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International Urogynecology Journal

, Volume 30, Issue 12, pp 2001–2011 | Cite as

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

  • Rakibul M. IslamEmail author
  • John Oldroyd
  • Juwel Rana
  • Lorena Romero
  • Md Nazmul Karim
Review Article

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 

Notes

Compliance with ethical standards

Ethics approval

This review is entirely based on published data. Thus, ethics committee approval or written informed consent is not required.

Conflicts of interest

None.

Supplementary material

192_2019_3992_MOESM1_ESM.docx (241 kb)
ESM 1 (DOCX 240 kb)

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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
  2. 2.Women’s Health Research Program, School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
  3. 3.Environmental and Occupational Health SciencesEHESP French School of Public HealthParisFrance
  4. 4.The Ian Potter LibraryThe Alfred HospitalMelbourneAustralia

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