Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors

Introduction and hypothesis Information on the prevalence, risk factors and social consequences of pelvic floor dysfunction (PFD) affecting women in 16 low-income and lower middle-income countries is reviewed. Methods Medline searches were performed for articles dealing with prevalence of PFD. Results Thirty studies were identified. The mean prevalence for pelvic organ prolapse was 19.7% (range 3.4–56.4%), urinary incontinence (UI) was 28.7% (range 5.2–70.8%) and faecal incontinence (FI) was 6.9% (range 5.3–41.0%). Risk factors for PFD are similar to those in more affluent countries particularly increased age and parity, but additionally, PFD is associated with other factors including poor nutrition and heavy work. The social consequences of PFD conditions can be devastating. Conclusions Pelvic organ prolapse and urinary and faecal incontinence are significant problems in developing countries. Access to health care to manage these conditions is often limited, and women usually have to live with the consequences for the rest of their lives.