Prevalence and risk factors of urinary incontinence among Iranian women

Beyond the Visible: The Relationship Between Social Appearance Anxiety, Hopelessness, and Depression in Women with Urinary Incontinence

OBJECTIVE

This study aims to examine the relationship between the severity of urinary incontinence and levels of social appearance anxiety, hopelessness, and depression in women.

METHODS

A total of 393 women participated in this descriptive and correlational study. Data were collected using the Introductory Information Form, Incontinence Severity Index (ISI), Social Appearance Anxiety Scale (SAAS), Beck Hopelessness Scale (BHS), and Beck Depression Inventory (BDI).

RESULTS

Of the participants, 46.3% reported moderate social appearance anxiety, while 25.2% had severe depression. The mean BHS score was 8.80 ± 5.63. No significant correlation was found between the severity of incontinence and social appearance anxiety (p > 0.05). A strong positive correlation was observed between the BDI and BHS scores (p < 0.001). A one-unit increase in age was associated with a 0.172 (B) increase in incontinence severity, and a one-unit increase in BDI score was linked to a 0.137 (B) increase in incontinence severity.

CONCLUSIONS

The results suggest that increasing age is associated with greater severity of urinary incontinence. Higher incontinence severity is also correlated with higher levels of hopelessness and depression. The psychological impact of urinary incontinence on women's mental health should be addressed, and referrals to psychiatric care should be considered when necessary for a comprehensive treatment approach.

Urinary incontinence (UI) in older women in low- and middle-income countries: a rapid review and case study from Burkina Faso

The prevalence of urinary incontinence (UI) in older women in low- and middle-income countries (LMICs) is not well understood. We conducted a rapid literature review to assess the burden of UI in this population and contextualize findings from a household survey of women aged 40 and older in Nouna, in northwestern Burkina Faso. The rapid review included 21 survey articles. UI prevalence for LMIC women 40 or older varied greatly (6%-80%), with differences by socio-demographics, gynecological factors (menopausal status, birth outcomes), comorbidities (age, education, obesity, diabetes, hypertension, arthritis), behaviors (smoking status) and survey location. The studies used validated tools-the International Consultation on Incontinence Urinary Incontinence Short Form (ICIQ UI-SF) was most common (n = 4, 19%)-and bespoke tools that have not yet been validated. In Nouna, 983 (64.5%) of 1,524 women, completed the ICIQ UI-SF. Overall UI prevalence, defined as reporting leakage at least 2-3 times a week, was 2.6% (95% CI 1.73%-3.85%), descriptively increased with age from 0.5% in 40-49 year-olds to 6.6% in those 70 and over. Of those with UI, 88.5% experienced leakage daily, and 50% reported moderate or greater interference with daily life, yet most (88.5%) had not spoken to a healthcare provider. Multivariable analysis revealed that UI was more common among women who were not currently married and decreased with higher education levels. Both the rapid review and survey highlight the burden of UI among older women in LMICs, particularly as they age beyond 60. Given UI's association with physical and mental health, it is crucial to raise awareness of its burden, improve healthcare access, and integrate routine screening into basic healthcare services. Additionally, training healthcare providers and developing culturally appropriate interventions will help address stigma and ensure effective management of UI in this vulnerable population.

Dietary Vitamin B12 Intake Affects the Association Between Urinary Incontinence and Depression in Women: A Cross-Sectional Study of NHANES 2007-2018

Purpose

The purpose of this study is to examine the protective role of dietary vitamin B12 against depression, particularly as its prevalence is notably high among women experiencing urinary incontinence (UI). Nevertheless, the relationship between vitamin B12 intake, UI, and depression requires further clarification. This research aims to explore this association specifically among women.

Methods

This cross-sectional study analyzed data from 14,154 women sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2018. Depression was measured using the Personal Health Questionnaire (PHQ-9). Vitamin B12 intake was assessed through 24-h dietary recall interviews. Weighted univariate and multivariate logistic regression models assessed the relationships between UI, vitamin B12 intake, and depression in women, with additional analyses conducted across different age, body mass index (BMI), and vaginal delivery groups. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).

Results

The study included 14,154 women, averaging 48.18±0.27 years in age, of whom 1609 (11.37%) exhibited depressive symptoms. Women with stress UI (OR=1.55, 95% CI: 1.26-1.91), urgency UI (OR=1.92, 95% CI: 1.52-2.44), and mixed UI (OR=2.60, 95% CI: 2.13-3.19) showed significantly greater odds of depression compared to those without UI. Vitamin B12 intake of ≥2.4 mcg/day was associated with lower odds of depression (OR=0.95, 95% CI: 0.080-1.14). In patients with UI, the odds of depression gradually decreased with a vitamin B12 intake of ≥2.4 mcg/day. A moderating role of vitamin B12 intake was observed among women with UI aged ≤ 64 years, with BMI ≥ 25 kg/m2, and those with or without vaginal deliveries.

