Exploring pelvic floor dysfunction: prevalence and risk factors through APFQ analysis

The Australian Pelvic Floor Questionnaire (APFQ) is a validated Patient-Reported Outcome Measure (PROM) assessing pelvic floor dysfunction (PFD) across bladder, bowel, prolapse, and sexual domains. Its ability to capture mild, subjective symptoms makes it suitable for community-based prevalence studies.

This cross-sectional study recruited participants during a nationwide hybrid pelvic floor health seminar in April 2024 for civilian and military wives. Following an educational session, attendees voluntarily completed the Indonesian-validated APFQ via a secure Google Form. For prevalence estimation, outcomes were dichotomized into binary categories, APFQ scoring for severity will be explored in future analysis. Multiple logistic regression analyses identified factors associated with PFD, with adjusted odds ratios (ORs) and 95% confidence intervals (CIs) reported.

High PFD prevalence was observed: urinary dysfunction in 66% (n = 819), defecatory dysfunction in 98% (n = 1,228), pelvic organ prolapse in 14.7% (n = 183), and sexual dysfunction in 75% (n = 933). Urinary and defecatory dysfunction were more likely among women aged ≥ 50 years, those with grade II obesity, and parity of three. Mode of delivery was not significantly associated with urinary or bowel dysfunction. Pelvic organ prolapse was more common among women aged 40-49 years, those with higher body mass index, higher parity, and vaginal delivery history. Sexual dysfunction was most prevalent among women aged 30-39 years, underweight women, and those with higher parity.

PFD prevalence was high, likely reflecting the sensitivity of the APFQ in capturing subjective symptoms. While clinical diagnosis requires physical examination, the APFQ is valuable for early detection, prevention, and population-level screening of PFD.