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Volume 122, Issue 11, Pages 1037-1042 (November 2009)


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Prevalence and Severity of Undiagnosed Urinary Incontinence in Women

Lauren P. Wallner, MPHab, Sima Porten, MD, MPHc, Richard T. Meenan, PhDd, Maureen C. O'Keefe Rosetti, MSd, Elizabeth A. Calhoun, PhDe, Aruna V. Sarma, PhDab, J. Quentin Clemens, MDaCorresponding Author Informationemail address

Abstract 

Background

Urinary incontinence is a highly prevalent condition in aging women that results in significant morbidity. Less than half of women who suffer from urinary incontinence seek treatment, resulting in a significant proportion of clinically relevant urinary incontinence remaining undiagnosed. Therefore, the purpose of this study was to quantify the prevalence of urinary incontinence in undiagnosed women in a managed care population.

Methods

There were 136,457 women aged 25-80 years enrolled in Kaiser Permanente Northwest who were free of genitourinary diagnoses, including urinary incontinence, who were included in this study. Of the 2118 women who were mailed questionnaires ascertaining information on demographic and urinary incontinence characteristics, 875 completed the survey. A chart review of the 234 women who reported moderate to severe urinary incontinence was performed.

Results

The prevalence of undiagnosed urinary incontinence was 53% in the preceding year, and 39% in the preceding week. The prevalence of undiagnosed stress, mixed, and urge incontinence was found to be 18.7%, 12.0%, and 6.8%, respectively. Quality of life was found to significantly decrease with increasing urinary incontinence severity. Of the 234 chart-reviewed women, 5% were found to have physician-documented urinary incontinence.

Conclusions

These results suggest that a significant proportion of women in this managed care population are suffering from urinary incontinence that remains undiagnosed. Efforts should be made to encourage women and physicians to initiate conversations about urinary incontinence symptoms in order to decrease the unnecessary burden of this disease.

a Department of Urology, University of Michigan, Ann Arbor, MI

b Department of Epidemiology, University of Michigan, Ann Arbor, MI

c Department of Urology, University of California at San Francisco, CA

d Center for Health Research Kaiser Permanente Northwest Division, Portland, Ore

e Department of Health Policy Administration, University of Illinois at Chicago School of Public Health, Chicago

Corresponding Author InformationRequests for reprints should be addressed to J. Quentin Clemens, MD, MS, Department of Urology, University of Michigan Medical Center, 1500 East Medical Center Drive, Taubman Center 3875, Ann Arbor, MI 48109-5330

 Funding: NIDDK UO1 DK060177.

 Conflict of Interest: Neither the primary author nor any of the corresponding authors have any conflicts of interest with the submission of this article.

 Authorship: All 7 authors of this manuscript have made a substantial contribution to writing the manuscript and had access to the data.

PII: S0002-9343(09)00585-3

doi:10.1016/j.amjmed.2009.05.016


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