Prevalence and determinants of non-fistulous urinary incontinence among Ghanaian women seeking gynaecologic care at a teaching hospital

Abstract

The study assessed the prevalence and determinants of non-fistulous urinary incontinence among gynaecologic care seekers as well as its interference with everyday life activities of affected women. A cross-sectional study involving 400 women was conducted in a tertiary facility in Ghana. Urinary incontinence was assessed using the International Consultation on Incontinence Questionnaire-short form (ICIQ-SF) which has not been validated locally. The questionnaire was administered mostly in the Asante Twi language with translation done at the time of the interview. The data was analysed for proportions and associations between selected variables. The prevalence of urinary incontinence was 12%, the common types being urgency (33.3%), stress (22.9%), and mixed (20.8%). Age ≥60 years compared to 18–39 years (OR 3.66 95%CI 1.48–9.00 P = 0.005), and a history of chronic cough (OR 3.80 95% CI 1.36–10.58 P = 0.01) were associated with urinary incontinence. Women with education beyond the basic level were 72% less likely to experience urinary incontinence (OR 0.28 95%CI 0.08–0.96 P = 0.04). Urinary incontinence interferes with everyday life activities of most affected women. Non-fistulous urinary incontinence is relatively common among gynaecologic care seekers yet very few women were referred with such a diagnosis. Advocacy measures aimed at urging affected women to report the condition and educating the general population on potential causes, prevention and treatment are needed.

Estimated burden, and associated factors of Urinary Incontinence among Sub-Saharan African women aged 15–100 years: A systematic review and meta-analysis

“…One thousand two hundred and twenty-nine articles were screened, of which 1071 papers were excluded. A total of 148 publications were evaluated for eligibility, with 25 studies [14][15][16][17] being included in the current review [ Fig 1]. This study included a total of 17863 women from SSA.…”

“…As a results, in order to strengthen continence programs, health systems should be able to estimate the burden especially in a region with a frail health system, such as SSA. Hospital and community based-studies had been conducted for UI in SSA countries [14][15][16][17]. A significant limitation of these observational studies is likely under-estimation of the burden of UI in SSA [16].…”

“…Hospital and community based-studies had been conducted for UI in SSA countries [14][15][16][17]. A significant limitation of these observational studies is likely under-estimation of the burden of UI in SSA [16]. Following a thorough search of the literature, it was revealed that no prior systematic review and meta-analysis addressing the burden of UI and associated factors on the African continent has yet been conducted and published.…”

Female urinary incontinence in sub‐Saharan Africa

“…Increasing age has also been demonstrated as an independent risk factor for n-fUI in SSA [32,34]. Several changes occur in older women that contribute to the increased risk including hypoestrogenism, decreased urethral closure pressure, decreased bladder sensation, development of detrusor overactivity and increased nocturnal urine production, in addition to changes that occur with the patient's functional status such as impaired mobility [35].…”

“…Non‐fistulous urinary incontinence was found to be more common in cross‐sectional studies from Nigeria, with adjusted odds ratios of 1.39 and 1.6 for overweight and obese women [29] and a twofold increased risk in patients who had a history of constipation [30]. Finally, studies in Ghana and Ethiopia have suggested up to four times increased risk of UI in women with a history of chronic cough [31,32]. Research has shown a growing burden of chronic respiratory disease in SSA [33] and this may become a more important factor for the development of female UI in the future.…”