Epidemiology of Female Pelvic Floor Disorders

女性骨盆底疾病是一个重大的公共卫生问题，对生活质量造成重大损害，并对个人和整个社会造成巨大负担。 子宫脱垂是60-79岁女性中最常见的子宫切除术适应症，也是50多岁女性中第二常见的适应症。 据估计，在整个年龄段的妇女中，尿失禁的患病率从10%到58%不等。 然而，令人惊讶的是，在国家健康数据集中进行的任何女性盆底疾病的研究很少。 因此，甚至没有关于美国女性骨盆底疾病的基本统计信息。 至关重要的是，在国家卫生数据集进行流行病学研究，以进一步了解妇女因骨盆底疾病而经历的问题的范围和性质。 在本申请中，我们建议利用全国门诊医疗保健调查（NAMCS）、全国医院门诊医疗保健调查（NHAMCS）、全国出院调查（NHDS）、全国住院病人样本（NIS）和全国门诊手术调查（NSAS）。这些数据集专门设计用于提供客观、可靠、基于人群的信息，并可用于解决有关女性盆底疾病的几个关键问题，包括门诊医疗保健利用、住院和门诊手术治疗、治疗中的医师专业差异、寻求治疗的女性特征和这些疾病造成的经济负担。利用这些数据集，我们将实现以下具体目标：1。描述NHDS和NIS数据集中女性盆底疾病的住院情况，包括阴道穹窿脱垂、子宫脱垂、子宫阴道脱垂、阴道肠疝、大便失禁和尿失禁，2。）描述NSAS中用于治疗女性盆底疾病的非卧床手术程序，3）描述NAMCS和NHAMCS中女性盆底疾病的门诊访视。

Female pelvic floor disorders are a significant public health problem, cause major impairments in quality of life, and impose a substantial burden on individuals and on society as a whole. Uterine prolapse is the most common indication for hysterectomy among women aged 60-79, and the second most common indication among women in their fifties. Estimates of the prevalence of urinary incontinence among women overall ages range from 10 percent to 58 percent. However, there have been surprisingly few studies of any female pelvic floor disorders conducted in the national health data sets. Consequently, even basic statistical information concerning female pelvic floor disorders among American women is not available. It is critically important that epidemiologic studies be conducted in national health data sets in order to further our understanding of the scope and nature of the problems experienced by women due to pelvic floor disorders. In this application we propose to conduct a descriptive study of the epidemiology of and recent trends in outpatient visits, in-hospital stays, and surgical procedutes for female pelvic follr disorders utilizing the National Ambulatory Medical Care Survey (NAMCS), the National Hospital Ambulatory Medical Care Survey (NHAMCS), the National Hospital Discharge Survey (NHDS), the Nationwide Inpatient Sample (NIS) and the National Survey of Ambulatory Surgery (NSAS). These data sets have been specifically designed to provide objective, reliable, population-based information and could be utilized to address several key issues concerning female pelvic floor disorders including outpatient health care utilization, in- hospital and ambulatory operative treatments, physician specialty differences in treatments, characteristics of women seeking treatment and the economic burden imposed by these disorders. Utilizing these data sets we will accomplish the following specific aims: 1.)Describe hospitalizations for female pelvic floor disorders including vaginal vault prolapse, uterine prolapse, uterovaginal prolapse, vaginal enterocele, fecal incontinence, and urinary incontinence in the NHDS and NIS data sets, 2.) Describe ambulatory operative procedures used as treatment for female pelvic floor disorders in the NSAS, and 3.) Describe office-based visits for female pelvic floor disorders in the NAMCS and the NHAMCS.