Prevalence, risk factors and quality of life in Turkish women with urinary incontinence: a synthesis of the literature

Addressing urinary incontinence by gender: a nationwide population-based study in Turkiye

BACKGROUND

Urinary incontinence (UI), which usually occurs in women but affects both sexes, is a significant public health challenge. This study aims to comprehensively investigate the prevalence and determinants of UI in men and women, considering gender-specific factors.

METHODS

The study performed a secondary analysis on data obtained from 13,383 individuals surveyed in the 2019 Turkish Health Survey, providing a representation of the Turkish population. The dataset included sociodemographic and health-related variables like UI, body mass index (BMI), physical activity, smoking, and chronic diseases-statistical analysis employed chi-square tests and gender-stratified logistic regression models to identify UI-associated factors.

RESULTS

Our results showed that UI affected 8.8% of the population, with a striking gender disparity. Women had a notably higher prevalence at 11.2%, while men had a lower rate of 5.5%. Importantly, this gender gap narrowed with age. For example, in the 34-44 age group, the female/male ratio was 6.9, but it decreased to 1.4 in the 65-74 age group. Marital status and employment status played significant roles. Separated, divorced, or widowed individuals, particularly women, had the highest prevalence at 19.3%. Employment status influenced UI prevalence, with employed men having the lowest rate (2.1%), while retired women faced the highest rate (15.0%). Higher BMI, especially in obese individuals, significantly raised UI prevalence, reaching 7.9% for men and 15.8% for women. Physical inactivity, notably in women (17.0%), and prolonged sedentary hours (13.9%) were associated with higher UI rates. Former smokers, especially women (15.9%), had a notable impact on UI. Poor perceived health and chronic conditions like Chronic Obstructive Pulmonary Disease (COPD), hypertension, and diabetes were significantly associated with higher UI prevalence. Logistic regression analysis revealed that age, education, perceived health status, COPD, and diabetes were significant factors associated with UI in both sexes, while in women, BMI, physical activity, and smoking also played notable roles.

CONCLUSIONS

This extensive UI study has unveiled notable gender disparities and determinants. Notably, these disparities decrease with age, underlining UI's changing nature over time. Modifiable factors impact women more, while non-modifiable factors are linked to men. The study underscores the importance of tailoring healthcare strategies to address UI based on gender.

Association Between Sleep Duration and Urinary Incontinence in Female Adults: A Cross-sectional Study in National Health and Nutrition Examination Survey 2007-2018

OBJECTIVE

To elaborate on the effect of sleep duration on urinary incontinence (UI), we investigated the association between sleep duration with the risk of UI from the National Health and Nutrition Examination Survey (NHANES) dataset.

METHODS

A cross-sectional survey of female participants aged 20years old and above were enrolled from the year 2007-2018. We performed weighted multivariable logistic regression models to assess the association between sleep duration and UI.

RESULTS

A total of 6838 female participants were included. Compared with sleep duration less than 6 hours, other sleep duration was found to be not significantly correlated with total UI, stress urinary incontinence, and mixed urinary incontinence in all three models Compared to sleep duration less than 6 hours, multivariate regression demonstrated that moderate sleep (6-8 hours) indicated a lower urgent urinary incontinence (UUI, odds ratio=0.764, 95% confidence interval=0.620-0.944, P = .013). Inadequate sleep (<6 hours) indicated a higher UUI (odds ratio=1.308, 95% confidence interval=1.060-1.614, P = .013) compared to moderate sleep duration (6-8 hours). The association might be modified by the family income-to-poverty ratio.

CONCLUSION

Inadequate sleep (<6 hours) was associated with a higher incidence of UUI. A moderate sleep duration (6-8 hours) was related to a lower rate of UUI. Further studies are warranted for clinical prevention and treatment guidance.

