Urinary incontinence symptoms and impact on quality of life in patients seeking outpatient physical therapy services

Abstract

Objective The objective of this study was to examine the frequency and types of urinary incontinence (UI) in patients seeking outpatient physical therapy for neuro-musculoskeletal conditions. Design Retrospective cross-sectional analysis. Patients A convenience sample of patients that positively responded to a UI screening question were included in this study. Methods Data were collected for age, sex, and primary treatment condition classified into one of the following (i.e. urinary dysfunction; fecal dysfunction; pelvic pain; spine; neurological disorders; or extremity disorders); UI type (i.e. mixed, urge, stress, or insensible); UI symptom severity; and quality of life impact. Main Outcome Measures Frequency of UI type, symptom severity, health-related quality of life (HRQoL) impact, and pad use were compared between treatment groups. Results The mean age of the sample (n=599) was 49.8 years (SD=18.5) and 94.7% were female. The urinary dysfunction group comprised 44.2% of the total sample, followed by the spine group with 25.7%, and pelvic pain with 17.2%. The urinary dysfunction group scored significantly higher on UI symptom severity and impact on quality of life compared to the pelvic pain and spine groups, but not compared to the extremity disorders, fecal dysfunction, or neurological disorders group. Conclusion These preliminary data indicate that UI is a condition afflicting many individuals who present to outpatient physical therapy beyond those seeking care for UI. We recommend using a simple screening measure for UI and its impact on HRQoL as part of a routine initial evaluation in outpatient physical therapy settings.

Role and Preparedness of Physiotherapists in Prevention of Chronic Diseases, Using Stress Urinary Incontinence in Women as an Example 

“…It was satisfactory to get this response, as it is reported in literature that conservative treatment should include, rst and foremost, pelvic oor muscle exercises. These exercises, also known as Kegel exercises, can take various forms and may involve exercises with additional equipment or without it, and can often be combined with a physical factor such as electrical current that strengthens the muscle contraction [34][35][36][37][38][39][40]. tapes -this answer is compatible with literature where tension free vaginal tapes (TVT) are a widely described and applied method of surgical treatment for this disorder [41,42].…”

“…Physiotherapists, as medical personnel, should provide professional and very precise terms regarding preventive measures with regard to a speci c disease entity. A similar situation took place in relation to the concept of 'physical activity' [37,38], as 15.3% of the respondents from University Med and 8.1% from University PE gave this answer.…”

Quality of life in obese women with symptoms of urinary incontinence

“…It is estimated that 46 to 67% of women with obesity and morbid obesity have UI. The latter acts as a determinant of health-related problems involving social, sexual, psychic and economic relationships, triggering feelings of low self-esteem, restricting social life, and difficulting individuals' foray into the job market [8,9], all of which reduce women's quality of life (QOL) [7,10]. UI is not a change intrinsic to the aging process, although its incidence does increase linearly with age [11], promoting negative impacts, especially those associated with BMI increase and hormonal changes that occur in menopause [4].…”

“…Brown et al [10] suggested that women with BMI higher than 30 kg/m² have roughly a 40% higher risk of developing UI in comparison to women with normal BMI (< 29.9 kg/m²), showing a positive correlation between UI and obesity.…”

“…In cases of UI associated with morbid obesity, physical therapy plays an important role in these patients' life both before and after bariatric surgery [10]. Considering the effects of such a condition over QOL, physical therapy of the pelvic floor muscle, recommended by the American College of Physicians (ACP) as a first-line treatment for women with stress UI [15], can reduce UI-related symptoms, improving social, physical, psychological and emotional aspects, and thus QOL itself [10,16].…”