Women With Diabetes: Understanding Urinary Incontinence and Help Seeking Behavior

Doshi, Ami; Eeden, Stephen K. Van Den; Morrill, Michelle Y.; Schembri, Michael; Thom, David H.; Brown, Jeanette S.

doi:10.1016/j.juro.2010.06.014

Cited by 31 publications

(27 citation statements)

References 23 publications

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“…For perspective, a woman’s lifetime risk of developing breast cancer is 14.8%, while the lifetime risk of lung cancer is 6.3%. (21) Despite the fact that the lifetime risk of stress incontinence and pelvic organ prolapse surgery is significantly higher than that of breast cancer or lung cancer, women lack awareness and knowledge regarding these gynecologic conditions,(22, 23) which translates into limited healthcare seeking for these conditions which greatly impair quality of life. (22, 24)…”

Section: Discussionmentioning

confidence: 99%

Lifetime Risk of Stress Urinary Incontinence or Pelvic Organ Prolapse Surgery

Matthews²,

Conover³

et al. 2014

Obstetrics &Amp; Gynecology

859

405

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Objective To estimate the lifetime risk of stress incontinence, pelvic organ prolapse surgery, or both using current, population-based surgical rates from 2007–2011. Methods We used a 2007–2011 a U.S. claims and encounters database. We included women aged 18–89 years and estimated age-specific incidence rates and cumulative incidence (lifetime risk) of stress incontinence surgery, pelvic organ prolapse surgery, and either incontinence or prolapse surgery, with 95% confidence intervals. We estimated lifetime risk until the age of 80 to be consistent with prior studies. Results From 2007–2011, we evaluated 10,177,480 adult women who were followed for 24,979,447 person-years. Among these women, we identified 65,397 incident, or first, stress incontinence, and 57,755 incident prolapse surgeries. Overall, we found that the lifetime risk of any primary surgery for stress incontinence or pelvic organ prolapse was 20.0% (95%CI 19.9, 20.2) by the age of 80 years. Separately, the cumulative risk for stress incontinence surgery was 13.6% (95%CI 13.5, 13.7) and that for pelvic organ prolapse surgery was 12.6% (95%CI 12.4, 12.7). For age-specific annual risk, stress incontinence demonstrated a bimodal peak at age 46 and then again at age 70–71 with annual risks of 3.8 and 3.9 per 1,000 women, respectively. For pelvic organ prolapse, the risk increased progressively until ages 71 and 73 when the annual risk was 4.3 per 1,000 women. Conclusion Based on a U.S. claims and encounters database, the estimated lifetime risk of surgery for either stress incontinence or pelvic organ prolapse in women is 20.0% by the age of 80.

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Section: Discussionmentioning

confidence: 99%

Lifetime Risk of Stress Urinary Incontinence or Pelvic Organ Prolapse Surgery

Matthews²,

Conover³

et al. 2014

Obstetrics &Amp; Gynecology

859

405

View full text Add to dashboard Cite

show abstract

“…This may be important given traditional treatments for urinary incontinence have been found to be less effective in women with diabetes, 10 and furthermore, one study found that women with diabetes were less likely to discuss urinary incontinence with physicians. 26 …”

Section: Discussionmentioning

confidence: 99%

Diabetes, Glycemic Control, and Urinary Incontinence in Women

Wang¹,

Lefevre²,

Hacker³

et al. 2015

Female Pelvic Medicine &Amp; Reconstructive Surgery

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OBJECTIVES To estimate the association between urinary incontinence and glycemic control in women ages 20 to 85. METHODS We included 7,270 women from the 2005–2010 National Health and Nutrition Examination Survey, stratified into three groups of glycemic control defined by hemoglobin A1c (HbA1c): i) those below the diagnostic threshold (HbA1c<6.5%), ii) those with relatively controlled diabetes (HbA1c 6.5–8.5%), and iii) those with poorly controlled diabetes (HbA1c>8.5%) to allow for a different relationship between glycemic control and urinary incontinence within each group. The primary outcomes were the presence of any, only stress, only urgency, and mixed urinary incontinence. We calculated adjusted risk ratios using Poisson regressions with robust variance estimates. RESULTS The survey-weighted prevalence was 52.9% for any, 27.2% for only stress, 9.9% for only urgency, and 15.8% for mixed urinary incontinence. Among women with relatively controlled diabetes, each one-unit increase in HbA1c was associated with a 13% (95% CI: 1.03–1.25) increase for any urinary incontinence and a 34% (95% CI 1.06–1.69) increase in risk for only stress incontinence but was not significantly associated with only urgency and mixed incontinence. Other risk factors included body mass index, hormone replacement therapy, smoking, and physical activity. CONCLUSIONS Worsening glycemic control is associated with an increased risk for stress incontinence for women with relatively controlled diabetes. For those either below the diagnostic threshold or with poorly controlled diabetes, the risk may be driven by other factors. Further prospective investigation of HbA1c as a modifiable risk factor may motivate measures to improve continence in women with diabetes.

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“…(1–3) Approximately 16% of adult women in the US report weekly or more frequent UI,(4, 5) but fewer than half of those women seek care. (6–9) Furthermore, despite comparable prevalence of UI amongst racial and ethnic groups,(1, 6, 10) there are conflicting reports of whether racial and ethnic factors play a role in which women endorse seeking care. (11, 12)…”

Section: Introductionmentioning

confidence: 99%

Urinary Incontinence and Health-Seeking Behavior Among White, Black, and Latina Women

Siddiqui¹,

Ammarell²,

Wu³

et al. 2016

Female Pelvic Med Reconstr Surg

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Structured Abstract Objective Fewer than half of women with urinary incontinence (UI) seek care for their condition. Our objective was to qualitatively assess themes surrounding treatment seeking behaviors. Methods We conducted 12 focus groups in women, and using purposive sampling we stratified by racial or ethnic group (White, Black, Latina) and by UI frequency. All sessions were transcribed and coded for common themes. Comparative thematic analysis was used to describe similarities and differences among groups. Results In total, 113 (39 White, 41 Black, and 33 Latina) community dwelling women participated in focus groups. There were no differences in treatment seeking themes between groups with different UI frequency. However, certain themes emerged when comparing racial/ethnic groups. Women from all groups shared experiences of embarrassment and isolation due to UI, which were impediments to care seeking. White and Black women described discussions with close friends or family that led to normalization of symptoms, and prevented care seeking. Latina women maintained more secrecy about UI and reported the longest delays in seeking care. Women articulated a higher likelihood of seeking care if they had knowledge of treatment options, but White women were more likely to seek UI-related knowledge compared to Black or Latina women. Physician communication barriers were identified in all groups. Conclusions Despite similar experiences, there are different perceptions about care seeking among White, Black, and Latina women. Culturally relevant educational resources that focus on a range of treatment options may improve knowledge and thus improve care seeking behaviors in women with UI.

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Women With Diabetes: Understanding Urinary Incontinence and Help Seeking Behavior

Cited by 31 publications

References 23 publications

Lifetime Risk of Stress Urinary Incontinence or Pelvic Organ Prolapse Surgery

Lifetime Risk of Stress Urinary Incontinence or Pelvic Organ Prolapse Surgery

Diabetes, Glycemic Control, and Urinary Incontinence in Women

Urinary Incontinence and Health-Seeking Behavior Among White, Black, and Latina Women

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