Lower urinary tract symptoms and toileting behaviors in Turkish adult women

This study aimed to investigate lower urinary tract symptoms (LUTS) in Turkish adult women and to compare toileting behaviors in women with and without LUTS. This cross-sectional study was conducted in 815 women. The International Consultation on Incontinence Modular Questionnaire - Female LUTS and a toileting behaviors form, created by the authors, were used in evaluations. Nearly 50 % of the women had at least one LUTS, 45.8 % had storage symptoms, 7.4 % had voiding symptoms, and 20.2 % had incontinence symptoms. The rates of premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS than in women without LUTS (p < .05). The rate of squatting on the toilet while urinating was lower in women with LUTS than those without LUTS (p < .05). Various LUTS were common in adult women. Some toileting behaviors such as premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS compared to women without LUTS. Since the rate of unhealthy toilet behaviors is higher in women with LUTS, it is important to know unhealthy toilet behaviors in the management of LUTS and to organize training programs to prevent these behaviors and LUTS.

The adaptation states of women with urinary incontinence according to the Roy Adaptation Model: A qualitative study

AIMS

This study aimed to explore experiences of women with urinary incontinence (UI) according to the Roy Adaptation Model (RAM).

METHODS

A phenomenological design was used in this study, and its conceptual framework was formed by the RAM. The sample was composed of 12 women with UI. Face-to-face in-depth interviews were conducted according to data collection tools. Semi-structured interviews were recorded in audio-recording device. Thematic approach was used to assess the data.

RESULTS

The average age of the women was 52.77 ± 7.32 years, seven women had menopause, eight had vaginal birth. According to the thematic approach, four main themes emerged: physiological mode, self-esteem mode, role function mode, and interdependence mode and they had difficulties in this regard.

CONCLUSIONS

The results show that women cannot adapt to the problem of incontinence according to the dimensions of RAM. These factors are important to consider when developing strategies to address UI, diagnosis, and treatment.

Impact of Urinary Incontinence on Quality of Life Among Women of Childbearing Age in Al Madinah Al Munawara, Saudi Arabia

Introduction

Urinary incontinence (UI) is a widely prevalent problem with a great impact on quality of life. It affects a person’s physical, social, occupational, and phycological aspects of life. Our study aimed to estimate prevalence, risk factors, effect on life, and help-seeking behaviors among women with urinary incontinence. 

Methods 

This is a cross-sectional analytic study conducted in primary health care centers among women of childbearing age in Al Madinah Al Munawara, Saudi Arabia. A total of 342 women aged between 18 to 50 years were included and interviewed using a previously validated and pretested Arabic version of the King's Health Questionnaire (KHQ). 

Result

Out of 342 patients, 71 (20.8%) had UI. The mean age of the patients was 31.51 +9.36 years. Risk factors associated with UI were: BMI (p = 0.022, odds ratio = 1.06), multiparity (p = 0.027, odds ratio = 1.16), smoking (p = 0.018, odds ratio = 4.71), and chronic constipation (p = 0.013, odds ratio = 5.83). Only 28.2% of the affected women sought medical consultation. The main reasons for not seeking medical advice were the belief that UI is a common, normal aging process in 45%, while 14.1% were embarrassed by the condition, and 5.6% did not know that there was a treatment. Overall, there was a limitation in all domains of quality of life among patients who suffer from UI. The majority of limitations were slight to moderate. The most affected domain was sleep and energy.

Conclusion 

UI is common and adversely affects the quality of life of women of childbearing age in Al Madinah Al Munawara. Obesity, multiparity, smoking, and chronic constipation are significant risk factors. Less than half of patients with UI sought medical care.

Analysis of Characteristics and Quality of Life of Elderly Women with Mild to Moderate Urinary Incontinence in Community Dwellings

Introduction: The incidence of urinary incontinence (UI) increases with age. Mild and moderate UI have little impact on women and are easily ignored. This study reports the characteristics of non-severe UI and quality of life (QOL) in elderly women using data from a Development and Evaluation of a Senile UI Alert System study. Methods: 926 women aged ≥60 were enrolled from six subcenters across China, among whom 717 SUI patients and 209 UUI/MUI patients were grouped into Group A and Group B, respectively, according to leakage symptoms. Demographic and clinical data, pelvic organ prolapse quantification and pelvic floor muscle strength measurement (PFMS) were collected from participants, followed by evaluation of QOL and sexual life. Result: The major type of UI in community women was SUI (77.4%); MUI and UUI accounted for 20.63% and 1.94%, respectively. Weakened PFMS was detected in 78.2% of the participants. Group B was significantly higher in terms of median age, weight, BMI, waist circumference and menopausal years, and had the greater UI severity and impact on QOL, as well as less active sex live than group A (p < 0.05). Conclusion: SUI distributes dominantly in elderly community women, but UUI/MUI has greater impact on QOL and is related to a less active sex life, which requires more attention from medical staff.

