| Summary: |
Pelvic floor disorders include a group of conditions that affect adult women including pelvic organ prolapse, urinary incontinence, faecal incontinence, and other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts.
The PROLAPSE OF THE PELVIC ORGANS AFFECTS 40% of the whole women population aged 45-85, according to a Dutch survey presented to the joint congress of the International Continence Society and of the International UroGynecological Association.
It is estimated that 50% OF ADULT WOMEN REPORT ANY FORM OF INCONTINENCE, the prevalence being higher than 50 % for women aged more than 65 years.
The lifetime risk of surgery for prolapse or incontinence is approximately 11%, with one third undergoing multiple (repeated) surgical procedures. By currently available estimates, more than 225,000 IMPATIENT SURGICAL PROCEDURES FOR PROLAPSE ARE PERFORMED PER YEAR IN THE UNITED STATES, at an estimated direct MEDICAL COST OF OVER ONE BILLION DOLLARS. By comparison, fewer impatient surgeries for urinary incontinence are performed per year (e.g., in 1997, approximately 84,000).
The fact that women will be living longer and are more often attending to pelvic floor disorders makes its study urgent, in particular due to its high complexity and SOCIETAL IMPACT.
A real understanding of the pathophysiology of pelvic floor disorders is still lacking. It seems apparent that multiple factors combine in each individual to develop a clinical condition. Findings of epidemiologic studies (which are not designed to prove cause and effect relationships) are frequently inconsistent. Without an understanding of the true causes of pelvic floor disorders, efforts at prevention are fruitless and therapy can only be empiric, rather than directed at specific injuries or function deficits. Unfortunately, surgery for pelvic floor disorders often fails.
Because of the relative paucity of research and the growing public health need, THE NATIONAL INSTITUTES  |
Summary
Pelvic floor disorders include a group of conditions that affect adult women including pelvic organ prolapse, urinary incontinence, faecal incontinence, and other sensory and emptying abnormalities of the lower urinary and gastrointestinal tracts.
The PROLAPSE OF THE PELVIC ORGANS AFFECTS 40% of the whole women population aged 45-85, according to a Dutch survey presented to the joint congress of the International Continence Society and of the International UroGynecological Association.
It is estimated that 50% OF ADULT WOMEN REPORT ANY FORM OF INCONTINENCE, the prevalence being higher than 50 % for women aged more than 65 years.
The lifetime risk of surgery for prolapse or incontinence is approximately 11%, with one third undergoing multiple (repeated) surgical procedures. By currently available estimates, more than 225,000 IMPATIENT SURGICAL PROCEDURES FOR PROLAPSE ARE PERFORMED PER YEAR IN THE UNITED STATES, at an estimated direct MEDICAL COST OF OVER ONE BILLION DOLLARS. By comparison, fewer impatient surgeries for urinary incontinence are performed per year (e.g., in 1997, approximately 84,000).
The fact that women will be living longer and are more often attending to pelvic floor disorders makes its study urgent, in particular due to its high complexity and SOCIETAL IMPACT.
A real understanding of the pathophysiology of pelvic floor disorders is still lacking. It seems apparent that multiple factors combine in each individual to develop a clinical condition. Findings of epidemiologic studies (which are not designed to prove cause and effect relationships) are frequently inconsistent. Without an understanding of the true causes of pelvic floor disorders, efforts at prevention are fruitless and therapy can only be empiric, rather than directed at specific injuries or function deficits. Unfortunately, surgery for pelvic floor disorders often fails.
Because of the relative paucity of research and the growing public health need, THE NATIONAL INSTITUTES OF HEALTH (NIH -USA), HAS RECOGNIZED THE FIELD OF FEMALE PELVIC FLOOR DISORDERS AS AN AREA OF HIGH PRIORITY FOR RESEARCH.
Multiple mechanisms of injuries have been hypothesized to contribute to the development of pelvic floor dysfunction, including direct injury to the pelvic floor muscles due to tearing or muscle detachment, and nerve injury due to stretch or compression or both during the second stage of labour, resulting in partial denervation of the pelvic floor. However, little is known about the relation of structure and function, structural changes and the impact on function and spontaneous recovery, as well as underlying risk factors.
The organs and muscles of the pelvic floor have complex three-dimensional (3D) structures and interact in a complex fashion to maintain continence. When they do not function properly, incontinence and or prolapse results. |