Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Marsha K. Guess

Subject Area(s)

Obstetrics and gynecology



Charisse L. Mandimika, William Murk, and Marsha K. Guess. Section of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT.

Urinary incontinence (UI) and pelvic organ prolapse (POP) are common, costly and debilitating problems that have a known negative impact on women's quality of life. Our study assessed women's baseline knowledge, demographic factors associated with a lack of knowledge, and specific areas of knowledge deficiency about UI and POP among White, African American (AA), and Other Women of Color (OWOC), a group comprised of Hispanic, Asian and Other women. This community-based, cross-sectional survey of 431 racially and socioeconomically diverse women aged 19-98 years used the validated Prolapse and Incontinence Knowledge Questionnaire to assess participants' knowledge. Primary endpoints were the total number of correct responses on the UI and POP scales respectively. Percentages of individuals achieving knowledge proficiency about UI (>80% correct) and POP (>50% correct) and demographic factors that predicted a lack of knowledge proficiency were explored as secondary outcomes. A sub-analysis evaluated associations between areas of knowledge lacking proficiency (etiology, diagnosis and treatments) and race/ethnicity. The average number of correct responses was 6.7 ± 3.7 (55.8% ± 30.8%) for UI knowledge and 5.5 ± 3.5 (45.8% ± 29.2%) for POP knowledge. Overall, 28.8% and 51.9% achieved knowledge proficiency in UI and POP respectively. AA women and OWOC demonstrated significantly less knowledge about UI and POP than White women, both before and after adjustment for age, education, and household income. Specific areas of deficiency for AA and OWOC were UI and POP etiology and POP treatments. Most women who reported symptoms of UI had not received treatment for their problems. There is a global lack of knowledge about UI and POP among community-dwelling women, with more pronounced knowledge gaps among AA and OWOC. UI and POP are chronic medical conditions that should be included in routine screening questions for well-woman care.


This is an Open Access Thesis.

Open Access

This Article is Open Access