1. Definition of Urinary Incontinence
Involuntary leakage of urine.
2. Classification of Urinary Incontinence
The main types of urinary incontinence are:
Stress urinary incontinence (SUI),
Urgency urinary incontinence (UUI),
Overflow urinary incontinence.
Many women experience more than one type of urinary incontinence; this condition is called mixed urinary incontinence.
a. Stress urinary incontinence (SUI):
complaint of involuntary leakage of urine during physical exertion (such as walking, straining, or exercise), or during sneezing, coughing, or other activities that increase intra-abdominal pressure.
b. Urgency urinary incontinence (UUI):
complaint of involuntary leakage of complaint of involuntary urine loss associated with urgency.
c. Mixed urinary incontinence:
Mixed urinary incontinence describes patients with symptoms of both stress and urgency urinary incontinence
d. Overflow urinary incontinence:
Persistent leakage or dribbling of urine occurs when the bladder cannot be completely emptied.
3. Prevalence of Urinary Incontinence
Urinary incontinence is a very common and undertreated condition.
It is estimated that approximately 60% of adult women have experienced urinary incontinence, but only 25% to 61% of symptomatic community-dwelling women seek treatment. Most studies show a prevalence of urinary incontinence in women between 25% and 40%, while the prevalence in women over 60 years of age may exceed 50% to 70%.
Many factors influence the prevalence of urinary incontinence, including study type, demographic factors (sex, age, race, location/nationality), comorbidity, assessment period, and assessment tool used.
Of all urinary incontinence cases, approximately 50% of women report stress incontinence, slightly lower rates of mixed incontinence, and even lower rates of urge incontinence. These prevalence rates are highly influenced by the study population, as the overall prevalence of stress incontinence tends to be higher in younger populations, while the differences are less pronounced in older populations. Overall, the prevalence of stress incontinence (10% to 25%) is often higher than that of urge incontinence (3% to 10%) or mixed incontinence (5% to 20%).
4. Comparison: Prevalence of Urinary Incontinence in Men
Compared to women, the prevalence of urinary incontinence in men is lower, but it is also more likely to occur with age. A study of community-dwelling men showed that the prevalence of experiencing at least one episode of urinary incontinence in the past 12 months increased from nearly 5% in the 19-44 age group to 11.2% in the 45-64 age group, and reached 21% in those over 65. Other studies show that the prevalence of urinary incontinence in men over 65 ranges from 11% to 34%.
5. Do the Symptoms of Urinary Incontinence Change?
In a prospective study, one-third of women aged 54-79 who reported monthly leakage at baseline progressed to at least weekly leakage during a two-year follow-up period.
However, not all women who experience urinary incontinence will have long-term symptoms. A longitudinal cohort study of 4,127 middle-aged women showed an annualized incidence of urinary incontinence of 3.3% and an annualized remission rate of 6.2%. Factors associated with persistent symptoms (i.e., no remission) included weight gain and menopause.
Most studies show an annualized remission rate of 1% to 5% for women with urinary incontinence, with younger women appearing to have higher remission rates. Other studies suggest that African American women may have the highest remission rates.
References:
Campbell-Walsh Urology, ch74, Urinary Incontinence and Pelvic Prolapse: Epidemiology and Pathophysiology
https://www.uptodate.com/contents/female-urinary-incontinence-evaluation
