Purpose
This research seeks to determine the prevalence of urinary incontinence in adult women in La Serena, Chile, exploring its association with known risk factors.

Methods
We conducted a cross-sectional, descriptive study with an analytical component. A validated questionnaire was applied to 371 women who consented, were aged 30 or older, and were users of primary health care centers.

Results
The prevalence obtained was 45.01%, associated with four main factors: hard work (odds ratio: 2.29; 95% confidence interval: 1.45 to 3.62), constipation (odds ratio: 1.99; 95% confidence interval: 1.21 to 2.76), type 2 diabetes (odds ratio: 1.88; 95% confidence interval: 1.16 to 3.06) and obesity (odds ratio: 1.09; 95% confidence interval: 1.05 to 1.14).

Conclusions
Given the high prevalence of urinary incontinence, its association with prevalent health problems, and its known impact on women's quality of life, the authors suggest that strategies be implemented to deal with this health problem at the primary care level.

Autores: Andrés Salgado-Maldonado[1,2], Muriel Ramírez-Santana[2]

Filiación:
[1] Centro de Salud Familiar Doctor Sergio Aguilar, Coquimbo, Chile
[2] Departamento de Salud Pública, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile

E-mail: mramirezs@ucn.cl

Correspondencia a:
[1] Calle Larrondo 1281,
Coquimbo, Chile

Citación: Salgado-Maldonado A, Ramírez-Santana M. Urinary incontinence in Chilean women: A prevalence study of the health profile and associated factors. Medwave 2020;20(6):e7977 doi: 10.5867/medwave.2020.06.7977

Fecha de envío: 3/3/2020

Fecha de aceptación: 4/6/2020

Fecha de publicación: 27/7/2020

Origen: No solicitado

Tipo de revisión: Con revisión por pares externa, por tres árbitros a doble ciego

