Urinary Incontinence – an Unnecessary Burden for Women

Symptoms of overactive bladder (OAB) and urinary incontinence (UI), categorized as Lower urinary tract symptoms (LUTS) are widespread, under-reported health issues that increase with age and have a significant impact on the physical and emotional quality of life in those affected. Urinary incontinence, along with Alzheimer’s and Stroke are generally considered the top three most adverse conditions for senior quality of life.

Whilst overactive bladder with urgency, frequency and nocturia affects men and women roughly equally, urinary incontinence, especially stress urinary incontinence, affects many more women. Stress urinary incontinence is the involuntary urine leakage/loss that occurs without warning with coughing, jumping, skipping, etc. Urgency urinary incontinence occurs with warning when a person rushing to the toilet doesn’t get there in time. Most UI is stress UI, urgency UI or a combination of both.

Factors contributing to urinary incontinence include, childbirth, constipation and other bowel symptoms, a high body mass index, as well as, a history of hysterectomy, prostatectomy or prolapse repair. For urgency UI, excessive neural firing of the bladder detrusor muscle is also involved.

 The Statistics - Urinary Incontinence affects:

• 25% Women Reproductive Age
• 40% Women Postpartum
• 50% - 75% Post-Menopausal Women

Those affected by incontinence make numerous lifestyle changes to manage their condition, relying on pads and padded underwear and avoiding travel for more than an hour or to areas where toilet facilities are uncertain. Women exercise less, have interrupted sleep and increasing daytime fatigue as a result. Urinary incontinence is the third leading reason for elderly admittance to nursing homes. 

A 2018 USA National poll conducted by the University of Michigan showed:

• 59% of women 50-80 incontinence use pads or protective underwear
• 41% said it is a “major problem "or “somewhat of a problem”
• 1/3 had leakage episodes almost daily
• Nearly half said they worried about the condition worsening
• 40% felt embarrassed
• 32% worry about incontinence odour
• 2/3 of patients are reluctant to bring up their incontinence to a doctor because they are embarrassed or think it can’t be helped

The important thing to realise is that incontinence can be treated.

References

Colligan P, Sand P. Patient Care. 1998;32(2):141–62.

Bartoli S et al. Urology. 2010;75(3):491–501.

Peake S, et al. Med Anthropol Q. 1999;13(3):267–85.

Rane A. Aust Fam Physician. 1999;28(6):584–6.

Chiarelli P, Brown W. Womens Health. 1999;29(1):1–13National poll was conducted by the University of Michigan Institute for Healthcare Policy and Innovation and sponsored by the AARP and Michigan Medicine.

Continence Foundation of Australia