Women's Risks for Losing Bladder Control

Urinary incontinence in women associated with demographics and number of pregnancies

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Many women lose control of their bladder after pregnancy. This can not only be embarassing, but treatment can be expensive and the condition can seriously affect a woman's overall quality of life.

A recent study found that age, education level and number of pregnancies significantly affected women's chance of having urinary incontinence (loss of bladder control) after pregnancy.

The researchers concluded that early diagnosis and treatment could help decrease the negative impact on a woman's quality of life.

"Discuss the risk factors of urinary incontinence with your doctor."

The lead author of this study was Işık Üstüner, MD, from the Department of Obstetrics and Gynecology at Recep Tayyip Erdoğan University in Rize, Turkey.

The study population included 690 premenopausal women between the ages of 18 and 53 years old. The average age was 35 years old, and all the women were still menstruating regularly.

Each participant had at least one previous pregnancy and was not pregnant at the time of the study. The study period was from April 2011 to January 2012.

The researchers gave each of the participants two questionnaires.

The first questionnaire asked about demographic data (age, race, education level), medical history and obstetric history, including the amount of pregnancies and births and whether the delivery was vaginal or by cesarean section.

The second questionnaire determined the frequency, type and severity of each participant's incontinence and the impact on their quality of life on a scale of 0 to 21, with higher scores indicating greater severity.

The findings showed that 188 participants (27 percent) had urinary incontinence.

Of the total study population, 11 percent reported having urinary incontinence once a week or less, 5 percent said they had incontinence twice or three times per week, 3 percent experienced incontinence once a day, 7 percent had urinary incontinence a few times a day, and 3 percent reported having incontinence always.

The findings revealed that 21 percent of all the participants reported only a small amount of urinary leakage, 4 percent said they had moderate amounts of leakage each time, and 2 percent reported having a large amount of leakage during each urinary incontinence episode.

Out of the 188 participants in the urinary incontinence group, 69 participants were found to have stress incontinence (during activities such as exercising, coughing, sneezing, laughing or lifting), 61 participants had urgency incontinence (frequent and sudden need to urinate while sleeping or drinking), and 58 participants had mixed incontinence (both stress and urgency-related urinary incontinence).

The researchers discovered that the average age and body mass index (BMI) — a height to weight ratio — were higher for those with urinary incontinence than for those with no incontinence.

For the urinary incontinence group, the average age was 38 years old and the average BMI was 27.4. The average age of those with no incontinence was 34 years old and the average BMI was 25.8.

The average amount of pregnancies and births in the urinary incontinence group were also higher compared to the no-incontinence group.

The findings revealed that the urinary incontinence group reported an average of 3.21 pregnancies and 2.42 births, compared to 2.30 pregnancies and 1.86 births for the group without incontinence.

The researchers also found that 79 percent of the urinary incontinence group had a vaginal delivery, versus only 68 percent of the no-incontinence group.

Education levels also significantly differed between the two groups.

A total of 7 percent of the urinary incontinence group reported not receiving any education, compared to 3 percent of the other group; and 69 percent of the urinary incontinence group received only a primary education (one to eight years of school), compared to 54 percent of the no-incontinence group.

The researchers determined that being over the age of 35 years old increased the odds of urinary incontinence by 1.9 times compared to the participants under 35.

Amount of education was also found to be significantly associated with the likelihood of having urinary incontinence — having either no education or just primary education increased the odds of urinary incontinence by 1.8 times.

In addition, if a participant had more than two pregnancies, the odds of incontinence were increased by 1.5 times.

Lastly, the average quality of life score among those with incontinence was 3.91.

The researchers concluded that more research is needed on the risk factors associated with the specific types of urinary incontinence.

This study was published in the December edition of Lower Urinary Tract Symptoms.

Review Date: 
December 11, 2013
Last Updated:
January 2, 2014