Occurrence of urinary tract infection and preventive strategies practiced by female students at a tertiary care teaching institution

BACKGROUND

Urinary tract infections (UTIs) are more common in females than males and predominantly based on their unhealthy practices in their day to day lives. This study is trying to assess the occurrence of UTI and strategies used by female student to prevent UTI.

MATERIALS AND METHODS

A cross-sectional descriptive study carried out in a tertiary care teaching institute. A total of 338 conveniently selected B. Sc. Nursing and MBBS Medical students were surveyed. The data were collected by using a pretested, a self-structured questionnaire related to occurrence and practices to prevent UTI along with necessary demographic details. Descriptive (frequency, percentage, mean and standard deviation) and inferential (Chi-square test) statistics was used to compute the data.

RESULTS

The result of this study shows that 10.05% female students reported of having UTI. The proportion was higher in nursing students (67.6%) than medical (32.4%) but did not show a significance difference (P = 0.61). Age, duration of hostel life, and marital status were significantly associated with the status of UTI (P = 0.001). To prevent UTI, students were using commercial product with Tea Tree Oil, soap, drinking 3-4 l water/day, increased frequency of peri-wash during menstruation period, and use of Citrus Fruits. The use of western toilet was also significantly associated with status of UTI (P = 0.04).

CONCLUSION

The occurrence of UTI was more among nursing students. Most of the perineal hygienic practices by the female students were associated with occurrence of UTI; hence, it is necessary to emphasize on preventive practices to minimize re-occurrence.

Prevalence, social impact and help-seeking behaviour among women with urinary incontinence in the Gulf countries: A systematic review

BACKGROUND

Urinary incontinence (UI) in women is a common problem worldwide. It has a major impact on the physical and social activities and interpersonal relationships. The societies in the Gulf countries are conservative and favours large families, high parity and short inter-pregnancy intervals. Moreover, there is a high prevalence of gestational diabetes with many macrosomic babies. This study aimed to review the published literature on UI among women in this region.

METHODS

All published literature which investigated the prevalence, social impact and help-seeking behavior in women with UI in the Gulf countries was reviewed.

RESULTS

Nine studies met the criteria and were very heterogeneous. None of them was a true population-based study and all except one, investigated subjects from healthcare facilities. The prevalence of UI ranged from 20.3% to 54.5%. Stress UI was the main type reported. The main predisposing factors were chronic respiratory diseases and constipation. There was a large impact on the quality of life with major interference with prayers (34-90%) and sexual relationships (18-57%). The main reasons for not seeking medical advice were embarrassment to see doctors especially male doctors and the belief that UI is common, normal or incurable disease.

CONCLUSIONS

There is a need for true whole population-based studies of UI in this region with the use of validated international questionnaires. UI was shown to have a major impact on the act of prayers and sexual relationships. A large proportion of women are still embarrassed to discuss the issue with doctors especially male doctors.

Prevalence and risk factors of urinary incontinence among Iranian women

BACKGROUND

Urinary incontinence is a common condition among women. Although it is not a life-threatening condition, it dramatically influences the quality of life. This study aimed to estimate the prevalence of urinary incontinence and its risk factors among Iranian women in Kerman, Iran.

METHODS

This cross-sectional, population-based study was conducted on 3100 Iranian women aged 15-80 years in 2017 in Kerman, Iran. The participants were selected via cluster sampling and were invited to complete the questionnaires. Their demographic information and medical history were assessed, the urinary incontinence questionnaire was completed, and the associated risk factors were also recorded. Quantitative variables are reported as mean ± SD, while qualitative and ranked variables are expressed in percentage. All analyses were conducted in Stata version 12 (Stata Corp.).

RESULTS

The mean age of the participants was 46 years, and the overall prevalence of urinary incontinence was estimated to be 63%. The highest and lowest prevalence rates of urinary incontinence were reported in the elderly and the youth, respectively (79% and 41%, respectively). Age, increase of body mass index (BMI), pregnancy, diabetes, anxiety, and depression were the associated risk factors.

