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

International Urogynecology Journal volume 31, pages 1851–1858 (2020)Cite this article

Abstract

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.

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Funding

This work was funded by the Maren Foundation, the Johns Hopkins University Center for Global Health, and the National Institute of Child Health and Development, United States National Institutes of Health (R01HD060712).

Author information

Affiliations

  1. Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA

    Chi Chiung Grace Chen & Andrea M. Avondstondt

  2. Nepal Nutrition Intervention Project – Sarlahi, Kathmandu, Nepal

    Subarna K. Khatry & Steven C. LeClerq

  3. Department of Obstetrics and Gynecology, Institute of Medicine, Kathmandu, Nepal

    Meeta Singh

  4. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Elizabeth M. Klasen, Steven C. LeClerq, Joanne Katz & Luke C. Mullany

  5. Milken Institute School of Public Health, Department of Global Health, George Washington University, Washington, DC, USA

    James M. Tielsch

Authors
  1. Chi Chiung Grace Chen
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  2. Andrea M. Avondstondt
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  3. Subarna K. Khatry
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  4. Meeta Singh
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  5. Elizabeth M. Klasen
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  6. Steven C. LeClerq
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  7. Joanne Katz
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  8. James M. Tielsch
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  9. Luke C. Mullany
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Contributions

• Chen: Study design, obtained funding, and oversaw all aspects of the study design and implementation, analysis, and manuscript writing.

• Avondstondt: Data interpretation and manuscript writing.

• Khatry: Study design, project implementation, data analysis, and manuscript writing

• Singh: Study design, project implementation, data analysis, and manuscript writing

• Klasen: Study design, project implementation, data analysis, and manuscript writing

• LeClerq: Study design, project implementation, data analysis, and manuscript writing

• Katz: Study design, project implementation, data analysis, and manuscript writing

• Tielsch: Study design, project implementation, data analysis, and manuscript writing

• Mullany: Study design, project implementation, data analysis, and manuscript writing

Corresponding author

Correspondence to Chi Chiung Grace Chen.

Ethics declarations

Ethics committee approval

IRB approval was obtained both from Johns Hopkins School of Public Health (Baltimore, MD, USA, IRB no. 00002572) and the Institute of Medicine, Tribhuvan University (Kathmandu, Nepal), on 27 January 2010.

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None.

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Chen, C.C.G., Avondstondt, A.M., Khatry, S.K. et al. Prevalence of symptomatic urinary incontinence and pelvic organ prolapse among women in rural Nepal. Int Urogynecol J 31, 1851–1858 (2020). https://doi.org/10.1007/s00192-019-04129-y

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  • DOI: https://doi.org/10.1007/s00192-019-04129-y

Keywords

  • Nepal
  • Low-income countries
  • Pelvic floor disorders
  • Urinary stress incontinence
  • Urinary urge incontinence
  • Pelvic organ prolapse