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Review
. 2016 Mar;43(1):1-13.
doi: 10.1016/j.ogc.2015.10.008.

The Epidemiology of Pelvic Floor Disorders and Childbirth: An Update

Jennifer L Hallock  1 , Victoria L Handa  2
Affiliations
Review

The Epidemiology of Pelvic Floor Disorders and Childbirth: An Update

Jennifer L Hallock et al. Obstet Gynecol Clin North Am. 2016 Mar.

Abstract

Using a lifespan model, this article presents new scientific findings regarding risk factors for pelvic floor disorders (PFDs), focusing on the role of childbirth in the development of single or multiple coexisting PFDs. Phase I of the model includes predisposing factors, such as genetic predisposition and race. Phase II includes inciting factors, such as obstetric events. Prolapse, urinary incontinence (UI), and fecal incontinence (FI) are more common among vaginally parous women, although the impact of vaginal delivery on risk of FI is less dramatic than prolapse and UI. Phase III includes intervening factors, such as age and obesity.

Keywords: Cesarean section; Childbirth; Fecal incontinence; Pelvic floor disorders; Pelvic organ prolapse; Urinary incontinence; Vaginal delivery.

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Figures

Figure 1
Figure 1
Overlap of the prevalence of urinary incontinence (weekly or more), symptomatic pelvic organ prolapse, and fecal incontinence (leaking monthly or more) in 714 symptomatic women. From Rortveit G, Subak LL, Thom DH, et al. Urinary Incontinence, Fecal Incontinence and Pelvic Organ Prolapse in a Population-Based, Racially Diverse Cohort. Female Pelvic Medicine & Reconstructive Surgery. 2010;16(5):278–283, with permission.
Figure 2
Figure 2
Model of the development of pelvic floor dysfunction in women. From Bump RC, Norton P. Epidemiology and Natural History of Pelvic Floor Dysfunction. Obstetrics and Gynecology Clinics of NA. 1998;25(4):723–746; with permission.
Figure 3
Figure 3
Graphical display of the life span model of pelvic floor function. This graph shows the development of pelvic floor disorders across three phases of a woman’s life. From DeLancey JOL, Low LK, Miller JM, Patel DA, Tumbarello JA. Graphic integration of causal factors of pelvic floor disorders: an integrated life span model. American Journal of Obstetrics and Gynecology. 2008;199:610.e1-.e5; with permission.
Figure 4
Figure 4
Clustering of obstetrical exposures in a population of 418 primiparous women who delivered vaginally. ASLAC: anal sphincter laceration. OVD: operative vaginal delivery. From Memon HU, Handa VL. Vaginal childbirth and pelvic floor disorders. Women's Health. 2013;9(3):265–277; with permission.
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References

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