Women's Management of Urinary Incontinence in Daily Living

PURPOSE: We investigated strategies used by older and working-aged women to manage urinary incontinence (UI) in their daily lives. DESIGN: Cross-sectional, descriptive study. SUBJECTS AND SETTING: The sample comprised 103 older (>65 years; mean = 74.6 years) and 104 working-aged (18-65 years; mean = 50.3 years) community-dwelling Australian women with self-reported UI. They had experienced UI for an average of 5 years and a majority rated their UI severity as moderate to severe. INSTRUMENT: Based on a comprehensive literature review, a 93-item author-developed questionnaire was developed and pilot tested to identify the type and frequency of strategies used by participants to manage UI. Items were developed that queried demographic and lower urinary symptom characteristics (type, severity, duration). METHODS: Participants were recruited via public and privately funded continence clinics and an advertisement in a local newspaper, with a 66% retention rate following recruitment. Questionnaires were posted to participants with a reply paid envelope for return. RESULTS: The women used a range of strategies to manage UI in their daily lives. A large proportion of women from both groups chose to (1) go to the toilet immediately after urge (older 94%; working-aged 92%); (2) integrate urine loss management a normal part of everyday life (older 81%; working-aged 78%); (3) stopping activities that make them leak (older 85%; working-aged 83%); and (4) using pads and aids for urinary containment (older 87%; working-aged 73%). Older women were more likely to use most of the strategies identified in the questionnaire. These strategies included the following: stop drinking in the evening (older 64%; working-aged 43%; P = .003); organize their bedroom close to the toilet (older 61%; working-aged 36%; P = .001); limit travel (older 45%; working-aged 18%; P = <.001); limit socializing (older 30%; working-aged 11%; P = .001); and limit new relationships (older 25%; working-aged 11%; P = .01). Respondents engaged in a variety of hygiene measures such as washing (older 86%; working-aged 60%; P = .001), changing pads frequently (older 76%; working-aged 58%; P = .008), and using deodorisers (older 68%; working-aged 50%; P = .008). Working-aged women were more likely to modify (older 17%; working-aged 70%; P < .001) or avoid (older 8%; working-aged 32%; P = .001) sexual activity. CONCLUSION: Both older and younger women aimed to normalize UI in their daily lives, using strategies designed to keep the bladder empty, maintain secrecy, and preserve social continence. Knowledge of these strategies and the difference between older and working-aged women will enable health care professionals to initiate more targeted support and advice for women with UI.