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Prevalence and Factors Associated with Urinary Incontinence Among Women with Pelvic Organ Prolapse
IUGA Academy. Ibrahim S. Jun 30, 2018; 212895; 506 Topic: Pelvic Organ Prolapse
Dr. Salih Ibrahim
Dr. Salih Ibrahim

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506

Prevalence and factors associated with urinary incontinence among women with pelvic organ prolapse

Ibrahim, S1; Kebede, E2; Abdella, A2; Mariye, Y2; Assefa, E2

1: Addis Ababa University; 2: Addis Ababa University

Introduction: Pelvic organ prolapse (POP) and Urinary incontinence (UI) are common problems that affect the quality of life of women worldwide. It is estimated that about 50% of parous women develop POP and about 17-45% of women develop urinary incontinence. The pathophysiology of POP and UI is related and can be considered multifactorial. In Ethiopia, POP is a commonly managed clinical problem and there is limited data that show the magnitude of UI among women with POP and on the risk factors associated with incontinence.

Objective: The objective of the study was to determine the prevalence and factors associated with UI in women with POP.

Methods: A descriptive cross-sectional study was conducted from May 2015 to August 2015 at three teaching hospitals. The study population was all women who visited these three teaching hospitals for POP. Study participants were recruited during the study period consecutively. Data was collected with a standardized questionnaire and the ICIQ-SF (International Consultation on Incontinence Questionnaire – Short Form) with measurement of BMI (body mass index) and POP-Q (Pelvic Organ Prolapse Quantification) staging of POP for each participant. The data was entered and cleaned using Epi Info V. 7. Analysis was done using SPSS V. 21.0 statistical software. Statistical significance was defined at a p-value of < 0.05 using chi square and odds ratio (OR). Adjusted odds ratio (aOR) was calculated using logistic regression for those variables with a significance p-value on bivariate analysis.

Results: A total of 154 women with POP were included in the study during the study period. The mean age of the participants was 50.5±12.5 (2SD) years. All participants were parous and the mean parity of the participants was 5.7±2.7 (2SD). Forty two (27.3%) of the participants were premenopausal. Most (53.9%) of the participants had stage 4 prolapse, 34.4% had stage 3 prolapse and the rest had stage 2 prolapse. Only 3.9% of participants had previous surgery for prolapse.

The prevalence of urinary incontinence in the study population was 35.1%. The prevalence of stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence was 23.4%, 28.6% and 12.9% respectively. Advanced stage prolapse (POP-Q stage 3 and 4) was independently and significantly associated with having any type of urinary incontinence (aOR=18.16, 95% CI [2.14-153.99]) and urge urinary incontinence (aOR=9.43, 95% CI [1.14-77.90]) in the study population. On the other hand diuretic drug use was independently and significantly associated with stress urinary incontinence (aOR=7.53, 95% CI [1.01-56.23]).

Conclusions: The prevalence of urinary incontinence in women with POP was high. Advanced stage prolapse and diuretic use were independently associated with different types of urinary incontinence. Women with POP should be evaluated for urinary incontinence and treatment should be planned for the two disorders simultaneously.

References:

Int Urogynecol J Pelvic Floor Dysfunct. 2002; 13: 256-60

Int Urogynecol J. 2013 Jul; 24(7): 1135-43.

Obstet Gynecol. 2014; 123(201): 279-287.

Disclosure:

Work supported by industry: no.

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