Prevalence of urinary incontinence in women with spinal cord injury
IUGA Academy. Elmelund M. Jun 30, 2018; 212846; 290 Topic: Stress Incontinence
Marlene Elmelund
Marlene Elmelund

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Prevalence of urinary incontinence in women with spinal cord injury

Elmelund, M1; Klarskov, N2; Biering-Sørensen, F3

1: Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen and Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark ; 2: Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark; 3: Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Denmark

Introduction: Urinary incontinence (UI) can occur as a consequence of neurogenic bladder dysfunction following a spinal cord injury (SCI). In a Danish study from 2010, the prevalence of UI in persons with a SCI was 43%.1 To date, the prevalence of UI has only been investigated in SCI populations comprised primarily of men; hence, there is a knowledge gap on UI in women with SCI.

Objective: To investigate the prevalence of UI and conditions associated with UI in women with a SCI.

Methods: We performed a cross-sectional database study including women with a SCI between September 1999−August 2016, who attended a consultation in our clinic during August 2010–August 2016. Data were obtained from an electronic medical record database in which standardized questionnaires, including the International SCI Lower Urinary Tract Function Basic Data Set,2 were filled out by the treating physician during the consultation. If the physician had failed to fill out the standardized routine question regarding UI, the woman was excluded from the study. Data regarding the level and completeness of injury, UI, bladder function and emptying method, mobility and spousal/cohabitation status were obtained from the most recently filled-out questionnaires. The association between bladder function and UI was investigated using Fisher’s exact test and a multivariate logistic regression analysis, investigating the risk of UI according to baseline characteristics was conducted. In addition, answers to a condition-specific standardized quality of life questionnaire were obtained and analyzed according to UI using Mann-Whitney-U tests.3

Results: Of the 733 identified women, 124 women (17%) had no answer to the UI-question and were excluded from the study. The mean age of the included 609 women were 54 years. The injury was non-traumatic in 72%, complete in 7% and the median follow-up period after injury was 7.2 years. A total of 299 women (49%) were urinary incontinent and 27% experienced UI daily (Figure 1). UI was significantly associated with more daily voluntary bladder emptyings and the use of bladder relaxant drugs. In the multivariate logistic regression analysis, the odds of UI significantly increased if the woman used a wheelchair permanently (OR 2.16, 95% CI 1.24−3.77) or needed aids to walk (OR 1.73, 95% CI 1.08−2.76) and if the woman’s spousal/cohabitation status was unmarried/not living with a partner (OR 1.60, 95% CI 1.11−2.32). Conversely, the odds of UI decreased if the woman used an indwelling catheter (OR 0.35, 95% CI 0.18−0.67) compared with normal bladder-emptying method. Finally, UI was associated with decreased quality of life on the general, physical and emotional domain.

Conclusions: Half of a female SCI population experience UI, of whom the majority experience UI daily. In addition, UI is associated with impaired mobility, unmarried/non-cohabiting status and reduced QoL. Despite attempts of optimal bladder management, UI is a prevalent and severe problem in women with SCI.

Figure 1. Urinary incontinence within the last three months (n=609).

UI: urinary incontinence.

  1. Spinal Cord. 2010;48(1):27-33.
  2. Spinal Cord. 2008;46(5):325-330.
  3. Spinal Cord. 2012;50(9):672-675.


Work supported by industry: no.

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