Objective: To determine the prevalence of stress, urge, and mixed urinary i
ncontinence and associated risk factors in postmenopausal women.
Methods: Before enrollment in a 4-year, randomized trial of combination hor
mone therapy to prevent coronary heart disease, 2763 participants completed
questionnaires on prevalence and type of incontinence. We measured factors
potentially associated with incontinence including demographics, reproduct
ive and medical histories, height, weight, and waist-to-hip circumference r
atio. We used multivariate logistic models to determine independent associa
tions between those factors and weekly incontinence by type.
Results: The mean (+/- standard deviation [SD]) age of the participants was
67 +/- 7 years; 89% were white and 8% were black. Fifty-six percent report
ed weekly incontinence. In multivariate analyses, the prevalence of weekly
stress incontinence was higher in white than black women (odds ratio [OR] 2
.8, 95% confidence interval [CI] 1.6, 5.1), in women with higher body-mass
index (BMI) (OR 1.1 per 5 units, 95% CI 1.0, 1.3), and higher waist-to-hip
ratio (OR 1.2 per 0.1 unit, 95% CI 1.0, 1.4). The prevalence of weekly urge
incontinence was higher in older women (OR 1.2 per 5 years, 95% CI 1.1, 1.
3), diabetic women (OR 1.5, 95% CI 1.1, 2.0) and women who had reported two
or more urinary tract infections in the prior year (OR 2.0, 95% CI 1.1, 3.
6).
Conclusion: Stress and urge incontinence are common in postmenopausal women
and have different risk factors, suggesting that approaches to risk-factor
modification and prevention also might differ and should be specific to ty
pes of incontinence. (C) 1999 by The American College of Obstetricians and
Gynecologists.