Asian Journal of Research and Reports in Urology

Prevalence of Urinary Incontinence and Possible Associated Etiological Risk Factors in Saudi Women

Samera F. AlBasri *

Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.

Reham A. Abdulgader

Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.

Rawan I. Heggi

Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.

*Author to whom correspondence should be addressed.

---

Abstract

Importance: Urinary incontinence (UI) is a frequent condition among women worldwide. It has a significant impact on physical, social, and interpersonal interaction.

Objectives: To investigate the prevalence of different types of urinary incontinence and possible associated etiological risk factors in Saudi women.

Study Design: This cross-sectional questionnaire-based study was made through an online and hard copy questionnaire on Saudi women aged between 20 to 55 years from January 2021 to March 2021. Eligible women complete 3 Incontinence Questions (3IQ) that identify if they had UI. Subsequently, a standard questionnaire was completed to know the demographic profile, obstetric history, medical diseases, and social factors to assess etiological risk factors. The obtained data were collected and analyzed.

Results: The prevalence of UI was 45.2% among Saudi women. The incontinence type was mostly urge incontinence, followed by stress incontinence and other causes. Risk factors for             UI among participants were age >30 years, obesity, married women, parity ≥3, previous episiotomy, history of 3^rd or 4^th-degree perineal tear (patients usually informed about                  these complications in postnatal clinic); history of recurrent urinary tract infections; history of childhood nocturnal enuresis; chronic constipation and history of depression. Meanwhile, mode of delivery, chronic cough, smoking, and regular exercise were not associated with the occurrence of UI.

Conclusions: Female UI is a public health issue with medical and social ramifications. More research is needed to appropriately address the UI burden in Saudi Arabia and help plan future healthcare strategies.

Keywords: Epidemiology, prevalence, questionnaires, Saudi women, childbirth, urinary incontinence, risk factors, quality of life

---

---

---

References

Agarwal BK, Agarwal N, B.K. and N: Agarwal. Urinary incontinence: prevalence, risk factors, impact on quality of life and treatment seeking behaviour among middle aged women. Int Surg J. 2017;6(6):1953-8.

DOI: 10.18203/2349-2902.isj20172131.

Mostafaei H, Sadeghi‐Bazargani H, Hajebrahimi S, Salehi‐Pourmehr H, Ghojazadeh M, Onur R et al. Prevalence of female urinary incontinence in the Developing World: A systematic review andmeta‐analysis—A Report from the Developing World Committee of the International Continence Society and Iranian Research Center for Evidence Based Medicine. Neurourol Urodyn. 2020;39(4):1063-86.

DOI: 10.1002/nau.24342

Bakarman MA, Al-Ghamdi SS. The effect of urinary incontinence on quality of life of women at childbearing age in Jeddah, Saudi Arabia. Glob J Health Sci. 2015;8(2):281-7.

DOI: 10.5539/gjhs.v8n2p281.

Al-Badr A, Brasha H, Al-Raddadi R, Noorwali F, Ross S. Prevalence of urinary incontinence among Saudi women. Int J Gynaecol Obstet. 2012;117(2):160-3.

DOI: 10.1016/j.ijgo.2011.12.014

Govender Y, Gabriel I, Minassian V, Fichorova R. The current evidence on the association between the urinary microbiome and urinary incontinence in women. Front Cell Infect Microbiol. 2019;9:133.

DOI: 10.3389/fcimb.2019.00133

Million E, Vexlard E, Lognos B, Cayrac M. Urinary incontinence as a marker of temporality in women: a qualitative study. Climacteric. 2021;24(6):605-11.

DOI: 10.1080/13697137.2021.1915272.

DeLancey JOL. The pathophysiology of stress urinary incontinence in women and its implications for surgical treatment. World J Urol. 1997;15(5):268-74.

DOI: 10.1007/BF02202011

Kirss F, Lang K, Toompere K, Veerus P. Prevalence and risk factors of urinary incontinence among Estonian postmenopausal women. SpringerPlus. 2013;2:524.

DOI: 10.1186/2193-1801-2-524.

Subak LL, Brubaker L, Chai TC, Creasman JM, Diokno AC, Goode PS et al. High costs of urinary incontinence among women electing surgery to treat stress incontinence. Obstet Gynecol. 2008;111(4):899-907.

DOI: 10.1097/AOG.0b013e31816a1e12.

Ganz ML, Smalarz AM, Krupski TL, Anger JT, Hu JC, Wittrup-Jensen KU et al. Economic costs of overactive bladder in the United States. Urology. 2010;75(3).

DOI: 10.1016/j.urology.2009.06.096.

Hammad FT. Prevalence, social impact and help-seeking behaviour among women with urinary incontinence in the Gulf countries: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2021;266:150-6.

DOI: 10.1016/j.ejogrb.2021.10.005.

Pakgohar M, Sabetghadam S, Vasegh Rahimparvar SF, Kazemnejad A. Quality of life (QoL) and help-seeking in postmenopausal women with urinary incontinence (UI): A population based study. Arch Gerontol Geriatr. 2014;59(2):403-7.