Conclusion

UI is linked to elevated depression odds, while vitamin B12 intake appears to moderate this relationship. It is essential for healthcare providers to prioritize early depression assessments in women with UI and to offer timely interventions to enhance their quality of life.

The relationship between the frequency of use of non-medication coping strategies with urinary incontinence and depression in older adults

BACKGROUND

The aim of this study is to examine the relationship between the frequency of use of non-medication coping strategies with urinary incontinence (UI) and depression in older adults.

METHODS

This study followed a descriptive design and was conducted with 345 older adults over the age of 65. The data of the study were collected using the Geriatric Depression Scale Short Form and the Frequency of Non-Medication Coping Strategies with Urinary Incontinence Scale. The data analysis of the study was conducted using descriptive statistics, Pearson correlation analysis, and hierarchical multiple regression analysis. The significance level was accepted as P < 0.05.

RESULTS

The mean age of the participants was 71.86 ± 5.43 years. Among the older adults, 58.8% were male and 50.2% were primary school graduates. It was determined that 43.8% of the participants experienced the frequency of UI more than once a week, 36.2% experienced stress incontinence, 51.9% consulted a physician due to UI, 53.6% received treatment for UI, and 47.8% reported that UI had an impact on their social life. The relationship between the frequency of use of non-medication coping strategies with UI and geriatric depression (β = -0.017; P = 0.043) was found to be significant and negative. It was found that there was a significant and positive relationship between age, frequency of UI, type of UI, the impact of UI on social life, and geriatric depression (P < 0.05).

CONCLUSION AND SUGGESTIONS

The older adults in this study were found to have moderate depression. It was determined that the level of depression was higher in the older adults who experienced UI more than once a week, those who experienced stress UI, those whose social lives were impacted, and those who had a higher frequency of non-medication coping strategies.

Association of diarrhea or constipation with urinary incontinence in adults: A cross-sectional analysis of the National Health and Nutrition Examination Survey

AIMS

This study aimed to investigate the association between diarrhea or constipation and urinary incontinence (UI) in adults.

METHODS

Data from the National Health and Nutrition Examination Survey for 2009-2010 was used to include 4686 adults aged 20 and over in the analysis. Stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) were used as outcome variables, with diarrhea and constipation as exposure factors. We first compared the baseline characteristics of those with and without SUI, as well as those with and without UUI. The impact of diarrhea or constipation on SUI and UUI was assessed using multivariate logistic regression models. To ensure the stability of the results, subgroup and stratified analyses were conducted.

RESULTS

The prevalence rates of UUI and SUI were 22.49% and 23.39%, respectively. Adjusted multivariate logistic regression analysis revealed that the risk of UUI was increased by either diarrhea (OR 1.66, 95% CI 1.36-2.04) or constipation (OR 1.42, 95% CI 1.11-1.83). The risk of SUI was also elevated by either diarrhea (OR 1.36, 95% CI 1.11-1.67) or constipation (OR 1.32, 95% CI 1.06-1.63). Subgroup analysis revealed no significant differences in the interaction tests between constipation or diarrhea and UI.

CONCLUSIONS

This study found that both constipation and diarrhea increase the risk of UUI and SUI.

Investigation of social isolation and depression in female employees with urinary incontinence during the COVID-19 pandemic period

BACKGROUND

Urinary incontinence (UI) affects almost one-third of adult women. This is often taken as a section of the aging process and incurable In general, women perceive UI as more of a social issue and a taboo rather than a medical problem; they are reluctant to discuss the matter or seek assistance.

OBJECTIVE

This research was conducted to investigate the level of social isolation and depression in female employees with UI during the COVID-19 pandemic period.

METHODS

The study was done with 533 paticipant. The study data were done using the Nottingham Health Profile Social Isolation Scale (NHPSIS), and Beck Depression Inventory (BDI).

RESULTS

The total scores of the NHPSIS and BDI were found to be 18.55±3.3 (minimum = 5, maximum = 25) and 49.22±11.4 (minimum = 12, maximum = 60), respectively. In the Pearson correlation analysis, a strong, statistically significant, and positive correlation was discovered between NHPSIS and the average BDI total scores among women.

CONCLUSION

The level of depression and social isolation were obtained to be high among UI women who had a mix UI, high frequencies of UI, belong to higher age groups, singles, and high body mass index. It was showed that the levels of depression and social isolation scores were showed to be high in women had UI.

Sitting on the fence: A qualitative study of perceptions regarding pelvic floor muscle training among pregnant women with urinary incontinence

Objectives

To explore the perceptions of pregnant women with urinary incontinence toward pelvic floor muscle training (PFMT).

Methods

Semi-structured personal interviews were used to collect data. Pregnant women with urinary incontinence and no contraindications to PFMT were recruited for semi-structured interviews in the Outpatient Department of Obstetrics in a Class A tertiary hospital in Shenzhen from October to November 2021. Purposive sampling was performed, and Braun & Clarke thematic analysis was used for the data analysis.

