Incontinence linked to the onset of disability in women

Key points:

• New research from the RUSH University Medical Center in Chicago, Illinois, has revealed that frequent urinary incontinence and leakage amounts is associated with higher odds of disability

• In Australia, 70 percent of people with urinary leakage do not seek advice and treatment for their problem

• Over half of women living in Australia with urinary incontinence are aged under 50 years

RUSH University Medical Center researchers have shown the link between incontinence and disability in a study published in the January issue of the journal Menopause.

Sheila Dugan, MD, chair of the Department of Physical Medicine and Rehabilitation at RUSH, said symptoms from urinary incontinence are often ignored until they become bothersome or limit physical or social activities.

“Because this study suggests that urinary incontinence is associated with disability, exploring treatment options in the early stages may help decrease this outcome in mid-life women,” she explained.

The two types of incontinence that may occur among women in mid-life are ‘stress incontinence,’ which is when sneezing or coughing can pressure other parts of the body, leading to incontinence or ‘urge incontinence,’ which is the growing need to go to the bathroom when approaching a toilet facility.

Women who experience both have what’s called mixed urinary incontinence, Dugan said.

Researchers considered the amount and frequency of the incontinence and whether the study participant had stress incontinence, urge incontinence, or both.

Researchers then measured disability by the World Health Organization disability assessment scale as the outcome of interest.

“We found that mixed incontinence was the most highly correlated with disability, along with daily incontinence and larger amounts of incontinence,” Dugan said.

“In a case of tight muscles, a woman may try to tighten the muscles further with more exercise, not knowing that it may make the incontinence worse.

“Pelvic floor muscles support pelvic organs and organ problems can lead to muscle problems or vice versa.

“One patient may have incontinence due to hip arthritis, another from a difficult delivery, or it can be caused by cancer treatment, for example, radiation in the pelvic area.”

Dugan helped create the Program for Abdominal and Pelvic Health at RUSH, which treats several types of conditions, including urinary incontinence.

In Australia, 65 percent of women and 30 percent of men sitting in a doctor’s waiting room reported some type of urinary incontinence, yet only 31 percent of these people reported seeking help from a health professional.

Loss of bladder and bowel function is recognised as a disability under the Disability Discrimination Act 1992 and can have an immense impact on the one in four Australians experiencing incontinence.

In the Continence Foundation of Australia’s 2021 Submission to the Australian Government Department of Social Services consultation on the National Disability Employment Strategy, advocates called on the government to address the prevalence and impact of incontinence.

Approximately one in three Australians with a disability currently experience incontinence and for National Disability Insurance Scheme participants, who usually have a greater level of functional impairment, this will likely mean a higher proportion require safe and effective continence support, according to the Foundation.

Incontinence costs Australians $67 billion annually including health system expenditure, productivity losses, cost of care and burden of disease, as estimated by a Deloitte Access Economics 2011 report.

Do you believe that Australia does enough to address incontinence and its impact on those who live with the condition? Let the team at Talking Disability know and subscribe to the newsletter for more news, information and industry updates.

Related content:

I have been approved for NDIS funding — what next?

How to make your workplace disability-friendly

Sexual dysfunction and disability