Impact of incontinence varies widely among women
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Although bladder-control problems can be embarrassing, the effect they have on quality of life varies widely among individuals, and even by country of residence, according to new study findings.
In a survey of nearly 1,600 women from four European countries, researchers found that while 80 percent found their urinary incontinence symptoms at least somewhat “bothersome,” they had wide-ranging views of their quality of life.
Not surprisingly, women with milder symptoms reported a better quality of life than did those with moderate or severe symptoms. But there were also differences among women with mild symptoms, which constituted the majority of study participants. Among these women, those with stress incontinence reported a higher quality of life than did women with other types of urinary incontinence.
In stress incontinence, the bladder tends to leak urine when movement puts pressure on it—during exercise, for example, or even when a person laughs or coughs. It is a common problem among women, and is sometimes related to childbirth or menopause.
Compared with survey respondents with mild symptoms of stress incontinence, those with milder forms of “mixed” incontinence reported more quality-of-life problems, such as feeling they had to avoid exercise and social activities. People with mixed-type incontinence have problems controlling their bladder during physical exertion, but also have urine leakage at other times.
Other key factors in quality of life included age—younger women were affected more than older women were—overall health, and even the country in which a woman lived, according to findings published in the October issue of the medical journal BJU International.
“The extent to which women are bothered by their urinary incontinence and report their symptoms have negative impact on their quality of life is largely subjective,” write the study authors, led by Sotiria Papanicolaou of the Eli Lilly and Co. Lily Research Centre in Surrey, UK.
This, the researchers add, points to the importance of considering the uniqueness of each woman’s circumstance when deciding on treatment.
Eli Lilly, along with German drug company Boehringer Ingelheim, markets the drug duloxetine, which is used to treat stress incontinence.
Other methods for managing incontinence include behavior changes, such as using the bathroom on a timed schedule, exercises for the pelvic muscles and, in some more serious cases, surgery.
The study included 1,573 women, age 18 or older, from France, Germany, Spain, or the UK. More than three quarters described their incontinence symptoms as mild, and the most common form was stress incontinence, except in France, where half of women said they had the generally more troublesome mixed-type incontinence.
Yet, when the researchers looked at the survey findings by country, women in France were least bothered by their symptoms and, along with German women, reported a better quality of life overall than their counterparts in Spain and the UK.
The reasons for the cultural differences are not clear. Quality of life, the researchers note, is a complex concept that includes people’s perceptions of their “physical, psychological and social” well being, and both personal and cultural values are important factors.
SOURCE: BJU International, October 2005.
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