Prevalence of symptomatic pelvic floor disorders in community-dwelling women in low and middle-income countries : A systematic review and meta-analysis

Journal article

Islam, Rakibul M., Oldroyd, John, Rana, Juwel, Romero, Lorena and Karim, Md Nazmul. (2019). Prevalence of symptomatic pelvic floor disorders in community-dwelling women in low and middle-income countries : A systematic review and meta-analysis. International Urogynecology Journal and Pelvic Floor Dysfunction. 30(12), pp. 2001-2011. https://doi.org/10.1007/s00192-019-03992-z
AuthorsIslam, Rakibul M., Oldroyd, John, Rana, Juwel, Romero, Lorena and Karim, Md Nazmul
Abstract

Introduction and hypothesis
Pelvic floor disorders (PFDs), including urinary incontinence (UI), faecal incontinence (FI) and pelvic organ prolapse (POP), are common debilitating conditions globally, with considerable variation of prevalence reported in low and middle-income countries (LMICs). It was hypothesised that the variation could be due to both random and non-random errors. The aim was to determine the pooled prevalence estimates of PFDs among community-dwelling women in LMICs and to examine possible reasons for the variations of prevalence reported.

Methods
A systematic search of MEDLINE, EMBASE, PsycINFO, CINAHL and Maternity & Infant Care was conducted to retrieve eligible studies. A meta-analysis with a random effects model and a meta-regression were performed. The manuscript was structured using the PRISMA checklist .

Results
A total of 49 studies were included. The overall pooled prevalence of PFDs in LMICs was 25% (95% CI 22–29%). The pooled prevalence of UI, FI and POP was 30% (95% CI 25–35%), 8% (95% CI 4–11%) and 15% (95% CI 10–20%), respectively. A significant difference in the prevalence of UI was found between studies conducted in low and lower middle-income and upper middle-income countries and for FI between studies that used validated and non-validated questionnaires. Other methodological features did not show any effect on the variation of prevalence estimates of UI, FI and POP.

Conclusions
PFDs affect a substantial proportion of women in LMICs. Since methodological heterogeneity was unexplained, this review suggests the need for large nationally representative population-based surveys to provide reliable estimates of the prevalence of PFDs in LMICs.

Keywordsfaecal incontinence; low and middle-income countries; pelvic floor disorders; pelvic organ prolapse; urinary incontinence
Year2019
JournalInternational Urogynecology Journal and Pelvic Floor Dysfunction
Journal citation30 (12), pp. 2001-2011
PublisherSpringer London
ISSN0937-3462
Digital Object Identifier (DOI)https://doi.org/10.1007/s00192-019-03992-z
Scopus EID2-s2.0-85067011045
Research or scholarlyResearch
Page range2001-2011
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online04 Jun 2019
Publication process dates
Accepted20 May 2019
Deposited12 Jul 2021
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