Prevalence of symptomatic urinary incontinence and pelvic organ prolapse among women in rural Nepal

Introduction and hypothesis: Although pelvic floor disorders (PFDs) are a significant public health issue in higher income countries, less is known about these disorders and associated risk factors in low income countries. We aimed to determine prevalence and associated risk factors for stress urinary incontinence (SUI), urge urinary incontinence (UUI), and pelvic organ prolapse (POP) in reproductive age women in Sarlahi District in rural Nepal. Methods: We conducted a community-based cross-sectional survey of parous, reproductive age women in rural Nepal and screened for pelvic floor disorders using validated screening questions for PFDs. Overall frequency of self-reported symptoms for SUI, UUI, and POP was estimated and compared across demographic and pregnancy history information. Results: Of 14,469 women available for analysis, the mean (SD, range) age was 33.5 (8.2, 13–52) years, and median (range) number of pregnancies was 4 (1–15). The prevalence of SUI was 24.1% (95% CI: 23.3–24.8), of UUI was 13.5% (95% CI: 13.0–14.1), and of POP was 8.0% (95% CI: 7.5–8.4). Bivariate analysis identified the risk of PFD increased incrementally with age and number of vaginal deliveries; these covariates were highly correlated. Multivariable logistic regression revealed age, vaginal deliveries, and previous pelvic surgeries were independently associated with PFD. Conclusions: PFDs are common in a community of parous, reproductive age women in rural Nepal. Risk factors for these conditions are similar to risk factors found in higher income countries.