URINARY-INCONTINENCE IN WOMEN - ITS PREVALENCE AND ITS MANAGEMENT IN A HEALTH PROMOTION CLINIC

Background. It has been suggested that regular clinics might improve t he management of urinary incontinence in general practice. Aim. A stud y was undertaken to determine the prevalence of urinary incontinence a mong women in one general practice and the feasibility of using a heal th promotion clinic in its management. Method. Questionnaires were sen t to a 10% sample of women aged 20 years and over on the practice regi ster. Pregnant women were excluded. Results. Of 384 questionnaires sen t to eligible women, 314 were completed correctly (82%). The overall r eported prevalence of urinary incontinence was 53%; 8% of these women had urge incontinence, 46% had stress incontinence and 43% had mixed i ncontinence. Incontinence was positively correlated with parity and wi th gynaecological operation other than hysterectomy and repair of prol apse but not with perineal suturing after childbirth, delivery of a ba by weighing 9 lb (4.1 kg) or more or mode of delivery. Twenty seven ou t of 78 incontinent women (35%) who completed a second questionnaire a dmitted to worrying about their incontinence but only 10 (13%) had con sulted their doctor about the problem. The main reason given for not c onsulting was that incontinence was a minor inconvenience only. The 16 7 incontinent women were offered an appointment at a women's clinic bu t only 13 attended. Of these, 10 were entered into a 12 week treatment trial. Various treatments were offered, such as the women being taugh t bladder training and pelvic floor exercises. One woman was lost to f ollow up, and for eight out of nine women their continence had improve d, both subjectively and objectively. Conclusion. Urinary incontinence in women is a common problem. It can be successfully diagnosed and tr eated in general practice but low attendance makes the health promotio n clinic setting an inefficient means of achieving this.