Epidemiology and Prevalence of Pelvic Floor Disorders
Pelvic floor disorders (PFDs) manifest with a variable spectrum of symptoms and can involve anterior, middle and posterior compartments. PFDs represent an important aspect of global healthcare, with about 28 million women affected by these diseases worldw
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Epidemiology and Prevalence of Pelvic Floor Disorders Carolina Ilaria Ciangola, Ilaria Capuano, Federico Perrone, and Luana Franceschilli
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Introduction
Pelvic floor disorders (PFDs) manifest with a variable spectrum of symptoms and can involve anterior, middle and posterior compartments. PFDs represent an important aspect of global healthcare, with about 28 million women affected by these diseases worldwide. This number is expected to reach 44 million in the next 40years. In the literature, the incidence and prevalence of PFDs are often reported inconsistently, depending on the definitions used, the measures considered to assess the stages, the gender and age of the patient, and the severity of the pathology. The etiology of these disorders is multifactorial and it is important to identify the risk factors, because avoiding them or reducing exposure to them can change the natural history of PFDs, allowing physicians to make an earlier diagnosis and use more effective therapy.
2.2
Definitions, Costs, and Prevalence of Pelvic Floor Disorders
Pelvic floor disorders (PFDs) manifest with a variable spectrum of symptoms and can involve the anterior, middle, and posterior compartments of the pelvic floor. PFDs can manifest as: • Urinary incontinence and sensory abnormalities of lower urinary tract • Pelvic organ prolapse • Anal incontinence • Obstructed defecation • Chronic pain syndromes related to the pelvic organs L. Franceschilli () Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy e-mail: [email protected] A. L. Gaspari, P. Sileri (Eds), Pelvic Floor Disorders: Surgical Approach, Updates in Surgery DOI: 10.1007/978-88-470-5441-7_2, © Springer-Verlag Italia 2014
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PFDs represent an important aspect of global healthcare, with an incidence of about 4 million visits per year to physicians in the USA (1% of total ambulatory visits). In 1997, costs of pelvic organ prolapsed (POP) surgery in the USA were US$1,012 million, including US$494 million for vaginal hysterectomy, US$279 million dollars for cystocele and rectocele repair, and US$135 million for abdominal hysterectomy. Moreover, costs for physician services and hospitalization increase the total expense. An indirect expense is represented by days absent from work due to illness [1]. The incidence of PFDs is increasing: 48,000 surgical procedures for urinary incontinence (UI) were performed in 1979, and over 100,000 were performed in 2004 [2]. For a woman aged 80years, the lifetime risk of undergoing surgery for PFD is 11% [3]. Annually, in the USA, 80,000 surgical procedures are performed for UI, 220,000 for POP, and 3,500 for fecal incontinence. The following rates have been reported for age distribution of surgical treatment: 7, 24, 31, and 17 per 10,000 in reproductive, perimenopausal, postmenopausal, and elderly women, respectively [4]. It is thought that these numbers will increase, as the number of women expected to develop PFD increases in future decades. At present, the
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