The impact of urinary incontinence on female sexual function

Although urinary incontinence is not a life-threatening disorder, it has been shown to have detrimental effects on quality of life in terms of psychological, social, and sexual problems. In this study, investigators explored the effects of different types of urinary incontinence on female sexual function with a reliable and validated questionnaire, the Female Sexual Function Index (FSFI). One hundred fifty-three women with complaints of incontinence were enrolled in the study. An age-matched group of 89 women who had no incontinence or lower urinary tract disorders were enrolled as a control group; all completed the FSFI. Incontinence was classified as urge, stress, and mixed type. Pelvic organ prolapse (POP), if present, was also recorded. FSFI scores were compared between the incontinent and control groups. A multivariate linear regression analysis model was used to explore the effects of patient characteristics on total FSFI domain score. All domain scores of FSFI except lubrication and pain were statistically significant in the incontinence group (for total domain score, P=.005). For FSFI, in terms of types of incontinence, the difference was significant when the group with mixed urinary incontinence was compared with the control group. In multivariate linear regression analysis, age, presence of POP, and mode of delivery were predictors of female sexual function. Mixed urinary incontinence, when compared with other types, had a significant impact on sexual function. When POP was also present, no negative effects were noted in incontinent women.     

Dimensions of the impact of urinary incontinence on quality of life of affected women: a review of the English literature

Urinary incontinence (UI) is a condition encountered by many women in their middle ages and although it is not life threatening, it tremendously affects the quality of life (QOL) of affected women. The purpose of this review was to characterize the dimensions of women's QOL affected by UI. A systematic review of published literature reporting about primary studies was conducted using specific Medical Subject Headings (MeSH) terms: (urinary incontinence) and 1 – (quality of life), 2 – (outcome), 3 – (well‐being), 4 – (health outcomes), 5 – (women), 6 – (social well fair) and 7 – (signs and symptoms). This yielded 545 articles and 12 articles met the inclusion criteria. Searches were conducted from electronic databases including PubMed, CINHAL and SCOPUS. The studies included in the review used different measurements to reach conclusion about the effect of UI on QOL. All the studies emphasized that UI has a negative impact on at least two aspects of the affected woman's QOL. The results of the review show that UI negatively impacts women's QOL in four main dimensions such as physical health, mental health, sexual health and social well‐being. UI negatively impacts affected women's in various aspects of their life and to effectively address their health care needs it requires a multidisciplinary and holistic approach to their health care needs.     

Impact of urinary incontinence on sexual quality of life in Portuguese adults

Urinary incontinence (UI) is a symptom of an underlying disorder with a high prevalence, constituting an important public health problem due to its physical, psychological and social consequences. The impact it has on the individuals' quality of life is revealed in their daily activities, self‐perception, socialization, emotional health and in their sexual life. The objective of this study is to analyse the impact of incontinence on the sexual quality of life, identifying the role of the variables: gender, duration and severity of incontinence, impact of incontinence on the quality of life and type of incontinence. The sample was composed by 55 patients (54·05% male and 45·5% female) from health facilities, in Lisbon, with a mean age of 55 years, who answered a set of questionnaires, which included: the Incontinence Impact Questionnaire (IIQ‐7); the Urogenital Distress Inventory (UDI‐6); the Questionnaire on Sexual Quality of Life, male and female versions (SQoL‐F/SQoL‐M) and a sociodemographic questionnaire. The results indicate that UI has a negative impact on the sexual quality of life in general, especially if the incontinence symptoms endure for a long period of time; also the impact of UI on social relationships, and the stress UI has a significant and negative impact on the sexual quality of life. In this study, UI has a negative impact on sexual life compounded by restrictions and other negative consequences of living with urinary leakage. The authors conclude that further research is required to ascertain the full impact of UI on sexual quality of life. Finally, implications for nurses are also discussed: in addressing the sexual health of their patients, nurses have an important contribution in assuring that experiencing UI should not necessarily translate into negative sexual quality of life.     

