Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
Int Urogynecol J. 2024 Aug;35(8):1643-1652. doi: 10.1007/s00192-024-05843-y. Epub 2024 Jul 3.
Risk factors for pelvic floor disorders (PFDs) are not well understood in lower resource settings. The objective of this study is to determine the risk factors associated with stress urinary incontinence (SUI), urge urinary incontinence (UUI), and pelvic organ prolapse (POP) among women of reproductive age in rural Nepal.
This is a case-control study nested within a community-based cross-sectional survey of parous women of reproductive age with PFDs in the Sarlahi District of Nepal. The presence of PFDs was confirmed by clinical assessment. Detailed sociodemographic information and histories were captured.
We examined 406 women; the mean (SD, range) age was 32.7 (8.5, 16-49) years, mean BMI (SD) was 19.7 (3.3) kg/m, and median (range) number of pregnancies was 4 (1-11). Two hundred and three women (50.0%) had either SUI or UUI, 85 (17.8%) had both SUI and UUI, and 71 (17.5%) had POP at or beyond the hymen. After controlling for other variables significant on bivariate analysis, age (adjusted odds ratio [aOR] 1.06 [95% CI 1.03-1.09]), illiteracy (aOR 2.24 [95% CI 1.04-4.80]), and presence of upper gastrointestinal issues (aOR 3.30, [95% CI 1.77-6.16]) were independently associated with SUI/UUI. Age (aOR 1.05 [95% CI 1.02-1.09]), bispinous diameter (aOR 2.88 ([95% CI 1.11-7.47]), and subpubic angle (aOR 2.78 [95% CI 1.55-5.03]) were independently associated with POP.
Risk factors for PFDs in a homogenous community of parous women of reproductive age in rural Nepal are similar to those found in parous women in higher income countries.
在资源匮乏的地区，对盆底功能障碍（PFD）的风险因素尚缺乏全面了解。本研究旨在确定尼泊尔农村地区生育年龄妇女中与压力性尿失禁（SUI）、急迫性尿失禁（UUI）和盆腔器官脱垂（POP）相关的风险因素。
这是一项嵌套在尼泊尔萨拉希地区基于社区的生育年龄妇女 PFD 横断面研究中的病例对照研究。通过临床评估确认 PFD 的存在。详细的社会人口统计学信息和病史被记录。
我们共检查了 406 名女性；平均（标准差，范围）年龄为 32.7（8.5，16-49）岁，平均 BMI（标准差）为 19.7（3.3）kg/m2，中位数（范围）怀孕次数为 4（1-11）次。203 名女性（50.0%）患有 SUI 或 UUI，85 名女性（17.8%）患有 SUI 和 UUI，71 名女性（17.5%）的 POP 发生在处女膜处或以上。在控制其他在单变量分析中有统计学意义的变量后，年龄（调整后的优势比[aOR]1.06[95%CI 1.03-1.09]）、文盲（aOR 2.24[95%CI 1.04-4.80]）和上消化道问题的存在（aOR 3.30[95%CI 1.77-6.16]）与 SUI/UUI 独立相关。年龄（aOR 1.05[95%CI 1.02-1.09]）、双棘径（aOR 2.88[95%CI 1.11-7.47]）和耻骨下角（aOR 2.78[95%CI 1.55-5.03]）与 POP 独立相关。
尼泊尔农村地区生育年龄妇女同质社区中 PFD 的风险因素与高收入国家生育妇女的风险因素相似。
