Prevalence and Trends in Urinary Incontinence Among Women in the United States 2005-2018

Urinary incontinence disproportionately affects women. Urinary incontinence results in significant physical, social, and psychological adverse consequences that impair women’s quality of life and contribute to considerable healthcare costs. At the moment, the contemporary burden of urinary incontinence in US women is unknown. Therefore, we described the prevalence and recent trends in urinary incontinence by its subtypes and explored correlates of urinary incontinence in a population-based sample of US women in the NHANES study.

We found that urinary incontinence affects nearly half of the female population in the US, with stress urinary incontinence leading in prevalence (observed in 45.9% of women), followed by urgency urinary incontinence (observed in 31.1%). Altogether, 18.1% of the US female population is affected by mixed urinary incontinence. In the past decade, we also observed a rise in mixed urinary incontinence among women 60 years and older, likely driven by increases in urgency urinary incontinence.

The etiology of urinary incontinence is not fully understood, but several hypotheses exist. Non-sex-specific risk factors of urinary incontinence include smoking and obesity. And a high prevalence of urinary incontinence in women is additionally related to biological and reproductive factors including childbirth, vaginal delivery, hormone replacement therapy, and a shorter urethra in women than in men.

The cross-sectional nature of our data limits our ability to make inferences about causality. Nevertheless, we did observe that urinary incontinence affects some women more than others by age, weight status, race, and comorbidities. The significant burden of urinary incontinence in the population warrants future investigation using prospective study designs to identify modifiable risk factors for prevention strategies.

Urinary incontinence is a very common female lower urinary tract disorder. Traditionally, these disorders have been considered a normal part of the aging process in women. Now, Prof. Siobhan Sutcliffe, the co-senior author on this paper, is leading the first-ever training program at Washington University School of Medicine, to provide clinical and research fellows with the necessary skills to address this growing women’s health problem: Fellowship in Women’s Health

Written by:

Dr. Lin Yang, Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada

Prof. Siobhan Sutcliffe, Division of Public Health Sciences, Department of Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA

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