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1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol. 2002 Jul;187(1):116-26. | CrossRef | PubMed |
2. Hannestad YS, Rortveit G, Sandvik H, Hunskaar S. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of Incontinence in the County of Nord-Trøndelag. J Clin Epidemiol. 2000 Nov;53(11):1150-7. | CrossRef | PubMed |
3. Sandvik H, Seim A, Vanvik A, Hunskaar S. A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighing tests. Neurourol Urodyn. 2000;19(2):137-45. | CrossRef | PubMed |
4. Salazar A, Oyanedel P, Montiglio C, Campero JM, Caro C, Monje B, et al. Prevalencia y factores de riesgo de la incontinencia de orina. Rev Chil Urol 2005; 70: 55–59. [On line] | Link |
5. Harwardt T, Fuentes B, Venegas M, Leal C, Verdugo F, Benier P. Estudio de prevalencia de incontinencia urinaria en mujeres de Isla de Pascua. Rev Chil Urol 2004; 69: 29–34.[On line] | Link |
6. Rincón Ardila O. Caracterización clínica de la incontinencia urinaria y factores asociados en usuarias de la Unidad de la Mujer del Centro de Salud Familiar Ultraestación en la ciudad de Chillán, Chile [Prevalence and risk factors for urinary incontinence among women consulting in primary care]. Rev Med Chil. 2015 Feb;143(2):203-12. Spanish. | CrossRef | PubMed |
7. Suárez Serrano CM, Medrano Sánchez E, Díaz Mohedo E, de la Casa Almeida M, Chillón Martínez R, Chamorro Moriana G. Afectación de la calidad de vida en mujeres con incontinencia urinaria. Fisioterapia. 2013 Jan 1;35(1):18–23. [On line] | Link |
8. Córcoles MB, Sánchez SA, Bachs GJ, Moreno DM, Navarro PH, Rodríguez VJ. Calidad de vida en las pacientes con incontinencia urinaria [Quality of life in patients with urinary incontinence]. Actas Urol Esp. 2008 Feb;32(2):202-10. Spanish. | CrossRef | PubMed |
9. Phelan S, Grodstein F, Brown JS. Clinical research in diabetes and urinary incontinence: what we know and need to know. J Urol. 2009 Dec;182(6 Suppl):S14-7. | CrossRef | PubMed |
10. Dhillon HK, MZain AZ, Quek KF, Singh HJ, Kaur G, Nordin RB. Prevalence and risk ractors of urinary incontinence and its impact on the quality of life and treatment seeking behavior among Malaysian women : A review. Women's Heal Care 2016; 5: 1–9. [On line] | Link |
11. Lian WQ, Li FJ, Huang HX, Zheng YQ, Chen LH. Constipation and risk of urinary incontinence in women: a meta-analysis. Int Urogynecol J. 2019 Oct;30(10):1629-1634. | CrossRef | PubMed |
12. Maeda T, Tomita M, Nakazawa A, Sakai G, Funakoshi S, Komatsuda A, et al. Female Functional Constipation Is Associated with Overactive Bladder Symptoms and Urinary Incontinence. Biomed Res Int. 2017;2017:2138073. | CrossRef | PubMed |
13. Martinez Saura F, Fouz López C, Gil Díaz P, Téllez Martínez-Fornés M. Incontinencia urinaria : una visión desde Atención Primaria. MEDIFAM 2001; 11: 25–40.[On line] | Link |
14. Reynolds WS, Kowalik C, Delpe SD, Kaufman M, Fowke JH, Dmochowski R. Toileting Behaviors and Bladder Symptoms in Women Who Limit Restroom Use at Work: A Cross-Sectional Study. J Urol. 2019 Nov;202(5):1008-1014. | CrossRef | PubMed |
15. Kim Y, Kwak Y. Urinary incontinence in women in relation to occupational status. Women Health. 2017 Jan;57(1):1-18. | CrossRef | PubMed |
16. Markland A, Chu H, Epperson CN, Nodora J, Shoham D, Smith A, et al.Occupation and lower urinary tract symptoms in women: A rapid review and meta-analysis from the PLUS research consortium. Neurourol Urodyn. 2018 Nov;37(8):2881-2892. | CrossRef | PubMed |
17. Liao YM, Dougherty MC, Biemer PP, Liao CT, Palmer MH, Boyington AR, et al. Factors related to lower urinary tract symptoms among a sample of employed women in Taipei. Neurourol Urodyn. 2008;27(1):52-9. | CrossRef | PubMed |
18. Pierce HM, Perry L, Gallagher R, Chiarelli P. Delaying voiding, limiting fluids, urinary symptoms, and work productivity: A survey of female nurses and midwives. J Adv Nurs. 2019 Nov;75(11):2579-2590. | CrossRef | PubMed |
19. Gobierno de Chile, Ministerio del Trabajo y Previsión Social. Ley 20001. Biblioteca del Congreso Nacional de Chile. 2005. | Link |
20. Islam RM, Oldroyd J, Rana J, Romero L, Karim MN. Prevalence of symptomatic pelvic floor disorders in community-dwelling women in low and middle-income countries: a systematic review and meta-analysis. Int Urogynecol J. 2019 Dec;30(12):2001-2011. | CrossRef | PubMed |
21. Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003 May;20(6):327-36. | CrossRef | PubMed |
22. Titman SC, Radley SC, Gray TG. Self-management in women with stress incontinence: strategies, outcomes and integration into clinical care. Res Rep Urol. 2019 Apr 17;11:111-121. | CrossRef | PubMed |
23. Ministerio de Salud de Chile. Encuesta Nacional de Salud 2016-2017 Primeros resultados. 2017. [On line] | Link |
24. Rodríguez Adams, EL. Non obstetric risk factors and quality of life in middle-aged women suffering from urinary incontinence. Rev Cuba Ginecol y Obstet 2014; 40: 119–135.[On line] | Link |
25. Instituto Nacional de Estadísticas. Publicación Estadísticas Vitales, 2017. 2019. [On line] | Link |
26. Ministerio de Salud de Chile. Departamento de Estadisticas e Informacion de Salud. Registro estadístico mensual. Atencion de maternidad.2018. [On line] | Link |
27. Bascur-Castillo C, Araneda-Gatica V, Castro-Arias H, Carrasco-Portiño M, Ruiz-Cantero MT. Determinants in the process of seeking help for urinary incontinence in the Chilean health system. Int J Gynaecol Obstet. 2019 Jan;144(1):103-111. | CrossRef | PubMed |
28. FONASA. Boletin estadistico agosto. Boletin estadistico 2017-2018. | Link |
29. Cerruto MA, Asimakopoulos AD, Artibani W, Del Popolo G, La Martina M, Carone R, et al. Insight into new potential targets for the treatment of overactive bladder and detrusor overactivity. Urol Int. 2012;89(1):1-8. | CrossRef | PubMed |
30. Robinson D, Giarenis I, Cardozo L. The medical management of refractory overactive bladder. Maturitas. 2013 Apr;74(4):386-90. | CrossRef | PubMed |
31. Rubilotta E, Balzarro M, D'Amico A, Cerruto MA, Bassi S, Bovo C, et al. Pure stress urinary incontinence: analysis of prevalence, estimation of costs, and financial impact. BMC Urol. 2019 Jun 4;19(1):44. | CrossRef | PubMed |

