Highlights
Urinary Incontinence in the United States
According to several 2006 surveys:
- Urinary incontinence affects about 38% of all women
- Middle-aged women (ages 50 to 54) are nearly twice as likely to have severe urinary incontinence as younger women (under age 40)
- 21% of women ages 85 and older experience daily incontinence
- Only half of women with urinary incontinence have discussed this problem with their doctors; only a third have received treatment
Diagnosis
A simple 3-question test may help doctors distinguish between urge and stress incontinence, according to a study published in the Annals of Internal Medicine.
Childbirth
- Episiotomy does not prevent urinary incontinence and may cause more harm than good, suggests a 2006 study in the Journal of the American Medical Association. Episiotomy, a surgical incision made during childbirth to widen the vaginal opening, is routinely performed in about 35% of all vaginal births.
- Vaginal birth can sometimes cause pelvic prolapse, a condition where the uterus or other pelvic organs slip into the vagina. Performing surgery for urinary incontinence (Burch colposuspension) at the same time as prolapse surgery (sacrocolpopexy) can reduce the risk of stress incontinence, according to an important study in the New England Journal of Medicine.
Risk Factors
- Higher body mass index, smoking, diabetes, and hysterectomy are all significant risk factors for urinary incontinence.
- Childhood bedwetting and other urinary problems are associated with later development of adult overactive bladder, suggests a 2006 study in the Journal of Urology.
Kegel Exercises
Pelvic floor muscle training (Kegel exercises) is very helpful in reducing urinary incontinence, according to a review in the Cochrane Database. Researchers found the exercises worked best for stress incontinence and for women who performed them for at least 3 months.