社区老年女性尿失禁生活质量及影响因素的调查分析

目的调查乌鲁木齐社区老年女性尿失禁患者的生活质量与其影响因素。方法采用整群分层抽样法,选取2011年1月—2012年12月乌鲁木齐30个社区的老年女性尿失禁患者1340例,运用尿失禁问卷简表中文版和尿失禁生活质量量表进行问卷调查。结果1340例患者的生活质量平均得分为（78．5±15．6）分,其中逃避和限制性行为（26．1±5．3）分;心理社会影响（34．1±8．6）分;社交活动受限（15．4±4．9）分。影响患者生活质量的因素共有9个,最终进入回归方程的有4个,分别是民族、文化程度（初中、高中、大专及以上）、混合性尿失禁和中重度尿失禁。结论乌鲁木齐社区老年女性尿失禁患者的生活质量水平整体较好,影响因素较多,应依据影响因素的不同进行针对性的护理干预。     

Quality of life in climacteric Turkish women with urinary incontinence

Urinary incontinence (UI) is a common health problem and negatively affects the quality of life of women who are afflicted. The aim of the study is to explore the prevalence and risk factors of UI among climacteric Turkish women and to examine the effects of UI on their quality of life. This cross‐sectional study was conducted with 258 women aged 40–64 years who visited the outpatient clinic in Ankara, Turkey, between 15 June 2012 and 15 January 2013. The data were collected using the International Consultation on Incontinence Questionnaire Short Form and the Incontinence Quality of Life Questionnaire. This paper reveals that the overall prevalence of UI was 45.3%. Stress UI, mixed UI, and urge UI were reported by 54.7%, 22.2%, and 10.3% of the subjects, respectively. The proportion of women suffering from UI who seek medical treatment was low despite mild or moderate negative effect impacts on their quality of life. Increasing women's awareness of UI and protective measures is essential, and standard UI assessment should be added to all patient examinations.     

Validation of the Korean language version of the incontinence‐quality of life scale

The purpose of this study is to determine the reliability and validity of the translated Korean version of the incontinence‐quality of life (I‐QOL) in a sample of community‐dwelling Korean American women with urinary incontinence in the USA. A survey design was used and a convenience sampling method of 176 Korean American women who reported having urinary incontinence symptoms was used. Translation–back translation procedures were used to translate the English version of the I‐QOL into Korean version. Reliability of the Korean I‐QOL questionnaire was demonstrated by Cronbach's α coefficients. Pearson's correlations of an item with its own scale and other scales were calculated to evaluate item‐convergent and item‐discriminant validity. Confirmatory factor analysis was performed to examine the underlying factor structure of the Korean version of the I‐QOL. Cronbach's α coefficient for all three subscales was greater than 0·70. The results of item‐convergent validity indicated that each item was strongly correlated with the originally belonged subscale. Item‐discriminant validity was evidenced by all lower correlations of an item to the other subscales than that of own subscale. Three factors were extracted from I‐QOL, accounting for 67·37% of the variance. The findings supported the reliability and validity of Korean version of I‐QOL questionnaire. It would be considered as a valuable instrument to assess the different aspects of health‐related quality of life in incontinence patients and recommended for use in clinical research.     

Quality of life and self-esteem in women living with urinary incontinence in Turkey

This study was conducted to determine the quality of life and self-esteem levels of women with urinary incontinence (UI). A total of 180 women participated in this cross-sectional study. This study was conducted in two stages. First, the international consultation on incontinence questionnaire-UI short form (ICIQ-SF) was implemented, and then other measures were applied to the women who scored 8 or more as the most appropriate cut-off point for ‘irritating’ UI. More specifically, a personal information form, the Rosenberg self-esteem scale (RBSS), the urogenital distress inventory-6 (UDI-6), and the incontinence impact questionnaire-7 (IIQ-7) were applied. It was observed that the mean self-esteem score of women with UI was generally sufficient. In line with the data obtained, it was observed that as the UI levels of women increased, their quality of life decreased. Similarly, a decrease was observed in the self-esteem levels of women whose quality of life decreased. As a woman's UI worsens, levels of urogenital distress increase and quality of life decreases, which leads to decreased self-esteem. Urinary incontinence is often kept secret, ignored, considered private, and seen as an unavoidable consequence of ageing.     

