Urinary Incontinence in Female Patients

Urinary incontinence (UI) is a common condition that may affect women of all ages, with a wide range of severity and nature. Although rarely life-threatening, UI may end up with serious physical, psychological and social problem. UI may also develop impact on the quality of the patient’s life. The patient may experience social isolation and psychiatric disorder such as depression and sleep disorder, and bear social stigma. The prevalence of UI ranges from 3 to 55% depending on the definition used and the age of population studied. The prevalence of UI increases with advancing age. The prevalence in women above 80 years of age may reach 46%. UI is defined by the International Continence Society as any involuntary leakage of urine. Many clinicians have simply categorized UI in women as stres UI and urge UI. Practically UI is classified into 4 categories, i.e. urge UI, stress UI, overflow incontinence (OI), and total UI. Risk factors includes pregnancy, childbirth, obesity, menopause, aging, hysterectomy and chronic diseases. Initial assessment in UI management is identifying the impact of UI on patients and exploring the patient’s expectation for treatment. This should be followed by determination of the type of UI and associated symptoms. Management of UI consists of conservative and surgical treatment. The conservative treatment includes education on intervening life style, pelvic floor muscle training and pharmacological treatment. Surgical treatment is recommended when patients are not responded to conservative treatment. Considering the strong associations between UI and physical, functional and psychological morbidity, early identification of UI etiology has become a very important step for determination wether to refer the patient to the higher level care unit. By doing so, one can reduce the health cost and increase the patient’s quality of life.