Residents’ Papers Gynecology
Urinary incontinence and pelvic organ prolapse in women with Marfan or Ehlers-Danlos syndrome

https://doi.org/10.1067/mob.2000.105410Get rights and content

Abstract

Objective: This study was undertaken to determine the prevalence of urinary incontinence and pelvic organ prolapse in a cohort of women with either Marfan syndrome or Ehlers-Danlos syndrome. Study Design: Female patients with either Marfan syndrome or Ehlers-Danlos syndrome were identified through a medical records search at two urban hospitals. Each patient’s medical record was reviewed, and the history of pelvic organ prolapse and urinary incontinence was obtained through telephone interview. Results: Twelve women with Marfan syndrome were identified. Among these women 5 (42%) reported a history of urinary incontinence and 4 (33%) reported a history of pelvic organ prolapse. Eight women with Ehlers-Danlos syndrome were identified. Among these women 4 (50%) reported a history of urinary incontinence and 6 (75%) reported a history of pelvic organ prolapse. Conclusions: Women with Marfan or Ehlers-Danlos syndrome have high rates of urinary incontinence and pelvic organ prolapse. This finding supports the hypothesized etiologic role of connective tissue disorders as a factor in the pathogenesis of these conditions. (Am J Obstet Gynecol 2000;182:1021-3.)

Section snippets

Material and methods

A medical records search of all women 18 years of age or greater with an International Classification of Diseases, Ninth Revision diagnosis code of either Marfan syndrome or Ehlers-Danlos syndrome was performed at an urban university-associated medical center and at an urban community-based teaching hospital. Through telephone interview each patient answered a series of items that included demographic information and gynecologic, urologic, obstetric, medical, surgical, and social histories.

Results

The medical records search by International Classification of Diseases, Ninth Revision diagnosis codes identified 19 women with Marfan syndrome and 10 women with Ehlers-Danlos syndrome. Among those with Marfan syndrome, 5 were dead and 2 were not available for interview. Two of the 10 women with Ehlers-Danlos syndrome were not available for interview. The remaining 12 patients with Marfan syndrome and 8 patients with Ehlers-Danlos syndrome were used for statistical analysis.

Demographic and

Comment

Although several case reports and small series have described potential obstetric risks among patients with Marfan syndrome and Ehlers-Danlos syndrome, little information regarding gynecologic and urologic complications exists. In this series we found high rates of both urinary incontinence and pelvic organ prolapse among women with either Marfan syndrome or Ehlers-Danlos syndrome. These findings are notable in light of the young mean age and relatively low median parity of both groups. It is

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Reprint requests: Michael E. Carley, MD, Department of Obstetrics and Gynecology, Division of Gynecologic Surgery, Mayo Graduate School of Medicine, 200 First St SW, Rochester, MN 55905.

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