The Importance of Screening

Urinary incontinence is a common problem and has a major impact on physical, behavioral and psychological health. It can also reduce the quality of life of a person.

It is a great health and quality of life issues that need attention. Someone who is experiencing urinary incontinence especially women, will feel uncomfortable and embarrassed. Psychological impacts on both patients and their families are enormous.

Women who have urine incontinence are reported to be more depressed, have low self-esteem and being ashamed of their appearance and smell. Urinary incontinence affects their sexual function in terms of sexual drive as well as sexual activity. This can inhibit their social interaction to the extent they withdraw themselves and even isolating themselves at home.

Urinary Incontinence a Concern for Women

It’s more common in women. Studies in urinary incontinence in some countries revealed that 25-51% of women sufferred urinary incontinence.

Higher rates up to 80% among those staying in nursing home care facilities.

Urinary incontinence is an underdiagnosed and underreported problem among elderly people. A study in a rural community in the state of Selangor, found a lower rate of 9.9% of the elderly with urinary incontinence.

It’s less likely to be reported because the sufferer, especially women, may be shy to get help, or assumed it is a ‘normal’ process due to aging or they do not know that something can be done to help reduce their illness.

In one study, only 50% of women came to complain about their urinary incontinence problem to doctors.

Therefore, urinary incontinence screening is very important. Screening can detect the problem, hence effective treatment can be given. This can reduce misery and improve the quality of life of its sufferers.

At Risk Groups

Urinary incontinence is usually caused by interactions among various risk factors. It is rarely caused by only one risk factor.

These are the known risk factors for urinary incontinence. Urine incontinence screening should be done if any of the risk factor is present;

Gender

• Women are more prone to get urine incontinence.
• This is because women may have undergone events in their life that increases the risk of urinary incontinence such as pregnancy, childbirth andmenopause. Additionally, the anatomical difference in the urinary tract between women and men increases the risk of urinary incontinence as well. These processes may cause injury to the connective tissues, muscles and nerves.
• In one study, the risk of a woman giving birth naturally is 2.3 times greater to get urine incontinence compared with women giving birth through caesarian section.

Age

• Urinary incontinence and age are very closely related.
• With increase of age, the muscles in the bladder and the groin begin to lax.
• Ability to hold urine will decrease. This leads to a type of urinary incontinence known as stress incontinence.
• In addition, with increasing age, the ability of the bladder to keep urine is reduced. The receptors involve in the bladder control become less sensitive, this can lead to urinary incontinence.

Obesity / overweight

• Excessive weight may cause high pressure in the abdomen. This is due to the fat accumulating in it. It increases the pressure on the bladder and the muscles around it, resulting in uncontrolled urine excretion especially during coughing or sneezing.
• Studies show that urinary incontinence is closely related to Body Mass Index (BMI). The higher the body mass index, the worse the urinary incontinence.

Smoking

• Those who smoke are at risk for chronic cough that can trigger incontinence or worsen the incontinence that stems from other causes.
• Women who smoke are at double risk for incontinence compared with non-smokers.

Other Diseases

• Kidney disease, diabetes, dementia, depression, sedentary lifestyle or nerve-related illness such as stroke can increase the risk of a person getting incontinence.

Medicines

• There are medications that have side effects on the bladder system and cause incontinence. Get advice from your doctor or pharmacist if you have any questions about medicines.

Reference

1. The Prevalence of Urinary Incontinence among the Elderly in a Rural Communicating in Selangor Malays J. Med Sci. 2010 Apr – Jun; 17(2): 18-23
2. Buckley BS, Lapitan MC, Epidemiology Committee of the Fourth International Consultation on Incontinence, Paris, 2008. Urology. 2010;76(2):265.
3. Burgio KL, Ives DG, Locher JL, et al. Treatment seeking  for urinary incontinence in older adults. J Am Geriatr Soc 1994;42:208–12
4. Markland AD, Richter HE, Fwu CW, Eggers P, Kusek JW. Prevalence and trends of urinaryincontinence in adults in the United States, 2001 to 2008. J Urol. 2011;186(2):589.
5. Sherina MS. The Prevalence of urinary incontinence among the elderly in a rural community in Selangor. Malaysian J. of Med.l Sci. 2010; 17(2): 18-23.