Managing women presenting with urinary incontinence: is hardiness significant?

Excerpt

Urinary incontinence (UI) in women constitutes a very significant problem for the individual, her family and health care services. UI (including overactive bladder, stress, urge and mixed incontinence) is thought to affect around 9.6 million women in the UK [1] and is a reported symptom of up to 46 % of patients attending primary care clinics [2]. However, as precise prevalence estimates are difficult to ascertain because of under-reporting, it is conceivable that the actual number of people with UI is considerably higher [2]. This shortfall in presentation is thought to be due to a range of reasons such as symptom severity, embarrassment, lack of information and/or confidence regarding treatment options [1]. Conservative estimates of the cost to the National Health Service (NHS) of managing UI suggest that annual expenditure in 2001 was in excess of £350 million [3], the majority spent on non-pharmacological interventions, i.e. surgery and secondary care [4]. The impact of UI on quality of life is well-documented, affecting as it does personal relationships, social activities, work, and emotional and psychological well-being [5]. Because of the scope and severity of the problems experienced by many of these women, it might be expected that they would be more inclined to present for treatment than is currently the case. While one possible explanation for under-presenting may relate to the stigma attached to incontinence, it is conceivable that other factors, such as the patient’s psychological traits and states, may also play a part. …