ROCKVILLE, MD (UroToday.com) - Urinary incontinence (UI) is the involuntary loss of urine.1 About 25 percent of young women,2 44 to to 57 percent of middle-aged and postmenopausal women,3 and about 75 percent of older women experience some involuntary urine loss.4
UI can affect women’s physical, psychological, and social well-being, and sometimes imposes significant lifestyle restrictions. The effects of UI range from slightly bothersome to debilitating. The cost of incontinence care in the United States averaged $19.5 billion in 2004.5 Six percent of nursing home admissions of older women are attributable to UI,5 and by one estimate, the annualized cost of women’s nursing home admissions due to UI was $3 billion.6 Nonpharmacological therapies target strengthening the pelvic floor and changing behaviors that influence bladder function, whereas pharmacological therapies address innervating the bladder and sphincter. The etiology of incontinence is multifactorial; risk factors include age, pregnancy, pelvic floor trauma after vaginal delivery, menopause, hysterectomy, obesity, urinary tract infections, functional and/or cognitive impairment, chronic cough, and constipation.7 Assessments of women complaining of UI begin with exclusion of underlying causes such as pelvic organ prolapse, urinary tract infection, and poor bladder emptying,8 all of which are beyond the scope of this review, as is neurogenic UI associated with spinal cord injury or stroke.9 We focus specifically on women with stress UI associated with sphincter function, and with urgency UI, often associated with overactive bladder (Table 1 in the full report)...Click here to view or download the full executive summary.
