Research
Urogynecology
Incidence and remission of urinary incontinence in middle-aged women

https://doi.org/10.1016/j.ajog.2007.03.041Get rights and content

Objective

The objective of the study was to describe changes in urinary incontinence in middle-aged women.

Study Design

A prospective analysis of 64,650 women aged 36-55 years in the Nurses’ Health Study II. Participants reported urine leaking in 2001 and 2003. Two-year incidence and remission proportions were estimated.

Results

The 2-year incidence of incontinence was 13.7%. Incidence generally increased through age 50 years and then declined slightly in older women. Among women with incident incontinence at least weekly, the incidence of stress incontinence increased through age 50 years (2-year incidence 1.7%), and the incidence of urge incontinence was stable across age groups (2-year incidence 0.4%). Also, a minority (38%) mentioned leaking to their physician. Complete remission of symptoms occurred in 13.9% of women with incontinence at baseline.

Conclusion

We found that incontinence occurs frequently in middle-aged women. Yet few women mentioned incontinence to their physicians; thus, it may be important to initiate conversations about urinary symptoms even among younger patients.

Section snippets

Study population

The NHS II cohort was established in 1989 when 116,671 female nurses aged 25-42 years in 14 states completed a mailed questionnaire about their medical history, lifestyle, and health behaviors. Questionnaires are sent to participants every 2 years and follow-up rates of the cohort have remained approximately 95% through 2001. To maintain high follow-up, 5 mailing cycles of the questionnaire are conducted; for later cycles, only an abbreviated version of the questionnaire is sent. Information on

Data Analysis

Two-year incidence proportions were calculated by dividing the number of cases by the total number of women at risk in 2001. Proportions were calculated separately for each case definition based on frequency of symptoms, severity of symptoms, and incontinence type. Incident cases of frequent incontinence who did not complete the supplementary questionnaire were excluded from the calculations (ie, from both the numerator and denominator) of incontinence type. Analyses of incontinence remission

Results

Overall, there were 64,650 women included in these analyses, among whom 33,952 were at risk for developing incident incontinence in 2001. Among all women, the mean age was 46.4 years (Table 1). The prevalence of overweight and obesity (body mass index 25 kg/m2 or greater) was 50.3%, and 79.0% were parous. Among continent women in 2001, the mean age was 46.0 years, 42.8% were overweight or obese, and 76.4% were parous (Table 1).

Comment

Overall, in this prospective study, 13.7% of women aged 36-55 years who reported no leaking or minimal leaking developed at least monthly incontinence over the next 2 years, corresponding to an average incidence of 6.9% per year. In general, the incidence tended to increase with age through age 50 years; however, the incidence stabilized or declined at age 51-55 years. Among incontinent women at baseline, 13.9% reported complete remission of their symptoms at the end of follow-up, although the

References (22)

  • J.F. Wyman et al.

    Psychosocial impact of urinary incontinence in the community-dwelling population

    J Am Geriatr Soc

    (1990)
  • Cited by (0)

    This work was supported in part by Grants DK62438 and CA50385 from the National Institutes of Health (NIH). M.K.T. is supported by NIH Grant R25 GM55353.

    Cite this article as: Townsend MK, Danforth KN, Lifford KL, et al. Incidence and remission of urinary incontinence in middle-aged women. Am J Obstet Gynecol 2007;197:167.e1-167.e5.

    View full text