Skip to main content
NCBI home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 2001 Oct;51(471):801–804.

Needs assessment of women with urinary incontinence in a district health authority.

K MacKay 1, L Hemmett 1
PMCID: PMC1314124  PMID: 11677702

Abstract

BACKGROUND: The prevalence of urinary incontinence in women is difficult to estimate because definitions vary between researchers and among women, for whom thresholds of complaint differ. However, studies have also shown that only about a quarter of women affected by urinary incontinence consult a doctor for their symptoms, despite evidence of effective treatments and better management of the condition in primary care. AIM: To assess the perceived needs of women with urinary incontinence living at home. DESIGN: Cross-sectional community survey. SETTING: A 1% stratified random sample of women living at home, registered with a local GP, and aged 45 years and over (n = 720) in a north London district health authority with a total population of 308,000. RESULTS: Out of 720 questionnaires, 489 were returned completed (68%). A total of 227 (46%) women had symptoms of significant urinary incontinence. Seventy-eight (16%) had significant symptoms which they said were not a problem, and 149 (30%) of the total number of responders acknowledged that they had significant symptoms and that these symptoms were a problem for them; of these, 48 (32%) sought help from their GP; 16 out of the 48 consulting their GP were happy with the treatment given, and the remaining 101 women who considered their incontinence to be a problem had not consulted their GP and 76 of those had also not told anyone else that they had a problem. The commonest reasons given by the 101 women who admitted having a problem and who had not consulted their GPs were that they thought that they should cope on their own (43 [42.6%]), that incontinence was inevitable with age (26 [25.7%]) or that it was embarrassing to talk about the problem to their GP (14 [13.8%]). CONCLUSIONS: Despite the existence of effective interventions for urinary incontinence, many women who are incontinent do not seek help even when they perceive their incontinence to be a problem. Half of the women who did consult their GP did not find the treatment offered helpful. Achieving health gain for women with urinary incontinence will require a more active approach than currently exists to inform people that better care is available, to help counteract the stigma attached to the problem, and to ensure that primary care professionals are able to provide effective services.

Full Text

The Full Text of this article is available as a PDF (66.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Appell R. A. Clinical efficacy and safety of tolterodine in the treatment of overactive bladder: a pooled analysis. Urology. 1997 Dec;50(6A):90–99. doi: 10.1016/s0090-4295(97)00599-2. [DOI] [PubMed] [Google Scholar]
  2. Berghmans L. C., Hendriks H. J., Bo K., Hay-Smith E. J., de Bie R. A., van Waalwijk van Doorn E. S. Conservative treatment of stress urinary incontinence in women: a systematic review of randomized clinical trials. Br J Urol. 1998 Aug;82(2):181–191. doi: 10.1046/j.1464-410x.1998.00730.x. [DOI] [PubMed] [Google Scholar]
  3. Brocklehurst J. C. Urinary incontinence in the community--analysis of a MORI poll. BMJ. 1993 Mar 27;306(6881):832–834. doi: 10.1136/bmj.306.6881.832. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Burgio K. L., Locher J. L., Goode P. S., Hardin J. M., McDowell B. J., Dombrowski M., Candib D. Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial. JAMA. 1998 Dec 16;280(23):1995–2000. doi: 10.1001/jama.280.23.1995. [DOI] [PubMed] [Google Scholar]
  5. Bø K., Talseth T., Holme I. Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. BMJ. 1999 Feb 20;318(7182):487–493. doi: 10.1136/bmj.318.7182.487. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cammu H., Van Nylen M., Derde M. P., DeBruyne R., Amy J. J. Pelvic physiotherapy in genuine stress incontinence. Urology. 1991 Oct;38(4):332–337. doi: 10.1016/0090-4295(91)80146-x. [DOI] [PubMed] [Google Scholar]
  7. Crosland A., Jones R. Rectal bleeding: prevalence and consultation behaviour. BMJ. 1995 Aug 19;311(7003):486–488. doi: 10.1136/bmj.311.7003.486. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. DeLancey J. O. The pathophysiology of stress urinary incontinence in women and its implications for surgical treatment. World J Urol. 1997;15(5):268–274. doi: 10.1007/BF02202011. [DOI] [PubMed] [Google Scholar]
  9. Dolan L. M., Casson K., McDonald P., Ashe R. G. Urinary incontinence in Northern Ireland: a prevalence study. BJU Int. 1999 May;83(7):760–766. doi: 10.1046/j.1464-410x.1999.00022.x. [DOI] [PubMed] [Google Scholar]
  10. Fantl J. A., Cardozo L., McClish D. K. Estrogen therapy in the management of urinary incontinence in postmenopausal women: a meta-analysis. First report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol. 1994 Jan;83(1):12–18. [PubMed] [Google Scholar]
  11. Ferrie B. G., Smith J. S., Logan D., Lyle R., Paterson P. J. Experience with bladder training in 65 patients. Br J Urol. 1984 Oct;56(5):482–484. [PubMed] [Google Scholar]
  12. Gallagher M. S. Urogenital distress and the psychosocial impact of urinary incontinence on elderly women. Rehabil Nurs. 1998 Jul-Aug;23(4):192–197. doi: 10.1002/j.2048-7940.1998.tb01780.x. [DOI] [PubMed] [Google Scholar]
  13. Grealish M., O'Dowd T. C. General practitioners and women with urinary incontinence. Br J Gen Pract. 1998 Feb;48(427):975–977. [PMC free article] [PubMed] [Google Scholar]
  14. Hannay D. R., Maddox E. J. Incongruous referrals. Lancet. 1975 Dec 13;2(7946):1195–1197. doi: 10.1016/s0140-6736(75)92672-0. [DOI] [PubMed] [Google Scholar]
  15. Jolleys J. V., Wilson J. V. Urinary incontinence. GPs lack confidence. BMJ. 1993 May 15;306(6888):1344–1344. doi: 10.1136/bmj.306.6888.1344-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. O'Brien J., Austin M., Sethi P., O'Boyle P. Urinary incontinence: prevalence, need for treatment, and effectiveness of intervention by nurse. BMJ. 1991 Nov 23;303(6813):1308–1312. doi: 10.1136/bmj.303.6813.1308. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. O'Brien J., Long H. Urinary incontinence: long term effectiveness of nursing intervention in primary care. BMJ. 1995 Nov 4;311(7014):1208–1208. doi: 10.1136/bmj.311.7014.1208. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Seim A., Sandvik H., Hermstad R., Hunskaar S. Female urinary incontinence--consultation behaviour and patient experiences: an epidemiological survey in a Norwegian community. Fam Pract. 1995 Mar;12(1):18–21. doi: 10.1093/fampra/12.1.18. [DOI] [PubMed] [Google Scholar]
  19. Seim A., Sivertsen B., Eriksen B. C., Hunskaar S. Treatment of urinary incontinence in women in general practice: observational study. BMJ. 1996 Jun 8;312(7044):1459–1462. doi: 10.1136/bmj.312.7044.1459. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Thakar R., Stanton S. Regular review: management of urinary incontinence in women. BMJ. 2000 Nov 25;321(7272):1326–1331. doi: 10.1136/bmj.321.7272.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Thom D. Variation in estimates of urinary incontinence prevalence in the community: effects of differences in definition, population characteristics, and study type. J Am Geriatr Soc. 1998 Apr;46(4):473–480. doi: 10.1111/j.1532-5415.1998.tb02469.x. [DOI] [PubMed] [Google Scholar]
  22. Valerius A. J. The psychosocial impact of urinary incontinence on women aged 25 to 45 years. Urol Nurs. 1997 Sep;17(3):96–103. [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES