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Pelvic floor symptoms and bone mineral density in women undergoing osteoporosis evaluation

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Abstract

Introduction and hypothesis

Our aim was to characterize pelvic floor symptoms in postmenopausal women who had undergone osteoporosis evaluation and examine their association with bone mineral density (BMD).

Methods

Pelvic floor symptom questionnaires were mailed to 4,026 women. Multivariate logistic regression models controlling for age, race, body mass index (BMI), and chronic obstructive pulmonary disease (COPD) were performed comparing symptoms in women with osteoporosis (T score ≤ −2.5) and osteopenia (T score > −2.5 to < −1) at any site to women with normal BMD (T score: ≥ −1, referent).

Results

There were 1,774/4,026 (44 %) questionnaires returned; 1,655 were included in the analysis (362 osteoporosis, 870 osteopenia, 423 normal BMD). Overall prevalence of any urinary incontinence (UI) was 1,226/1,640 (75 %), with UI ≥2–3 times/week in 699/1,197 (58 %), fecal incontinence over the past month in 247/1,549 (16 %), and prolapse in 162/1,582 (10 %). Multivariate analyses revealed that women with osteopenia had increased risk of incontinence of solid stool [adjusted odds ratio (aOR) 1.7, 95 % confidence interval (CI) 1.1–2.4). Risk of UI ≥2–3 times/week was not increased in women with osteoporosis (aOR 0.9, CI 0.6–1.3) and was lower in women with osteopenia (aOR 0.7, CI 0.5–0.9). In women with osteoporosis, the odds of moderate- to large-volume urine loss versus small/none was higher for those in the lower T-score quartile (lower BMD; aOR 1.43, CI 1.1–1.9).

Conclusions

In women undergoing osteoporosis evaluation, those with osteopenia were at increased risk of fecal incontinence but not UI compared with normal women. Osteoporotic women with the lowest T scores had higher risk of moderate- to large-volume UI. It is unclear whether there is a pathophysiologic link between BMD loss and development of pelvic floor symptoms.

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Acknowledgments

We acknowledge Ligong Chen, PhD, and Alice A. Howell, RN, BSN, CCRC, for their assistance with this project.

Conflicts of interest

HER-Astellas Consultant, Pelvalon research funding, no COI; SLM-ISCD Board and Amgen Consultant, no COI; JLG-no disclosures or COI; JMS-no disclosures or COI; PSG-Pfizer research funding, no COI; KLB-Pfizer Consultant, no COI. Funding sources wer the University of Alabama at Birmingham, Protective Life Clinical Initiatives (PLCI) Award Program; partially supported by the National Institutes of Diabetes and Digestive and Kidney Diseases, 2K24-DK068389 to HER

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Authors and Affiliations

  1. University of Alabama at Birmingham, 1700 6th Av South, Suite 10382, Birmingham, AL, 35233, USA

    Holly E. Richter, Sarah L. Morgan, Jonathan L. Gleason, Jeff M. Szychowski, Patricia S. Goode & Kathryn L. Burgio

  2. Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA

    Patricia S. Goode & Kathryn L. Burgio

Authors
  1. Holly E. Richter
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  2. Sarah L. Morgan
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  3. Jonathan L. Gleason
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  4. Jeff M. Szychowski
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  5. Patricia S. Goode
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  6. Kathryn L. Burgio
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Corresponding author

Correspondence to Holly E. Richter.

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Richter, H.E., Morgan, S.L., Gleason, J.L. et al. Pelvic floor symptoms and bone mineral density in women undergoing osteoporosis evaluation. Int Urogynecol J 24, 1663–1669 (2013). https://doi.org/10.1007/s00192-013-2056-4

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  • DOI: https://doi.org/10.1007/s00192-013-2056-4

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