CONCLUSION

We found that the prevalence of urinary incontinence is high in Iran. Therefore, to control this condition and improve women's quality of life, effective plans are needed.

The effect of a self-care programme on urinary incontinence and self-esteem in elderly men dwelling in nursing homes in Iran

INTRODUCTION

Whilst self-care programme involving comprehensive lifestyle plans including physical and behavioural interventions have reported positive outcomes for the aged suffering from urinary incontinence (UI), very few programmes have been implemented amongst Iranian nursing home residents, particularly in men.

OBJECTIVES

The aim of this study was to examine the effect of a self-care programme on UI and self-esteem in elderly men dwelling in nursing homes in Iran.

MATERIALS AND METHODS

Sixty-one elderly men (aged 60-75 years of age), at two different sites and living in nursing homes in the west of Iran, suffering from urinary incontinence were included in this study. Participants were selected using convenience sampling based on selected and randomized criteria in experimental and control groups. Data collection tools included Mini-Mental State Examination (MMSE), Rosenberg Self-Esteem Scale Questionnaire (RSES), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), and demographic information form. Data were analysed using SPSS vesion18 (SPSS Inc., Chicago, IL).

RESULTS

A significant decrease in the mean scores of ICIQ-SF in the experimental group compared with the control group following intervention (p < .001). Furthermore, a significant increase was observed in self-esteem in the experimental group compared to the control group (p < .001).

CONCLUSION

The study findings demonstrate that the self-care programme significantly reduced UI in elderly men living in nursing homes, and that this in turn contributed to boosting their self-esteem. Implementing such an intervention has shown to be useful in managing both UI and improving self-esteem in this patient population.

Urinary incontinence and its relation to delivery circumstances: A population-based study from rural Kilimanjaro, Tanzania

OBJECTIVES

To investigate the prevalence and risk factors of urinary incontinence (UI), the different UI subtypes and the association between UI and delivery circumstances.

DESIGN

Cross-sectional population-based study conducted in Kilimanjaro Region, Tanzania.

PARTICIPANTS AND SETTINGS

1048 women aged 18-90 women living in rural Kilimanjaro. Simple random sampling was done to select villages, households and participants. Community health workers helped in identifying eligible women and trained nurses/midwives conducted face-to-face interviews. Data were analysed using descriptive statistics and Univariate and Multivariate logistic regression modelling.

RESULTS

The overall prevalence rate of UI was 42%. When focusing on the different types of UI, 17% of the women had stress UI, 9% had urge UI and 16% had mixed UI. Only one woman (0.1%) with vesico-vaginal fistula was identified. UI was found to be significantly associated with increasing parity (OR = 2.41 (1.55-3.74). In addition, women who in relation to their first delivery had delivered at home or had been in labour for more than 24 hours, had increased adjusted ORs of 1.70(1.08-2.68) and 2.10(1.08-4.10), respectively, for having UI.

CONCLUSION

UI is common in rural Tanzania and of the subtypes of UI, Stress Urinary Incontinence (SUI) is the commonest followed by Mixed Urinary Incontinence (MUI). Home delivery, prolonged labour and increasing parity especially having 5 or more deliveries are associated with increased risk for developing UI.

Evaluation of the efficacy of transobturator tape surgery in the treatment of stress urinary incontinence using urodynamics and questionnaires

OBJECTIVE

To measure the efficiency of transobturator tape (TOT) surgery using urodynamics and questionnaires in stress urinary incontinence.

MATERIALS AND METHODS

Ninety-two patients with stress and mixed urinary incontinency who underwent TOT surgery were selected for the study. We retrospectively examined the patients' urodynamics, ultrasonography, demographic characteristics, incontinency surveys, life quality scores [incontinence impact questionnaire, (IQ-7) and urinary distress inventory (UDI-6)], diagnostic findings, Q-type test, surgical records, and complications. Patients treatment adherence, life quality scores, and urodynamics were evaluated as per the findings and complications following discharge of the patients between 12 and 36 months. Patients with a surgical history as the result of incontinence were excluded from the study.

