Hidden female urinary incontinence in urology and obstetrics and gynecology outpatient clinics in Turkey: what are the determinants of bothersome urinary incontinence and help-seeking behavior?

Abstract

The purpose of this study was to assess the prevalence of female urinary incontinence (UI) and risk factors of bothersomeness and help-seeking behavior of hidden female UI in urology and obstetrics and gynecology outpatient clinics. This multicentric and cross-sectional study was conducted as a part of the Turkish Overactive Bladder Study. Female patients (n = 5,565) who were referred with complaints other than UI and overactive bladder symptoms were surveyed using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) with supplementation of five more questions. The crude prevalence of UI was found to be 35.7%. The prevalence of frequent and severe incontinence was 8.2 and 6.8%, respectively. The mean age of incontinent patients was significantly higher (p < 0.001). The prevalence of stress, urge, and mixed UI was 39.8, 24.8, and 28.9%, respectively. More than half (53%) of incontinent patients were not bothered by UI, and only 12% of incontinent patients had previously sought medical help for their problem. Frequency, severity, and type of UI were independent factors for predicting bothersome UI, while only bothersomeness increased help-seeking behavior. The ICIQ-SF score of 8 has been found to be the best cutoff value to delineate the bothersome UI. Although the crude prevalence of female UI was found to be high, bothersome UI was not so common. The majority of incontinent female patients did not seek medical help. Frequency, severity, and mixed type of UI were found to be the determinants of bothersome UI for which the ICIQ-SF cutoff score of 8 was obtained.

Factors Associated with Help Seeking Behavior of Turkish Women with Urinary Incontinence; A Single Center Cross-Sectional Study

“…One Turkish study showed that frequency, severity and type of UI were independent factors for predicting bothersomeness while another Norwegian study found that increasing age, severity and UI duration were also significantly associated with consultation rate (4,17) .…”

“…The Sandvik Severity Index is a validated measurement of incontinence severity, which has been shown to correlate with the objective measurement of incontinence using a 24-hour pad test. The SSI is comprised of an index score calculated by multiplying the frequency of incontinence by the amount of urine leaked, yielding three categories of severity: slight (1-2), moderate (3)(4)(5) and severe (6-8) (8).…”

“…In a recent review, it has been reported that UI has a wide interval of prevalence between 16.2% and 81.9% (2). The prevalence of UI among Turkish women has been reported to be between 20.9 and 35.7% (3,4).…”

Urinary incontinence among women registered with a family health center in the Southeastern Anatolia Region and the factors affecting its prevalence

“…Only 12.4%-27.7% of women in Turkey seek medical aid for UI, even though it negatively affects their life quality (5,18). In the metaanalysis study conducted by Minassian et al the researchers found that 31%-42% of women sought medical aid (27).…”

Percutaneous Vaginal Tape Surgery at Stress Urinary Incontinence: Our Medium-Term Results

“…Among incontinence types, stress urinary incontinence (SUI) is defined as involuntary urinary leakage during effort, exercising, sneezing, and/or coughing by the International Continence Society (ICS) in their 2002 terminology report [1]. Though the numbers related to the incidence of SUI vary, generally it is observed at around 30%, with a significant number of patients between 30-60 years, and is known to be the most frequently observed incontinence type in women [2][3][4][5]. Whether urethral hypermobility or intrinsic sphincter deficiency underlies beneath the problem, urethral resistance is insufficient to oppose increased abdominal pressure, and increased pressure within the bladder, and incontinence develops.…”