Prevalence of, and risk factors for, pelvic floor disorders in women at midlife in Bangladesh: a population-based study

Objective: We investigated, using validated questionnaires, the weighted prevalence of symptomatic pelvic floor disorders (PFDs) and their risk factors in a nationally representative sample of Bangladeshi women randomly recruited from the community. Methods: 1590 women, aged 30–59 years, were recruited from 7 districts of 7 divisions in Bangladesh, by a multistage cluster sampling technique, between September 2013 and March 2014. The weighted prevalence of, and the factors associated with, PFDs were investigated using simple and multivariable weighted logistic regression. Results: The weighted prevalence of urinary incontinence (UI) was 23.7% [95% confidence interval (CI) 21.3%–26.0%], faecal incontinence (FI) 5.3% (3.7%–5.8%), pelvic organ prolapse (POP) 16.2% (14.2%–18.2%) and at least one PFD 35.3% (32.6%–37.9%). Compared with women aged 30–39 years, having at least one PFD was more likely for women aged 40–49 years [adjusted odds ratio (AOR) 1.46, 95% CI 1.02–2.08; p¼0.040] and 50–59 years (AOR 2.39, 95% CI 1.59–3.58; p<0.0001). Having at least one PFD was significantly associated with having >2 children compared with fewer children (AOR 1.61, 95% CI 1.14–2.27; p¼0.007), 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; p¼0.002) or lowest (AOR 3.13, 95% CI 1.68–5.86; p<0.0001) wealth quintile compared with the highest wealth quintile, and self-reporting diabetes mellitus (AOR 2.55, 95% CI 1.54–4.23; p<0.0001). Conclusions: Symptomatic PFDs affect a substantial proportion of women at midlife in Bangladesh. Associated factors include age, higher parity, lower wealth status and diabetes. There is a need for increased attention to diagnosis, treatment, and ultimately prevention of PFDs in Bangladesh and other developing countries, as these chronic conditions are distressing, and can be disabling.