Incontinence impact varies among women

NEW YORK (Reuters Health) – Although bladder-control
problems can be embarrassing, the effect they have on quality
of life varies widely among individuals, and even by country of
residence, according to new study findings.

In a survey of nearly 1,600 women from four European
countries, researchers found that while 80 percent found their
urinary incontinence symptoms at least somewhat “bothersome,”
they had wide-ranging views of their quality of life.

Not surprisingly, women with milder symptoms reported a
better quality of life than did those with moderate or severe
symptoms. But there were also differences among women with mild
symptoms, which constituted the majority of study participants.
Among these women, those with stress incontinence reported a
higher quality of life than did women with other types of
urinary incontinence.

In stress incontinence, the bladder tends to leak urine
when movement puts pressure on it — during exercise, for
example, or even when a person laughs or coughs. It is a common
problem among women, and is sometimes related to childbirth or
menopause.

Compared with survey respondents with mild symptoms of
stress incontinence, those with milder forms of “mixed”
incontinence reported more quality-of-life problems, such as
feeling they had to avoid exercise and social activities.
People with mixed-type incontinence have problems controlling
their bladder during physical exertion, but also have urine
leakage at other times.

Other key factors in quality of life included age —
younger women were affected more than older women were —
overall health, and even the country in which a woman lived,
according to findings published in the October issue of the
medical journal BJU International.

“The extent to which women are bothered by their urinary
incontinence and report their symptoms have negative impact on
their quality of life is largely subjective,” write the study
authors, led by Sotiria Papanicolaou of the Eli Lilly and Co.
Lily Research Center in Surrey, UK.

This, the researchers add, points to the importance of
considering the uniqueness of each woman’s circumstance when
deciding on treatment.

Eli Lilly, along with German drug company Boehringer
Ingelheim, markets the drug duloxetine, which is used to treat
stress incontinence.

Other methods for managing incontinence include behavior
changes, such as using the bathroom on a timed schedule,
exercises for the pelvic muscles and, in some more serious
cases, surgery.

The study included 1,573 women, age 18 or older, from
France, Germany, Spain, or the UK. More than three quarters
described their incontinence symptoms as mild, and the most
common form was stress incontinence, except in France, where
half of women said they had the generally more troublesome
mixed-type incontinence.

Yet, when the researchers looked at the survey findings by
country, women in France were least bothered by their symptoms
and, along with German women, reported a better quality of life
overall than their counterparts in Spain and the UK.

The reasons for the cultural differences are not clear.
Quality of life, the researchers note, is a complex concept
that includes people’s perceptions of their “physical,
psychological and social” well being, and both personal and
cultural values are important factors.

SOURCE: BJU International, October 2005.