Results

Sixteen pregnant women with urinary incontinence and a mean age of (30.81 ± 3.66) years participated in the interview. "Sitting on the fence" was the predominant theme acquired after analysis. Pregnant women had contradictory attitudes toward PFMT. A total of four themes and nine sub-themes have been extracted: "It is normal and does not really matter" (normalized urinary incontinence, insufficient attention to PFMT); "There is nothing I can do" (insufficient subjective motivations, limitation of objective conditions, lack of social support); "We have to take care of ourselves" (the increasing self-care awareness, emerging autonomous motivation to practice PFMT); "Training should be guaranteed" (requiring the guidance, suggestions, and surveillance of healthcare professionals; requiring the perceptive benefits).

Conclusions

This study reveals varying attitudes towards PFMT among pregnant women with urinary incontinence. To better promote pregnant women's engagement in PFMT, it is necessary to provide professional guidance, increase self-care awareness, improve social support, and emphasize the benefits of PFMT.

Effectiveness of Pelvic Floor Muscle Training on Quality of Life in Women with Urinary Incontinence: A Systematic Review and Meta-Analysis

Background and Objectives: Urinary incontinence (UI) is a condition that is more common in women than men and has an increasing prevalence with age. It provides a range of psychological and physical burdens that negatively affect the patient's quality of life (QoL). However, the economic burden for the healthcare system is being augmented due to the increasing life expectancy of the population. This article aims to identify the effectiveness of pelvic floor muscle training (PFMT) on the QoL in women with UI. Materials and Methods: A systematic review and meta-analysis were conducted in the PubMed, EMBASE, ProQuest medicine, Cochrane Library, and Google Scholar databases. The terms selected according to components of PICOS were women with urinary incontinence, pelvic floor muscle training, watchful or other types of therapies, quality of life, randomized controlled trials, and interventional or observational studies. The articles included were those published between November 2018 and November 2022. Ten articles were found for the systematic review and eight for the meta-analysis. Results: The QoL moderately increased when PFMT was used on women with UI, the results indicating an overall small effect on the QoL across the controlled studies and a moderate effect on the QoL across the one-group pre-post-studies. Conclusions: Specific QoL domains, such as social activities and general health, also demonstrated benefits from PFMT interventions. This study confirmed the effectiveness of PFMT on the QoL in women with UI, mainly for patients with stress urinary incontinence.

Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study

BACKGROUND

Urinary incontinence (UI) is one of the most common symptoms during menopause, leading to a decreased quality of life and limited social activities. This study aimed to determine the prevalence and severity of urinary incontinence and associated risk factors in postmenopausal women.

METHODS

It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021-2022. Data were collected using questionnaires of socio-demographic characteristics, Questionnaire for Urinary Incontinence Diagnosis (QUID), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF). Multivariate logistic regression was used to determine factors related to urinary incontinence.

RESULTS

The overall prevalence of urinary incontinence was 39.5%; 20.6% stress urinary incontinence (SUI), 10.4% urgency urinary incontinence (UUI), and 8.5% mixed urinary incontinence (MUI). Multivariate logistic regression analysis showed that the prevalence of SUI (aOR 0.38; 95% CI 0.18-0.77) and UUI (aOR 0.38; 95% CI 0.15-0.94) was significantly lower in women with three childbirths than the ones with fewer childbirths. Also, the odds of UUI increased significantly in women at the 50-55 age range (aOR 3.88; 95% CI 1.16-12.93) than those less than 50 years.

CONCLUSION

Due to the high prevalence of urinary incontinence in postmenopausal women, caregivers should screen for early diagnosis and appropriate treatment of urinary incontinence to prevent its destructive impact on the quality of life.

Efficacy of frankincense‐based herbal product in urinary incontinence: A randomized, double‐blind, placebo‐ and active‐controlled clinical trial

Urinary incontinence is a silent epidemic that has a serious impact on a person's quality of life (QOL). This study aimed to evaluate the efficacy of frankincense-based herbal product (FHP) in urinary incontinence compared with placebo and solifenacin. In this randomized, double-blind clinical trial, 120 postmenopausal women with mixed urinary incontinence were randomized to one of the three groups of FHP, placebo, and standard treatment (solifenacin). Frequency, amount of leakage, and score of urinary incontinence as well as the QOL were measured at the end of the second and fourth weeks and 2 weeks after the interruption of the treatment. The ICIQ-UI SF and I-QOL questionnaires were used for the measurements. Mean frequency of urinary incontinence and amount of leakage significantly decreased in the FHP and solifenacin groups in the fourth week compared to the placebo group. In addition, 2 weeks after treatment completion, the effects of the FHP were significant compared to the solifenacin group. Due to the effect of FHP on improving the QOL and also the prolonged effect of this drug, the use of FHP in urinary incontinence, as a complementary treatment could be suggested.