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

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Authors	Islam, 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.
Keywords	faecal incontinence; low and middle-income countries; pelvic floor disorders; pelvic organ prolapse; urinary incontinence
Year	2019
Journal	International Urogynecology Journal and Pelvic Floor Dysfunction
Journal citation	30 (12), pp. 2001-2011
Publisher	Springer London
ISSN	0937-3462
Digital Object Identifier (DOI)	https://doi.org/10.1007/s00192-019-03992-z
Scopus EID	2-s2.0-85067011045
Research or scholarly	Research
Page range	2001-2011
Publisher's version	License All rights reserved File Access Level Controlled
Output status	Published
Online	04 Jun 2019
Publication process dates
Accepted	20 May 2019
Deposited	12 Jul 2021

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