Transactions of the Sixty-Seventh Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society
The demographics of pelvic floor disorders: Current observations and future projections,☆☆

Presented at the Sixty-seventh Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society, Kamuela, Hawaii, November 14-19, 2000.
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Abstract

Objective: Our aim was to assess current demand for care of pelvic floor disorders and create projections for future demand for care. We also sought to better understand the characteristics of women seeking care. Study Design: Current demand for care was calculated by comparing those women seeking care through the female pelvic floor disorders clinic with those women of the same age range at risk within an integrated health care delivery program. Patients underwent complete urogynecologic evaluation including cystometry. Women seeking care were compared with regard to age, distribution of conditions (pelvic organ prolapse, stress conditions, urge conditions), and probability of undergoing surgery. Modeling the study population by use of data from the US Census Bureau, which projects population changes over the next 30 years, created predictions of future demand. Results: Data were available on 2070 consecutive patients with an age range of 30 to 89 years normally distributed around a median age of 61.5 years drawn from an at-risk population of 149,000 women aged 30 to 89 years. Older women generated more consults per 1000 woman years than did the younger cohorts (1.7 vs 18.6 consults per 1000 woman years for those 30-39 years old vs those 70-79 years old; P < .05). Estimates of growth in demand at 30 years indicate a 45% increase in demand while net growth of the same population segment should be 22%. Stress conditions were more common among younger women and urge conditions were more common among older women. Pelvic organ prolapse was equally distributed throughout the age ranges. Conclusions: Over the next 30 years, growth in demand for services to care for female pelvic floor disorders will increase at twice the rate of growth of the same population. Demand for care for pelvic floor disorders comes from a wide age range of women, although mature age groups generate 10 times the number of consults per 1000 woman years as do their younger counterparts. Age plays a major role in the distribution of conditions with which patients present. These findings have broad implications for those responsible for administering programs to care for women, allocating research funds in women’s health and geriatrics, and training physicians to meet this rapidly escalating demand. (Am J Obstet Gynecol 2001;184:1496-503.)

Section snippets

Material and methods

We undertook a population-based study to investigate the age of women seeking care for symptomatic pelvic floor disorders and how age affected the demand for service and distribution of disorders within this population. We also created a coherent model from which to make projections of future demand for care of female pelvic floor disorders.

This research was undertaken within the Kaiser Permanente Health Care Program in Southern California. Demographic data regarding the age and gender of

Results

Two thousand seventy women were included in the study. Ages ranged from 30 to 89 years with a normal distribution around a median age of 61 years (Fig 1).

. Age distribution of women seeking care for pelvic floor disorders (N = 2070).

There were 149,000 women in the at-risk population. The age ranges of the at-risk population were similar to the age distribution of the female population of the United States with a median age of 44 years (Figs 2 and 3).

. At-risk population; women aged 30-89 years (n

Comment

Many physicians have made the casual observation that an increasing number of women are seeking care for problems related to pelvic floor dysfunction. As there has been no means of validating this observation, policy makers and program directors have been left to speculate without valid data. The observations, modeling, and projections reported here will allow those responsible for policy decisions to anticipate more accurately the demands for care of pelvic floor disorders over the next

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Reprint requests: Karl M. Luber, MD, Department of Obstetrics and Gynecology, 4647 Zion Ave, San Diego, CA 92120. E-mail: [email protected] .

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Editorsnote: This manuscript was revised after these discussions were presented.

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