Anal and urinary incontinence in nulliparous women – Prevalence and associated risk factors

Abstract

Objective To establish the prevalence and risk factors of urinary and anal incontinence in nulliparous women. Study design Thirty-one catholic convents were sent a validated questionnaire to determine the prevalence and severity of urinary incontinence, and a similarly structured questionnaire to assess anal incontinence. Multivariable regression models were used to determine independent risk factors associated with the likelihood of urinary incontinence or anal incontinence. Main outcome measures Urine/faecal/flatal incontinence and symptom severity. Results Of 202 nuns, 167 (83%) returned the questionnaire. Twenty-two women were excluded due to history of childbirth. Of 145 nulliparous women, 56.2% reported urinary incontinence and 53.8% reported anal incontinence. Women aged 66–76 years had significantly increased odds of experiencing urinary incontinence in comparison to women aged 40–65 years: OR: 2.35 (95% CI: 1.02–5.45) ( p = 0.04). The risk of urinary incontinence was increased in women with a body mass index ≥ 30 in comparison to those with a body mass index < 19: OR: 6.25 (95% CI: 1.03–38.08) ( p = 0.04). With regards to anal incontinence, although none of the differences with age and body mass index groups reached statistical significance, there was a trend towards women in higher body mass index groups having an increased prevalence of anal incontinence. Current/previous hormonal replacement therapy was also associated with significantly increased odds of experiencing urinary incontinence: OR: 2.53 (95% CI: 1.01–6.36), ( p = 0.04). However, when adjusting for age and body mass index, there was no significant association with urinary incontinence. Conclusions This study highlights that while childbirth is an important risk factor, urinary incontinence and anal incontinence also occur in over 50% of nulliparous women. Additional studies are required to identify other risk factors that may be associated with incontinence in this population.

Association of Clustered Dietary Inorganic Salt Intake With Risk of Urinary Incontinence Among Middle-aged and Older US Women: A Cross-Sectional Analysis Utilizing NHANES 2009-2018 Data

“…The study found that hormone replacement therapy (HRT), BMI, and age were risk factors for UI in nulliparous women. [30] Additionally, pregnancy itself is a risk factor for UI, [31] and uterine growth pressure [32]and constipation [5] have also been identi ed as risk factors for UI in nulliparous women. The interaction between dietary inorganic salt intake and vaginal deliveries has not been reported in previous articles.…”

Screening and Treating Urinary Incontinence in Primary Care: A Missed Opportunity

“…Increasing age, especially greater than 70 years, increasing body mass index (BMI), especially greater than 40 kg/m 2 , and a history of any vaginal birth have the greatest associations with UI [3]. The prevalence of UI increases with age even among nulliparous women [9,10]. UI is often part of a geriatric syndrome including falls and cognitive impairment.…”