DOI: 10.1016/j.archger.2014.07.004.

Strickland R. Reasons for not seeking care for urinary incontinence in older community-dwelling women: a contemporary review. Urol Nurs. 2014; 34(2):63-8.

DOI: 10.7257/1053-816X.2014.34.2.63.

Brown JS, Bradley CS, Subak LL, Richter HE, Kraus SR, Brubaker L. The sensitivity and specificity of a simple test to distinguish between urge and stress urinary incontinence. Ann Intern Med. 2006;144(10):2006144, 715-723.

DOI: 10.7326/0003-4819-144-10-200605160-00005.

DAA Y, Mohammed SMA, I. RIM, I. N. B.: Urinary incontinence in healthy. Urinary Incontinence in Healthy Saudi women. Egypt J Hosp Med. 2017;69(7):2890-6.

DOI: 10.12816/0042583.

Altaweel W, Alharbi M. Urinary incontinence: prevalence, risk factors, and impact on health related quality of life in. Saudi women. Neurourol Urodyn. 2012;31(5):642-5.

DOI: 10.1002/nau.22201.

Melville JL, Katon W, Delaney K, Newton K. Urinary incontinence in US women: a population-based study. Arch Intern Med. 2005;165(5):537-42.

DOI: 10.1001/archinte.165.5.537.

Luber KM. The definition, prevalence, and risk factors for stress urinary incontinence. Rev Urol. 2004;6;Suppl 3:S3-9.

Panugthong P, Chulyamitporn T, Tanapat Y. Prevalence and risk factors of urinary incontinence in Thai menopausal women at Phramongkutklao Hospital. J Med Assoc Thai. 2005;3;Suppl 3:25-30.

Subak LL, Johnson C, Whitcomb E, Boban D, Saxton J, Brown JS. Does weight loss improve incontinence in moderately obese women? Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(1):40-3.

DOI: 10.1007/s001920200008.

Rizk DE, Shaheen H, Thomas LD, Dunn E, Hassan MY. The prevalence and determinants of health care-seeking behavior for urinary incontinence in United Arab Emirates women. Int Urogynecol J Pelvic Floor Dysfunct. 1999;10(3):160-5.

DOI: 10.1007/s001920050038.

Ghafouri A, Alnaimi AR, Alhothi HM, Alroubi I, Alrayashi M, Molhim NA et al. Urinary incontinence in Qatar: A study of the prevalence, risk factors and impact on quality of life. Arab J Urol. 2014;12(4):269-74.

DOI: 10.1016/j.aju.2014.08.002.

Kuh D, Cardozo L, Hardy R. Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort. J Epidemiol Community Health. 1999;53(8):453-8.

DOI: 10.1136/jech.53.8.453.

Cerruto MA, D’Elia C, Aloisi A, Fabrello M, Artibani W. Prevalence, incidence and obstetric factors’ impact on female urinary incontinence in. Europe: a systematic review. Urol Int. 2013;90(1):1-9.

DOI: 10.1159/000339929.

Swanson JG, Kaczorowski J, Skelly J, Finkelstein M. Urinary incontinence: common problem among women over 45. Can Fam Physician. 2005;51:84-5.

Moore EE, Jackson SL, Boyko EJ, Scholes D, Fihn SD. Urinary incontinence and urinary tract infection: temporal relationships in postmenopausal women. Obstet Gynecol. 2008;111(2 Pt 1):317-23.

DOI: 10.1097/AOG.0b013e318160d64a.

Lifford KL, Curhan GCH, Hu FB, Barbieri RL, Grodstein F. F: type 2 diabetes mellitus and risk of developing urinary incontinence. J Am Geriatr Soc. 2005;53(11):1851-7.

DOI: 10.1111/j.1532-5415.2005.53565.x.

ZORN BH, Montgomery H, Pieper K, Gray M, Steers WD. Urinary incontinence and depression. J Urol. 1999;162(1):82-4.

DOI: 10.1097/00005392-199907000-00020.

Lim YM, Lee SR, Choi EJ, Jeong K, Chung HW. Urinary incontinence is strongly associated with depression in middle-aged and older Korean women: data from the Korean longitudinal study of ageing. Eur J Obstet Gynecol Reprod Biol. 2018220. 2018;220:69-73.

DOI: 10.1016/j.ejogrb.2017.11.017.

Cheng S, Lin D, Hu T, Cao L, Liao H, Mou X et al.. Hu. Association of urinary incontinence and depression or anxiety: a meta-analysis. J Int Med Res. 2020;48(6):300060520931348-10.

DOI: 10.1177/0300060520931348.

Gurbuz A, Karateke A, Kabaca C. Enuresis in childhood, and urinary and fecal incontinence in adult life: do they share a common cause? BJU Int. 2005;95(7): 1058-62.

DOI: 10.1111/j.1464-410X.2005.05466.x

Yarnell JW, Voyle GJ, Sweetnam PM, Milbank J, Richards CJ, Stephenson TP. Factors associated with urinary incontinence in women. J Epidemiol Community Health. 1982;36(1):58-63.

DOI: 10.1136/jech.36.1.58