济南市社区女性尿失禁患者生活质量及影响因素的调查分析

目的调查济南市社区女性尿失禁患者的生活质量(quality of life,QOL)状况,了解其影响因素。方法采用方便抽样的方法,对济南市3个大型社区506例女性尿失禁患者进行问卷调查。结果 506例患者的QOL水平整体较好,平均得分为(79.5±16.6)分。逃避和限制性行为、社交活动受限是尿失禁患者QOL受影响较为明显的2个方面。影响患者QOL的因素共有9个,最终进入回归方程的有3个,分别是:文化程度(初中、高中、大专及以上)、混合性尿失禁和中重度尿失禁,共可解释QOL变异量的31.1%。结论济南市社区女性尿失禁患者的QOL水平整体较好,但其影响因素较多,应依据影响因素的不同进行针对性的护理干预,进一步提高患者的QOL。     

老年尿失禁患者社会功能缺陷的评估

目的 了解老年尿失禁患者社会功能状况,分析影响老年尿失禁患者社会功能的相关因素,并提出有针对性的护理干预措施.方法 使用国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)、尿失禁生活质量量表(I-QOL)及社会功能缺陷筛选量表(SDSS)对110例老年尿失禁患者进行调查.结果 老年尿失禁患者SDSS平均分为4.0分,介于神经症患者和精神病患者之间.被调查的老年尿失禁患者当中存在社会功能缺陷者90例,社会功能缺陷发生率为81.82%.年龄越大,尿失禁程度越严重,对社会功能的影响越明显.老年尿失禁患者的社会功能与生存质量之间存在相关关系,患者的社会功能缺陷越严重,生存质量越差.结论 被调查的老年尿失禁患者的社会功能缺陷明显,应采取积极有效的护理措施改善这一状况,提高患者的生存质量.     

Does biofeedback affect incontinence and quality of life in Turkish women?

Although urinary incontinence (UI) is not a life‐threatening disease, it is a common health problem that affects quality of life. This study was conducted to investigate the effect of pelvic floor muscle exercise (PFE) with biofeedback on incontinence and quality of life in women with UI. This clinical study was a randomized, controlled and experimental research conducted on 60 patients in total (30 control and 30 intervention patients) at a university hospital. Data were collected by using a questionnaire, Incontinence Quality of Life (I‐QOL) instrument, and International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF). The intervention group received biofeedback treatment for 16 sessions in total, each of which lasted 20 min, for 8 weeks, twice weekly, in a urodynamic unit. The obtained data were evaluated using χ², Student's t, one‐way analysis of variance (anova) , Mann–Whitney U and Kruskal–Wallis tests. It was observed that the incontinence inquiry form mean score of 16·1 ± 2·2 in the intervention group before biofeedback application decreased to 11·6 ± 4·6 after the application, whereas it increased from 14·0 ± 4·7 to 14·7 ± 4·7 in the control group (p < 0·05). It was also determined that the quality of life total mean score of 52·1 ± 10·5 in the intervention group before biofeedback application increased to 58·7 ± 14·7 after the application, whereas it decreased from 58·1 ± 16·1 to 53·5 ± 16·1 in the control group (p < 0·05). At the end of this study it was observed that PFE with biofeedback reduced incontinence and increased quality of life in women.     

The meaning of women's experience of living with long-term urinary incontinence is powerlessness

Aim. The aim was to illuminate the meaning of women's experiences of living with urinary incontinence (UI). Background. Living with long‐term UI means a variety of consequences for everyday life. Women's narratives about their lived experiences are important in enabling nurses to better understand and to help women achieve symptom control. No previous study could be found that has focused on the meaning of women's experience of living with UI from a symptom management perspective. Method. Fourteen women with UI (range: 34–52 years) who had sought professional help were interviewed. A phenomenological hermeneutic method was used to analyse and interpret the interview texts. Findings. The women's experiences of living with UI are presented in terms of two interlaced themes of being in a vulnerable situation and striving for adjustment. Being in a vulnerable situation means that the women had no control over UI and experienced powerlessness. The sub‐themes in this case were living with an uncontrolled body, living with incontinence as taboo and experiencing a less satisfying encounter. Striving for adjustment means that the women tried to handle their incontinence in different ways to regain power and continue to live as normal. The sub‐themes here were living in readiness, making urine leakage comprehensible, accepting living with UI and being familiar with the situation. Conclusion. The meaning of women's experience of living with UI is powerlessness. Relevance to clinical practice. Nurses should supervise women in pelvic floor muscle training to achieve control over incontinence, thereby helping them regain power. Additionally, Integrated Approach to Symptom Management can help nurses enhance women's self‐care abilities.     