RESULTS

Prior to surgery, 57 (61%, 95) patients had stress urinary incontinence (SUI), and 35 (38%, 05) patients had mixed urinary incontinence (MUI). During surgery, 45 (48%, 91) patients underwent extra pelvic surgical intervention. The mean follow-up time was 22.17±7.55 months. Our subjective success rate was 91%, 3 and the objective success rate was 78%, 3. In the life quality evaluation, a statistically significant improvement was found between IIQ-7 and UDI-6 scores. Parity over 4 was an important failure reason. Two (2%, 17) patients developed vaginal erosion, 2 (2%, 17) of the patients developed temporary urine retention, and 1 (1%, 08) patient developed nova urge incontinence.

CONCLUSION

Our study demonstrates that TOT surgery provides high objective and subjective success and has a positive impact on life quality. The ease of application and lower complication rate makes TOT a valuable alternative for other treatment approaches in the surgical treatment of SUI.

Toileting behaviours and lower urinary tract symptoms among female nurses: A cross-sectional questionnaire survey

BACKGROUND

Unhealthy toileting behaviours exist among women, and lower urinary tract symptoms have a high prevalence and significant effects on quality of life. However, the relationship between toileting behaviours and lower urinary tract symptoms is unclear.

OBJECTIVES

This study aimed to investigate the prevalence of lower urinary tract symptoms among female nurses, and the association between toileting behaviours and lower urinary tract symptoms.

DESIGN

A cross-sectional stratified cluster sampling study.

PARTICIPANTS

A total of 636 female clinical nurses from tertiary hospitals in Jinan (the capital city of Shandong Province, China).

METHODS

The Toileting Behaviour-Women's Elimination Behaviours and the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms scales were used to assess the participants' toileting behaviours and lower urinary tract symptoms, respectively. Multiple linear regression analysis was used to evaluate the association between toileting behaviours and lower urinary tract symptoms.

RESULTS

Unhealthy toileting behaviours were common among the female nurses, with delayed voiding being the unhealthiest toileting behaviour, which was followed by place and position preference for voiding. Nearly 68% of the female nurses had at least one lower urinary tract symptom, nearly 50% had incontinence symptoms, 40% had filling symptoms, and 18% had voiding symptoms. Unhealthy toileting behaviours (premature voiding, delayed voiding, and straining to void) were positively associated with lower urinary tract symptoms. However, lower urinary tract symptoms were not significantly associated with voiding place or position preference. Among the control variables, being married or having a history of a urinary tract infection was associated with lower urinary tract symptoms. Having a higher income and regular menstrual period were negatively associated with lower urinary tract symptoms. Compared with vaginal delivery, caesarean delivery had a protective association with lower urinary tract symptoms.

CONCLUSION

Lower urinary tract symptoms among female nurses should not be overlooked, because their prevalence among female clinical nurses exceeded that among the general population of women. These findings highlight the importance of avoiding unhealthy toileting behaviours (especially premature voiding, delayed voiding, and straining to void), as these unhealthy toileting behaviours were significantly associated with susceptibility to lower urinary tract symptoms.

Factors associated with urinary incontinence in middle-aged women: a population-based household survey

INTRODUCTION AND HYPOTHESIS

The objective was to determine the prevalence of urinary incontinence (UI) and factors associated in a sample of Brazilian middle-aged women.

METHODS

A cross-sectional study was conducted between September 2012 and June 2013 with 749 women. UI was defined as any complaint of involuntary loss of urine. The independent variables were sociodemographic data and health-related habits and problems. Statistical analysis was carried out using Chi-squared test and Poisson regression.

RESULTS

The mean age was 52.5 (±4.4) years. The prevalence of UI was 23.6 %. Of these, 48 (6.4 %) had stress urinary incontinence, 59 (7.8 %) urinary urgency, and 70 (9.5 %) had mixed urinary incontinence. In the final statistical model, self-perception of health as fair/poor/very poor (PR: 1.90; 95 % CI, 1.45-2.49; P < 0.001), ≥1 vaginal deliveries (PR: 1.84; 95 % CI, 1.35-2.50; P < 0.001), higher body mass index (PR: 1.04; 95 % CI, 1.02-1.06; P = 0.001), vaginal dryness (PR: 1.60; 95 % CI, 1.23-2.08; P = 0.001), current or previous hormone therapy (PR: 1.38; 95 % CI, 1.06-1.81; P = 0.019), pre-/perimenopause (PR: 1.42; 95 % CI, 1.06-1.91; P = 0.021), and previous hysterectomy (PR: 1.41; 95 % CI, 1.03-1.92; P = 0.031) were associated with a greater prevalence of UI. Current or previous use of soy products to treat menopausal symptoms was associated with a lower prevalence of UI (PR: 0.43; 95 % CI, 0.24-0.78; P = 0.006).

