Clinical research study
Prevalence and Severity of Undiagnosed Urinary Incontinence in Women

https://doi.org/10.1016/j.amjmed.2009.05.016Get rights and content

Abstract

Background

Urinary incontinence is a highly prevalent condition in aging women that results in significant morbidity. Less than half of women who suffer from urinary incontinence seek treatment, resulting in a significant proportion of clinically relevant urinary incontinence remaining undiagnosed. Therefore, the purpose of this study was to quantify the prevalence of urinary incontinence in undiagnosed women in a managed care population.

Methods

There were 136,457 women aged 25-80 years enrolled in Kaiser Permanente Northwest who were free of genitourinary diagnoses, including urinary incontinence, who were included in this study. Of the 2118 women who were mailed questionnaires ascertaining information on demographic and urinary incontinence characteristics, 875 completed the survey. A chart review of the 234 women who reported moderate to severe urinary incontinence was performed.

Results

The prevalence of undiagnosed urinary incontinence was 53% in the preceding year, and 39% in the preceding week. The prevalence of undiagnosed stress, mixed, and urge incontinence was found to be 18.7%, 12.0%, and 6.8%, respectively. Quality of life was found to significantly decrease with increasing urinary incontinence severity. Of the 234 chart-reviewed women, 5% were found to have physician-documented urinary incontinence.

Conclusions

These results suggest that a significant proportion of women in this managed care population are suffering from urinary incontinence that remains undiagnosed. Efforts should be made to encourage women and physicians to initiate conversations about urinary incontinence symptoms in order to decrease the unnecessary burden of this disease.

Section snippets

Study Population

The managed care population utilized for this study, Kaiser Permanente Northwest (KPNW), is a mostly Caucasian population of 436,000 enrollees representing the metropolitan Portland, Oregon area. KPNW has an 85% retention rate yearly and is unique in that the EpicCare clinical information system, a comprehensive electronic medical record that allows for population-based research of physician-diagnosed disorders, was implemented beginning in 1998. Women aged 25 to 80 years who were members of

Results

Among the 875 participants in this study, 461 (52.6%) reported having urinary incontinence in the past 12 months and 340 (38.9%) reported having urinary incontinence in the past 7 days. The age-adjusted prevalence of undiagnosed urinary incontinence was 51% in the past 12 months and 38% in the past 7 days. The age-adjusted rates of stress urinary incontinence, urge urinary incontinence, and mixed urinary incontinence were 18.7%, 6.8%, and 12.0%, respectively. While the rates of urge urinary

Discussion

In this managed-care population of women aged 25-80 years, the prevalence of undiagnosed urinary incontinence was 53% in the preceding year and 39% in the preceding week. Of these women, >65% reported moderate to severe incontinence severity. While barriers in care have been suggested to result in a proportion of cases of urinary incontinence going undiagnosed in women, the magnitude of this problem is not well characterized. To date, the majority of research estimates the prevalence of urinary

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Funding: NIDDK UO1 DK060177.

Conflict of Interest: Neither the primary author nor any of the corresponding authors have any conflicts of interest with the submission of this article.

Authorship: All 7 authors of this manuscript have made a substantial contribution to writing the manuscript and had access to the data.

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