CI) 21.3–26.0%), FI 5.3% (95% CI 4.0–6.6%), POP 16.2% (95% CI 14.2–18.2%), and having at least one PFD 35.3% (95% CI 32.6–37.9%). Women were more likely to have at least one PFD if aged 40–49 years (adjusted odds ratio (AOR) 1.46, 95% CI 1.02–2.08; p = 0.040) or 50–59 years (AOR 2.39, 95% CI 1.59–3.58; p < 0.0001), compared with women aged 30–39 years. Having at least one PFD was positively associated with having three or more versus fewer children (AOR 1.61, 95% CI 1.14–2.27; p = 0.007), being in the middle (AOR 3.05, 95% CI 1.72–5.41; p < 0.0001), second lowest (AOR 2.49, 95% CI 1.39–4.47; p = 0.002) or lowest (AOR 3.13, 95% CI 1.68–5.86; p < 0.0001) wealth quintile compared with the highest, and self-reporting diabetes (AOR 2.55, 95% CI 1.54–4.23; p < 0.0001).

Conclusions: One-third of Bangladeshi women aged 30–59 years had at least one symptomatic PFD. Risk factors included greater age, higher parity, lower wealth status and self-reported diabetes. The diagnosis, treatment, and prevention of PFDs in Bangladesh need greater attention, as the prevalence of these disabling conditions is likely to increase with the aging of the population.

Keywords:

• Prevalence
• pelvic floor disorders
• urinary incontinence
• fecal incontinence
• pelvic organ prolapse
• Bangladesh

Acknowledgements

We would like to thank the Bangladesh Civil Service Administration Cadre Md. Alamgir Kabir who arranged accommodation for our survey team in all study sites. We are thankful to Dr Roslin Botlero for verifying our study instrument. We thank Afruza Arman, Lamia Anwar, Lila-Nur Shemonto and Tasmia Haque for their sincere efforts in data collection and the women of Bangladesh for participating in this study.

Conflict of interest

S. R. Davis is a consultant and investigator for Trimel Pharmaceuticals Canada. S. R. Davis and R. J. Bell have received research funding support from Lawley Pharmaceuticals. S. R. Davis has received honoraria from Abbott Australia and Pfizer Pharmaceuticals. The other authors have no competing interests to declare.

Source of funding

The study was supported by philanthropic donations to the Women’s Health Research Program, Monash University. The donors had no role in the study design, data collection, data analysis, data interpretation, or writing of the manuscript. S. R. Davis is an Australian NHMRC Principal Research Fellow (Grant no 1041853) and R. M. Islam is supported by a Monash University International Post-graduate Research Scholarship and Monash University Graduate Scholarship.