CONCLUSIONS

Several factors are associated with UI in middle-aged Brazilian women. The results highlight the importance of carrying out interventions aimed at reducing modifiable factors.

Incidence and risk factors of urinary incontinence in women visiting Family Health Centers

Background

The objective of this study is to determine the incidence and the risk factors of the urinary incontinence in women visiting the Health Family Center.

Methods

430 women, who visited three Family Health Centers in the city center of Erzurum for any reason between 25 November and 20 January 2016, were included in this study without any sampling. The data were collected by using the face-to-face interview method. Percentage distribution, Chi square test, and logistic regression analysis were used in order to analyze the data.

Results

It was determined that 37.2 % of these women had urinary incontinence, but only 29.3 % of them visited a physician because of this complaint. Among a total of 160 women with urinary incontinence findings, stress type incontinence was observed at the highest rate (33.7 %), which was followed by mixed type (31.8 %), urge type (20.6 %) and other types (overflow, continuous urinary incontinence) (13.7 %). It was found that urinary incontinence had a significant correlation with the number of children, genital prolapse, duration of delivery longer than 24 h, diabetes and urogenital infection, but not with the age at the first and last childbirth, presence of the episiotomy, birth weight over 4 kg, and smoking.

Conclusions

It was determined that one-third of the women had urinary incontinence and certain medical and obstetric conditions were affecting the development of urinary incontinence. It is thought that it is important for the healthcare personnel to take the progression of the urinary incontinence under control by preventing the risk factors and to encourage the patients to seek treatment with the help of the proper information indicating that urinary incontinence is a treatable and preventable condition.

Quality of life of women with urinary incontinence in rehabilitation treatment

This article analyzed how sexual satisfaction, suffering, severity and impact of urinary incontinence, and psychological morbidity affected women's quality of life and whether suffering mediated the relationship between psychological morbidity and quality of life. The study included 80 women diagnosed with urinary incontinence receiving rehabilitation treatment. Regression analysis showed that sexual satisfaction, suffering, and urinary incontinence severity and impact predicted quality of life and that suffering mediated the relationship between psychological morbidity and quality of life. The findings suggest that interventions should be tailored according to the suffering reported by women and the impact of the urinary incontinence on the couple's sexual relationship.

Risk factors associated with urinary incontinence in Portugal and the quality of life of affected women

OBJECTIVE

To identify risk factors for urinary incontinence (UI) and assess the quality of life (QoL) of affected women.

METHODS

A cross-sectional study was conducted of all women with UI who attended the urology and gynecology services of four hospitals in central Portugal between March and December 2012. Information was obtained from participants using questionnaires assessing sociodemographic, obstetric, gynecologic, and lifestyle variables.

RESULTS

Among 505 participants, 351 (69.5%) had urgency UI, 107 (21.2%) stress UI, and 47 (9.3%) mixed UI. Stress UI was associated with smoking, alcohol consumption, constipation, gravidity, parity, and vaginal infections (P≤0.02 for all). Urgency UI was associated with age above 50 years, employment, smoking, and sitting for 2 hours or less per day (P≤0.02 for all). Mixed UI was associated with age 50 years or younger, smoking, sitting for 2 hours or less per day, and frequently carrying more than 3 kg in weight (P<0.001 for all). A negative impact on QoL was reported by 501 (99.2%) women. Compared with younger participants, women older than 50 years presented with more sleep/energy disturbances and performance limitations (P≤0.04 for both).

CONCLUSION

UI is associated with several risk factors and has a negative impact on QoL. Appropriate investigation regarding the factors associated with the types of UI should be performed to diminish its impact on QoL.