Urinary incontinence in women in rural Pakistan: prevalence, severity, associated factors and impact on life.

OBJECTIVE

To estimate the prevalence of urinary incontinence (UI) and its subtypes in women in rural Pakistan, associated factors, severity and impact on daily life.

DESIGN

Population-based, cross-sectional study.

SETTING

A rural community in Sindh Province, Pakistan.

POPULATION

Randomly selected women aged 15 years or older.

METHODS

A three-level random sampling strategy was used to select women: a random sample of health centres; a random sample of Lady Health Workers (LHWs) from each health centre; and a random sample of women in the LHW catchment areas. The LHWs used an interview-based structured questionnaire to collect data from women.

MAIN OUTCOME MEASURE

Urinary incontinence reported by women.

RESULTS

Among the 5064 participants (response rate 95.8%) the prevalence of any UI was 11.5% (581/5064; 95% CI 10.6-12.3). The most common subtype was stress incontinence, with a prevalence of 4.7% (95% CI 4.1-5.3), followed by urge incontinence, with a prevalence of 3.2% (95% CI 2.7-3.7), mixed incontinence, with a prevalence of 2.8% (95% CI 2.3-3.2), other incontinence, with a prevalence of 0.4% (95% CI 0.2-0.5) and continuous incontinence, with a prevalence of 0.5% (95% CI 0.3-0.6). Older age, higher parity and marriage at an early age were independently associated with UI. We found that 52% of women with UI reported leakage at least daily, and 45% reported a great or moderate impact on their daily life. Only 15.7% of women with UI had consulted a doctor.

CONCLUSIONS

The prevalence of UI reported in rural Pakistan was lower than is generally found in studies from the developed world, but among the women affected it commonly occurred on a daily basis and impacted on their everyday lives, yet few had obtained medical advice.