Stress urinary incontinence: A problem for many women

FLORENCE, Italy – Results from a milestone multinational survey, "Stress Urinary Incontinence and Women: Discovering the Truth," provides new insights into the impact of stress urinary incontinence (SUI) on the lives of women worldwide.

The survey’s findings indicate that a staggering one in three women worldwide across all age groups have SUI, yet most are reluctant to talk about their symptoms, and the majority of women surveyed who have the disorder were unaware of its name.

Urinary incontinence is a medical disorder defined by the complaint of any involuntary leakage of urine. SUI is the most common form of urinary incontinence among women and is defined as involuntary urine leakage on effort or exertion, or on sneezing or coughing.

According to the World Health Organization, urinary incontinence is "a widespread global disease and one of the last medical taboos for many people."

The survey results were announced during a media briefing at the International Society’s (ICS) 33rd Annual Meeting attended by thought leaders and patient advocacy groups from around the world.

Conducted among more than 4,500 women aged 18 to 65-plus from three continents, the survey examined the attitudes, awareness and impact of SUI on women worldwide.

The survey counters the notion of SUI as an older women’s disorder. In fact, it indicates that almost two in five women (37 percent) between the ages of 35 and 54 experience SUI symptoms, approximately the same percentage as those in the over 55 age group (39 percent).

Furthermore, almost a quarter (24 percent) of the respondents aged 18 to 44 report that they have symptoms, and almost one-fifth (18 percent) admit first experiencing symptoms before age 29.

"SUI intrudes on the lives of millions of women and is often unrecognized, unreported and untreated," said Professor Walter Artibani, chairman of the ICS annual meeting and the society’s incumbent general secretary.

"We hope the findings will spark dialogue among women and healthcare professionals to help bring this disorder out of the closet and into the open. The survey highlights the truth about SUI: It can affect any woman at any age, resulting in a loss of freedom and vitality – a loss that is often overlooked and misrepresented."

Impact On Daily Life

The multinational survey indicates that the greatest impact may be in how SUI changes and disrupts the daily lives of affected women. For example, women with SUI symptoms report wearing pads everyday, having to carry a change of clothes or underwear and limiting business and personal travel as ways to manage their symptoms.

As a result, they may feel less confident, give up careers and/or outside activities, avoid intimacy with their partners, and experience overall social isolation.

Despite the prevalence of SUI, the survey suggests that embarrassment and low awareness may inhibit women from truly understanding their symptoms or seeking professional help.

Several risk factors for or contributing variables to the development of SUI have been suggested over the last decade: Childbirth, obesity, constipation, pelvic organ prolapse, chronic coughing or pelvic nerve surgery may damage the connective tissue and the neuromuscular structures in and outside of the urethra.

While no drug has been approved globally for the treatment of SUI, novel pharmaceutical treatments are currently in development.

According to the survey, many women with SUI symptoms cannot connect its causes to the disorder itself. "This further underscores the need for SUI education. If you mistake SUI symptoms for a normal part of aging, for example, and are too embarrassed to talk about it, you’re less likely to seek medical advice on treatment options," said Dr. Philip Van Kerrebroeck, professor of the University Hospital Maastricht, Netherlands.

"We found remarkable consistencies around the world regarding the prevalence, attitudes and impact of this disorder. Women interviewed in this survey from Europe, Canada, Mexico and Australia, like their American counterparts, register low awareness and understanding of SUI."

Professional Help

The survey also indicates differences in attitude and action between women who have SUI and those who do not – especially when they are questioned about how they might react to its symptoms.

Interestingly, of almost all respondents who do not have SUI, 96 percent say they would consult their doctor within one year of experiencing it, and most (71 percent) report that they would be comfortable discussing symptoms.

But findings among women with SUI paint a very different picture: Nearly two-thirds have never consulted a doctor. Of those who have consulted a doctor (38 percent), one in five waited up to three years before doing so and one in 10 waited up four years or more. Also, about one-half of women with SUI responded that they do not like discussing their symptoms.

"The survey indicates how difficult it is for women with SUI to overcome their embarrassment and seek professional help. This is compounded by women’s lack of understanding that they have a recognized medical disorder and that emerging treatment options are showing promising results," said Kerrebroeck.

"Moving forward with the results of this milestone survey," continued Kerrebroeck," we hope to place SUI on the global health agenda and communicate the truth about it. Our aim is to enable women worldwide to openly access education and professional healthcare support so they can live life to the fullest."

There are three types of urinary incontinence: stress, urge and mixed. Urge incontinence is defined as an involuntary loss of urine associated with a strong, sudden urge to go to the restroom. Mixed incontinence is a combination of stress and urge symptoms.

The multinational survey, sponsored by the ICS in partnership with Boehringer Ingelheim and Eli Lilly and Co., was conducted by Wirthlin Worldwide, which interviewed 4,558 women by telephone – 500 from the nine countries and three continents, aged 18 to 65-plus, with nationally representative samples ensured with region and age quotas.

The nine countries were France, Germany, Italy, Spain, Sweden, United Kingdom, Canada, Mexico and Australia.