Needs assessment of women with urinary incontinence in a district health authority.

Abstract

BACKGROUND: The prevalence of urinary incontinence in women is difficult to estimate because definitions vary between researchers and among women, for whom thresholds of complaint differ. However, studies have also shown that only about a quarter of women affected by urinary incontinence consult a doctor for their symptoms, despite evidence of effective treatments and better management of the condition in primary care. AIM: To assess the perceived needs of women with urinary incontinence living at home. DESIGN: Cross-sectional community survey. SETTING: A 1% stratified random sample of women living at home, registered with a local GP, and aged 45 years and over (n = 720) in a north London district health authority with a total population of 308,000. RESULTS: Out of 720 questionnaires, 489 were returned completed (68%). A total of 227 (46%) women had symptoms of significant urinary incontinence. Seventy-eight (16%) had significant symptoms which they said were not a problem, and 149 (30%) of the total number of responders acknowledged that they had significant symptoms and that these symptoms were a problem for them; of these, 48 (32%) sought help from their GP; 16 out of the 48 consulting their GP were happy with the treatment given, and the remaining 101 women who considered their incontinence to be a problem had not consulted their GP and 76 of those had also not told anyone else that they had a problem. The commonest reasons given by the 101 women who admitted having a problem and who had not consulted their GPs were that they thought that they should cope on their own (43 [42.6%]), that incontinence was inevitable with age (26 [25.7%]) or that it was embarrassing to talk about the problem to their GP (14 [13.8%]). CONCLUSIONS: Despite the existence of effective interventions for urinary incontinence, many women who are incontinent do not seek help even when they perceive their incontinence to be a problem. Half of the women who did consult their GP did not find the treatment offered helpful. Achieving health gain for women with urinary incontinence will require a more active approach than currently exists to inform people that better care is available, to help counteract the stigma attached to the problem, and to ensure that primary care professionals are able to provide effective services.