Urinary incontinence and health burden of female patients in China: Subtypes, symptom severity and related factors

Abstract

Aim Urinary incontinence (UI) causes long‐term physical and psychological suffering to patients. Risk factors for different UI subtypes and symptom severity are still unclear, as well as their associations. We aimed to examine the potential influencing factors of UI episodes, UI severity and UI subtypes, and the associations among them. Methods A total of 611 women were recruited in Shantou, China. Clinical and demographic data were collected through electronic medical records, measurements and self‐reports. UI diagnosis, subtypes and symptom severity were confirmed according to international uniform standards. The health burden of UI was evaluated by the Incontinence Impact Questionnaire. Multivariate logistic and linear regression models were carried out to examine the potential risk factors and associations among UI subtypes, symptom severity, and health burdens. Results Age, body mass index, comorbidity, lower urinary tract symptoms and constipation were associated with UI episodes and UI severity. Mixed UI patients had worse severity than urgency UI and stress UI, especially in leak times/week and daily life obstructing. Mixed UI patients also had higher health burdens, including mental health burdens, than urgency UI and stress UI patients. UI severity was positively associated with higher health burdens (β = 0.46, 95% CI 0.34–0.60), especially in physical activities, travel and social relationship burden (β = 0.61, 95% CI 0.40–0.85; β = 0.55, 95% CI 0.19–0.76; β = 0.65, 95% CI 0.38–0.91; respectively). Conclusions Age, body mass index, comorbidity, somnipathy and constipation were associated with UI episodes and symptom severity. Mixed UI showed the highest symptoms severity and health burdens. Worse UI severity increased the patient's physical health burden, but was not obvious for mental health burden. Geriatr Gerontol Int 2022; 22: 219–226.

Proposal for a Clinical Protocol for the Conservative Treatment of Urge Urinary Incontinence

“…An overactive pelvic floor also contributes to constipation by preventing proper relaxation for evacuation. Other important conditions are fecal impaction and constipation, indicated by several studies as an important risk factor and related to incontinence [18][19][20][21] . Constipation is classified into primary and secondary, and its primary causes are associated with nonrelaxation of the anorectal PFM, inadequate fiber intake, colon inertia, incorrect diet, poor control of bowel habit; secondary causes involve neurological factors, caused by traumatic or systemic neuropathies, endocrine diseases, and drug treatments 22 .…”

Proposta De Protocolo Clínico Para Tratamento Conservador Da Incontinência Urinária De Urgência

“…Outras condições importantes são a impactação fecal e a constipação, apontadas por diversos estudos como importante fator de risco e relacionado a incontinência [18][19][20][21] . A constipação intestinal se classifica em primária e secundária, e suas causas primárias estão associadas ao não relaxamento da musculatura anorretal do assoalho pélvico, consumo inadequado de fibras, inércia colônica, alimentação incorreta, mau controle do hábito da evacuação; as causas secundárias envolvem fatores neurológicos, provocados por neuropatias traumáticas ou sistêmicas, doenças endócrinas e tratamentos medicamentosos 22 .…”

Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study

“…The sixth item is related to the time and type of urine leakage (not considered). The total score ranges from 0 to 21; mild (1-5), moderate (6)(7)(8)(9)(10)(11)(12), severe (13)(14)(15)(16)(17)(18), and very severe (19)(20)(21). A higher score indicates the intensity of UI.…”

“…It can be classified as follows: (A) Stress incontinence; unintentional and sudden loss of urine caused by increased intra-abdominal pressure with activities such as laughing, pushing, sneezing, and coughing, (B) Urgency incontinence; a sudden, intense urge to urinate followed by an involuntary loss of urine, and (C) Mixed incontinence; a combination of stress and urgency incontinence [ 8 ]. The frequency and severity of symptoms are related to age, body mass index (BMI), drowsiness, and constipation [ 9 ].…”