Silent no more: elderly women's stories of living with urinary incontinence in long-term care

Urinary incontinence (UI) is a prevalent health issue affecting the quality of life of many elderly women living in long-term care. Minimal consideration has been given to understanding the lived experience from women's perspectives. Using one-to-one interviews, this study explored elderly women's experiences with UI while living in long-term care facilities. Data were analyzed using thematic analysis that revealed three themes related to the meaning of UI to the women, physical implications of UI, and institutional culture of UI in long-term care. Within these three themes, the women expressed common concerns. The results of this study provided information that could influence changes in nursing practice related to individualized UI care, empowering women experiencing UI, and dispelling ageism in long-term care. The study also suggests opportunities for improving health care education related to the quality of life of women who experience UI, and the need to make the experience more visible and openly discussed as a health issue rather than the traditional condition of aging.     

Urinary incontinence restrictions in women's life

Our purpose with this study was to verify the restriction of the urinary incontinence (UI) in a woman's daily life, considering the type of incontinence, and find out how women deal with that. It is a secondary analysis of data taken from a previous study that were obtained using open and closed questions. Interviews were held with 164 incontinent inpatients of gynecological and urological clinics of two hospital schools in the city of Campinas, in the State of S?o Paulo, with ages ranging from 25 to 85 years. Of this universe, 104 (64%) indicated one or more restrictions regarding their daily life activities, such as altered sexual (40.9%), social (33.5%), domestic (18.9%) and occupational activities (15.2%). Mixed urinary incontinence and urge incontinence were mentioned as that affected the most women's daily life. The disposable pad system was the most utilized strategy in dealing with UI. It was concluded that UI has a negative impact on the daily life of these women.     

老年尿失禁患者的生存质量调查分析

目的 调查老年尿失禁患者患病情况及其生存质量状况,分析影响老年尿失禁患者生存质量的相关因素.方法 使用尿失禁问卷表和尿失禁生活质量世表(I-QOL),对110名老年尿失禁患者进行调查.结果 老年尿失禁患者的生存质量得分较低,总分平均分为(56.31±12.58)分;I-QOL量表各领域得分其中限制性行为和社交活动受限二者得分较低.年龄因素对老年尿失禁患者生存质量中的限制性行为领域有一定的影响,60～69岁年龄段老年尿失禁患者限制性行为领域得分与70～79岁年龄段和80岁及以上年龄段比较,有统计学意义(P=0.015).教育背景、经济状况、职业、婚姻状况及性别对老年尿失禁患者生存质量无明显影响(P>0.05).不同类型尿失禁患者间比较,混合性尿失禁患者总体生存质量得分最低为(48.66±11.90)分,其次是急迫性尿失禁患者为(56.51±10.00)分,压力性尿失禁患者得分较高为(61.94±11.83)分,二者的得分差异有统计学意义(P<0.01).不同程度尿失禁患者间比较,重度尿失禁患者总体生存质量得分最低,其次是中度尿失禁患者,轻度尿失禁患者得分较高,三者的得分差异有统计学意义(P<0.01).结论 受试老年尿失禁患者总体生存质世较低,主要表现为日常行为和社会交往受限.疾病因素对老年尿失禁患者生存质量的影响较非疾病因素显著.     

Frequency of urinary incontinence among Turkish women,effective factors and its effect on quality of life

