Mixed Urinary Incontinence: Greater Impact on Quality of Life

Abstract

Purpose-We compared the impact of mixed, stress and urge urinary incontinence on quality of life in middle-aged or older women.Materials and Methods-We analyzed cross-sectional data from a population based cohort of 2,109 ethnically diverse middle-aged or older women. Among participants reporting weekly incontinence, clinical type of incontinence was assessed by self-reported questionnaires and disease specific quality of life impact was evaluated using the Incontinence Impact Questionnaire. Multivariable logistic regression was used to compare the odds of greater quality of life impact from incontinence, defined as an Incontinence Impact Questionnaire score in the 75th percentile or greater in women with stress, urge and mixed incontinence.Results-More than 28% (598) of women reported weekly incontinence, including 37% with stress, 31% with urge and 21% with mixed incontinence. Unadjusted Incontinence Impact Questionnaire scores were higher for women with mixed vs urge or stress incontinence (median score 29 vs 17 and 13, respectively, p <0.01). Adjusting for age, race/ethnicity, health status and clinical incontinence severity, women with mixed incontinence were more likely to report a greater overall quality of life impact compared to those with stress incontinence (OR 2.5, 95% CI 1.4-4.3), as well as a greater specific impact on travel (OR 2.2, 95% CI 1.3-3.7) and emotional (OR 1.8, 95% CI 1.0 -3.4) Incontinence Impact Questionnaire domains. The overall impact of urge incontinence did not differ significantly from that of stress (urge vs stress OR 1.6, 95% CI 0.9 -2.7) or mixed incontinence (mixed vs urge OR 1.6, 95% CI 0.9 -2.8) in adjusted models.Conclusions-In middle-aged or older women mixed incontinence is associated with a greater quality of life impact than stress incontinence independent of age, race, health or incontinence severity. Identification of women with mixed incontinence symptoms may be helpful in discovering which women are most likely to experience functional limitations and decreased well-being from incontinence. Urinary incontinence is a common problem in middle-aged or older women, with up to 25% of reproductive age women and 50% of postmenopausal women reporting at least weekly incontinence. 1 While incontinence does not lead to death it can have a profound effect on quality of life 2,3 comparable to that of stroke, arthritis and chronic obstructive pulmonary disease. 4 In addition, incontinence accounts for more than $20 billion in annual expenditures in the United States, an amount greater than the annual direct costs of breast, ovarian, cervical and uterine cancers combined. 5 KeywordsTo date, most studies examining the impact of incontinence on quality of life have not distinguished among stress, urge and mixed incontinence. Additionally, many prior studies have been limited by a focus on specialized clinical populations 3,6,7 or the use of quality of life instruments that are not disease specific 6,8 and, thus, are less sensitive in measuring the specific impact of incont...

The Effect of Education on Quality of Life in Elderly Females with Urinary Incontinence, Refereeing to Jahandidegan Center in Shiraz-Iran, 2011

“…Their findings are consistent with several other studies such as [6,9,14,15,25,29,30]. They found that urinary incontinence has more widespread negative effects on quality of life.…”

“…There is a misconception that the condition cannot be treated [13,14]. UI is not life threatening [8], does not lead to death [15] but the symptoms often impair the social, physical and psychological well-being of affected individuals [16]. Elderly outpatients describe their experience with incontinence as embarrassing, upsetting, and distressing.…”

Prevalence and Risk Factors of Urinary Incontinence and its Impact on the Quality of Life and Treatment Seeking Behavior among Malaysian Women: A Review

“…Other American and Norwegian studies had reported MUI to be between 20 and 36% [23,33]. MUI is known to be more 'bothersome' and has a larger impact on QOL than other types of UI [1,7,24]. There is a clear need for more thorough studies to assess the types of UI and how it might impact the QOL of the sufferer.…”

“…Caucasian women are reported to suffer more of SUI compared to women of African American and Asian descent. Asian women are reported to suffer more from MUI [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Previous gynecological operations, abdominal hysterectomy, surgical menopause [45][46][47] or urologic surgery [36,44] have all been linked as risk factors to UI.…”

Predictive value of clinical history compared with urodynamic study in 1,179 women

“…2,3 UI prevalence increases with age, reaching one in three older women. 3 The prevalence of UI in young adults ranges from 20 to 30%, from 30 to 40% in middle-aged women, and from 30 to 50% in postmenopausal women.…”