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol. 2002 Jul;187(1):116-26. | CrossRef | PubMed |

Hannestad YS, Rortveit G, Sandvik H, Hunskaar S. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of Incontinence in the County of Nord-Trøndelag. J Clin Epidemiol. 2000 Nov;53(11):1150-7. | CrossRef | PubMed |

Sandvik H, Seim A, Vanvik A, Hunskaar S. A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighing tests. Neurourol Urodyn. 2000;19(2):137-45. | CrossRef | PubMed |

Salazar A, Oyanedel P, Montiglio C, Campero JM, Caro C, Monje B, et al. Prevalencia y factores de riesgo de la incontinencia de orina. Rev Chil Urol 2005; 70: 55–59. [On line] | Link |

Harwardt T, Fuentes B, Venegas M, Leal C, Verdugo F, Benier P. Estudio de prevalencia de incontinencia urinaria en mujeres de Isla de Pascua. Rev Chil Urol 2004; 69: 29–34.[On line] | Link |

Rincón Ardila O. Caracterización clínica de la incontinencia urinaria y factores asociados en usuarias de la Unidad de la Mujer del Centro de Salud Familiar Ultraestación en la ciudad de Chillán, Chile [Prevalence and risk factors for urinary incontinence among women consulting in primary care]. Rev Med Chil. 2015 Feb;143(2):203-12. Spanish. | CrossRef | PubMed |

Suárez Serrano CM, Medrano Sánchez E, Díaz Mohedo E, de la Casa Almeida M, Chillón Martínez R, Chamorro Moriana G. Afectación de la calidad de vida en mujeres con incontinencia urinaria. Fisioterapia. 2013 Jan 1;35(1):18–23. [On line] | Link |

Córcoles MB, Sánchez SA, Bachs GJ, Moreno DM, Navarro PH, Rodríguez VJ. Calidad de vida en las pacientes con incontinencia urinaria [Quality of life in patients with urinary incontinence]. Actas Urol Esp. 2008 Feb;32(2):202-10. Spanish. | CrossRef | PubMed |

Phelan S, Grodstein F, Brown JS. Clinical research in diabetes and urinary incontinence: what we know and need to know. J Urol. 2009 Dec;182(6 Suppl):S14-7. | CrossRef | PubMed |

Dhillon HK, MZain AZ, Quek KF, Singh HJ, Kaur G, Nordin RB. Prevalence and risk ractors of urinary incontinence and its impact on the quality of life and treatment seeking behavior among Malaysian women : A review. Women's Heal Care 2016; 5: 1–9. [On line] | Link |

Lian WQ, Li FJ, Huang HX, Zheng YQ, Chen LH. Constipation and risk of urinary incontinence in women: a meta-analysis. Int Urogynecol J. 2019 Oct;30(10):1629-1634. | CrossRef | PubMed |

Maeda T, Tomita M, Nakazawa A, Sakai G, Funakoshi S, Komatsuda A, et al. Female Functional Constipation Is Associated with Overactive Bladder Symptoms and Urinary Incontinence. Biomed Res Int. 2017;2017:2138073. | CrossRef | PubMed |

