Urinary incontinence is a widespread disorder, affecting over 200 million people around the world. This condition is marked by involuntary urine loss and mostly experienced by women.
It is essential to identify the type and cause of urinary incontinence so that an appropriate treatment plan can be devised. There are four distinct types of urinary incontinence: stress, urge, mixed, and overflow.
Table of Contents
Background
Involuntary urine leakage is a problem that can affect both older adults and younger women alike. Urinary incontinence poses serious problems for patients and their families, negatively affecting both health and quality of life.
The exact cause of urinary incontinence is complex and depends on several factors. Ageing can increase the likelihood of stress incontinence, while menopause also plays a significant role. Other potential causes include chronic cough, repeated heavy lifting or smoking.
Family physicians should be knowledgeable about the causes of urinary incontinence and be able to accurately diagnose reversible causes through a history and physical examination. This should include an extensive assessment of the patient’s urethral/bladder muscles, urethral sphinter function, as well as postvoid residual urine volume.
At this evaluation, the family physician should inquire about the patient’s symptoms and behaviors associated with incontinence. Additionally, they should assess for other underlying conditions that could be contributing to it. A careful review of medications taken and alcohol/caffeine consumption should also take place.
On all patients, urinalysis should be performed to detect urinary tract infection, glycosuria, proteinuria, hematuria and blood urea nitrogen. Blood urea nitrogen levels can also be used as an indicator for renal function and kidney damage.
A standardized questionnaire has been developed to assess the symptoms and effects of urinary incontinence. The International Continence Impact Questionnaire (ICIQ) is a concise but robust instrument designed to assess incontinence symptoms as well as its influence on daily living activities.
This survey is an effective tool for family physicians to screen patients for urinary incontinence and have them self-report symptoms and its effect on daily life. The results of this survey can help evaluate a patient’s health status and decide whether or not they require referral to a specialist.
In Iran, urinary incontinence is a highly prevalent disorder that can have an adverse effect on their health and quality of life. Yet despite its widespread prevalence in Iran, no previous studies have explored how older women manage their urinary incontinence management strategies.
Methods
Urinary incontinence is a widespread health issue that significantly reduces women’s quality of life and places an immense strain on healthcare resources. While there are various treatments available, including behavioral ones, there is also no one-size-fits all approach.
As the primary therapy for urinary incontinence (UI), pelvic floor muscle training (PFMT) is recommended. Studies have demonstrated that PFMT can significantly improve urinary symptoms, bladder function and quality-of-life for those suffering from UI.
Unfortunately, PFMT may not be suitable for all women with UI. Other treatments such as pessaries and urethral bulking have also been known to reduce UI frequency and severity.
Furthermore, some evidence suggests PFMT may reduce the risk of incontinence-related bowel dysfunction and constipation.
In this research, we aim to explore the experiences of elderly women with urinary incontinence and their approaches to its management. We used a purposive sampling method and conducted face-to-face unstructured in-depth interviews with 22 elderly women living in comprehensive health centers in Ahvaz, Iran.
Participants were women aged >60 years who had been clinically diagnosed with one type of urinary incontinence and suffered from it for at least 6 months. All were willing to participate in the study and had no history of mental disorders. We arranged the time and place of interviews with them beforehand.
Results
Women suffering from urinary incontinence (UI) are a common affliction that can have an adverse effect on mental health and quality of life. Causes for this condition range from aging to physical/sexual changes, pregnancy, pelvic floor disorders, medication usage and menopause – which has also been known to be an influential risk factor for UI in women.
Urinary incontinence is a chronic and debilitating disorder that often goes undetected, yet can have severe negative consequences on quality of life. It has an especially high prevalence among older women and is linked to numerous risk factors like age, education level, marital status and financial circumstances.
A survey of 828 women from China, Taiwan and South Korea who participated in the LUTS Asia study revealed that many suffered from stress urinary incontinence (SUI). Most participants reported SUI symptoms many times a day, several times a week or multiple times per month; sneezing and coughing being the primary causes for leakage-inducing movements for most.
SUI was a significant factor in decreasing work productivity, mental health and concentration levels. Furthermore, it had an adverse effect on their quality of life across physical and mental health domains as well as social relationships.
Studies have suggested that SUI (serious urinary incontinence) can be prevented and managed through lifestyle modification or the use of medications to reduce urination. Unfortunately, most of these studies only focused on young to middle aged women without taking into account elderly individuals.
Therefore, it is imperative to investigate the prevalence of UI among women and identify its risk factors among elderly women. Furthermore, having a comprehensive understanding of symptoms and management strategies can assist healthcare team members when creating an appropriate care program for older women with this condition.
This research study focused on 22 elderly women suffering from urinary incontinence who were selected through purposeful sampling from comprehensive healthcare centers in Ahvaz, Iran. Interviews were conducted about their experiences of urinary incontinence and disease management; furthermore, participants’ socioeconomic conditions were explored using questionnaires. Finally, comparisons were made between these participants’ stories and those of healthy women to uncover differences in urinary incontinence incidence, severity, and impact across various age groups of women.
Conclusions
Urinary incontinence (UI) is a widespread condition that impacts women and the elderly, often due to symptoms that interfere with social and everyday activities. Unfortunately, it contributes significantly to decreased quality of life for many women. The purpose of this study was to identify the causes of urinary incontinence and assess its effectiveness when treated.
Age, menopause, pelvic floor disorders, urinary tract infections, smoking, diabetes, heavy work, chronic respiratory diseases and pregnancy or cesarean delivery have been identified as risk factors for UI. Although several studies have suggested a link exists between lung disease and UI incidence rates, the evidence remains conflicted.
Though many patients with UI have been successfully treated, there remains uncertainty as to what causes it. A research study published in Neurouroluodyne journal explored this issue and discovered that familial dysautonomia may be linked to UI.
Genetic disorders can alter the way female hormone receptors respond to stress hormones. This alteration in response may explain why urinary incontinence occurs; researchers speculated that hormonal levels might have been affected due to a loss of bladder control, leading to more frequent leakage.
In this study, participants were recruited through a questionnaire and interviewed about their symptoms, medical history and urinary tract infection. Additionally, they underwent an abdominal leak point test as well as the International Consensus Index for the Assessment of Urinary Incontinence Scale (ICIQ-UI SF). To assess symptom severity, researchers utilized the International Consensus Index for Urinary Incontinence Scale (ICIQ-UI SF).
Participants were asked to rate their frequency of involuntary loss of urine. Their responses were classified as mild, moderate, severe or very severe.
Research revealed that stress urinary incontinence is characterized by sudden, intense loss of urine when the bladder is full. It also causes high levels of urgency and can be accompanied by feelings of heaviness. Furthermore, patients’ age and menopause status seem to influence how severe their condition will be.