What is the frequency of urinary incontinence in Turkish women and how does it affect their quality of life? The aim of this study is to determine the frequency of urinary incontinence among Turkish women, effective factors and its effect on quality of life. Urinary incontinence, a health problem that is commonly seen among women, leads to primarily social and hygienic problems, and affects the physiological, psychological and economic aspects of individuals who are effected. This cross‐sectional study was conducted in the gynaecological outpatient clinics of a Turkish hospital, between 01 August 2014 and 26 December 2014. The population of the study consisted of 155 women aged 19 and over who applied to the gynaecology outpatient clinics for reasons other than pregnancy. The entire population was included in the study without selecting a sample. The data were collected by using a 16‐question questionnaire and King's Health Questionnaire (KHQ). A total of 67·7% of the women were found to suffer from urinary incontinence problem. A significant correlation was found between the age groups and incontinence problems. While pollakiuria was observed more in the age group of 20–29 years (37·3%), urge incontinence (35·6%), stress incontinence (36·2%), and enuresis nocturna (31·6%) were observed more in the age group of 30–39 years. Quality of life of women with bladder problems was significantly impaired. When the women with stress incontinence were compared with women who suffered from other incontinence problems, all sub‐scale mean scores obtained by the women with stress incontinence from KHQ were higher and the quality of life of these women was seriously impaired.     

Examining prevalence of urinary incontinence and risk factors in women in third postpartum month

Are pregnancy and birth‐related parameters important risk factors in the development of urinary incontinence (UI)? The aim of this study is to examine the prevalence of UI and associated risk factors in Turkish women in the third postpartum month. Incontinence after childbirth is a common problem. A cross‐sectional study that included 370 women in third postpartum month in Çanakkale is presented in this paper. Wagner's quality of life scale questionnaire exploring the risk factors for UI was used as the principle data collection tool. All women gave consent prior to inclusion in the study. Chi‐square, t test, Mann‐Whitney U test and Binary logistic regression were used for comparison. The prevalence of self‐reported postpartum UI was 35.9%. In this study; age, educational level, parity, number of normal birth, nocturia and constipation were determined to be the associated risk factors for postpartum UI in univariate analysis. When examining these risk factors by using logistic regression, it was found that the number of birth being 2 increased UI 2.7 times (P = 0.002, 95% CI:1.434‐5.324), the number of birth being 3 or more increased UI 20.3 times (P = 0.001, 95% CI:7.130‐58.332) and nocturia being 3 times and more increased UI 2.6 times (P = 0.041, 95% CI:1.042‐6.790). Pregnancy and birth‐related parameters are important risk factors in development of UI. It would be useful to increase the awareness in women in pregnancy and the postpartum period, by providing health training and consultancy services about UI protection and the reduction of risk factors.     

Report of a mail survey of women with bladder control disorders

INTRODUCTION: Very little is known about a patients perception of the severity of incontinence, absorbent product use, and interaction with health care professionals despite the growing prevalence of bladder control disorders such as urinary incontinence (UI) and overactive bladder. PURPOSE: Using a simple mail-in questionnaire, this survey was meant to evaluate the limitations in intervention for UI in women due to communication shorffalls. It cites common resources utilized once a woman finds significance to her bladder control problem. The survey explores the adequacy of intervention relative to the effective availability of information, materials, and treatment. The objective was to understand the current patient-professional relationship in order to evaluate different vehicles that might effectively increase communication regarding incontinence issues. METHODS: In partnership with a mail order medical product company, the author formulated a questionnaire that was mailed by the company to 1,500 women. Half of the sample was derived from randomly selected "leads" from advertising sources and personal referrals who had identified themselves as incontinent but had never purchased incontinence supplies from them. The other half were randomly selected customers who had purchased the company's incontinence products. The 33-item multiple-choice questionnaire had 422 responses; of these, 405 women, aged 56 and older were evaluated. A research firm that conducts and analyzes consumer surveys using standard consumer research protocol tabulated results. FINDINGS: Of those suffering from UI, two groups emerged. The first felt that incontinence was related to aging, and were not embarrassed to discuss it with their physician. They had mixed feelings regarding impact on quality of life. The second group was reluctant to seek professional advice and was uncomfortable speaking about it. They felt strongly about its negative impact on daily life. Respondents from both groups who seek professional assistance still desired more information about the causes, treatments, and coping mechanisms. Most wanted more provider interaction and wanted their doctor or health care provider to proactively initiate discussion on incontinence and provide information, educational materials, and product samples. CONCLUSION: Respondents indicated that they want more information regarding incontinence. While they may not be equipped to fully understand the problem, they expect doctors, nurses, medical professionals, retail outlets, medical supply companies, and mail order houses to provide the information. Since respondents are receiving information through consumer advertising, which is usually commercially funded, a partnership between the health care community and these sources to produce this information would be ideal.