Martinez Saura F, Fouz López C, Gil Díaz P, Téllez Martínez-Fornés M. Incontinencia urinaria : una visión desde Atención Primaria. MEDIFAM 2001; 11: 25–40.[On line] | Link |

Reynolds WS, Kowalik C, Delpe SD, Kaufman M, Fowke JH, Dmochowski R. Toileting Behaviors and Bladder Symptoms in Women Who Limit Restroom Use at Work: A Cross-Sectional Study. J Urol. 2019 Nov;202(5):1008-1014. | CrossRef | PubMed |

Kim Y, Kwak Y. Urinary incontinence in women in relation to occupational status. Women Health. 2017 Jan;57(1):1-18. | CrossRef | PubMed |

Markland A, Chu H, Epperson CN, Nodora J, Shoham D, Smith A, et al.Occupation and lower urinary tract symptoms in women: A rapid review and meta-analysis from the PLUS research consortium. Neurourol Urodyn. 2018 Nov;37(8):2881-2892. | CrossRef | PubMed |

Liao YM, Dougherty MC, Biemer PP, Liao CT, Palmer MH, Boyington AR, et al. Factors related to lower urinary tract symptoms among a sample of employed women in Taipei. Neurourol Urodyn. 2008;27(1):52-9. | CrossRef | PubMed |

Pierce HM, Perry L, Gallagher R, Chiarelli P. Delaying voiding, limiting fluids, urinary symptoms, and work productivity: A survey of female nurses and midwives. J Adv Nurs. 2019 Nov;75(11):2579-2590. | CrossRef | PubMed |

Gobierno de Chile, Ministerio del Trabajo y Previsión Social. Ley 20001. Biblioteca del Congreso Nacional de Chile. 2005. | Link |

Islam RM, Oldroyd J, Rana J, Romero L, Karim MN. Prevalence of symptomatic pelvic floor disorders in community-dwelling women in low and middle-income countries: a systematic review and meta-analysis. Int Urogynecol J. 2019 Dec;30(12):2001-2011. | CrossRef | PubMed |

Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003 May;20(6):327-36. | CrossRef | PubMed |

Titman SC, Radley SC, Gray TG. Self-management in women with stress incontinence: strategies, outcomes and integration into clinical care. Res Rep Urol. 2019 Apr 17;11:111-121. | CrossRef | PubMed |

Ministerio de Salud de Chile. Encuesta Nacional de Salud 2016-2017 Primeros resultados. 2017. [On line] | Link |

Rodríguez Adams, EL. Non obstetric risk factors and quality of life in middle-aged women suffering from urinary incontinence. Rev Cuba Ginecol y Obstet 2014; 40: 119–135.[On line] | Link |

Instituto Nacional de Estadísticas. Publicación Estadísticas Vitales, 2017. 2019. [On line] | Link |

Ministerio de Salud de Chile. Departamento de Estadisticas e Informacion de Salud. Registro estadístico mensual. Atencion de maternidad.2018. [On line] | Link |

Bascur-Castillo C, Araneda-Gatica V, Castro-Arias H, Carrasco-Portiño M, Ruiz-Cantero MT. Determinants in the process of seeking help for urinary incontinence in the Chilean health system. Int J Gynaecol Obstet. 2019 Jan;144(1):103-111. | CrossRef | PubMed |

FONASA. Boletin estadistico agosto. Boletin estadistico 2017-2018. | Link |

Cerruto MA, Asimakopoulos AD, Artibani W, Del Popolo G, La Martina M, Carone R, et al. Insight into new potential targets for the treatment of overactive bladder and detrusor overactivity. Urol Int. 2012;89(1):1-8. | CrossRef | PubMed |

Robinson D, Giarenis I, Cardozo L. The medical management of refractory overactive bladder. Maturitas. 2013 Apr;74(4):386-90. | CrossRef | PubMed |

Rubilotta E, Balzarro M, D'Amico A, Cerruto MA, Bassi S, Bovo C, et al. Pure stress urinary incontinence: analysis of prevalence, estimation of costs, and financial impact. BMC Urol. 2019 Jun 4;19(1):44. | CrossRef | PubMed |