Urinary Incontinence - Overview

Incontinence

Urinary incontinence is the "involuntary loss of urine that is objectively demonstrable and a social or hygienic problem" (International Continence Society, 1988). In studies of prevalence, objective demonstration is often not a realistic option, and so various arbitrary cut-offs in the frequency or amount of urine loss have been used. In spite of this, the data are quite consistent from study to study and country to country.¹

The Causes of Urinary Incontinence

• A weakening of the pelvic floor muscles, the result of childbirth, a disease process such as multiple sclerosis or Parkinson's disease, birth defects, injuries from an accident, or a consequence of medications or surgery can cause incontinence.
  
• Aging does not cause incontinence. However, changes which occur with the natural ageing process, may contribute to incontinence, some examples are the decrease of estrogen which women experience can lead to incontinence and the natural enlargement of the prostate gland as men age. One in eight men over the age of 50 will develop prostate cancer, of these, 50% will develop incontinence.²

Types of Urinary Incontinence

• Stress : happens when the bladder can't handle the increased pressure during exercise, coughing or sneezing
• Urge : can be caused by a sudden, involuntary bladder spasm. It is the inability to delay urinating long enough to get to a toilet when you get the feeling
• Overflow : happens when the bladder becomes too full because it can't be completely emptied and these is a frequent leakage of urine without the urge to urinate
• Total : results from the complete absence of control, which may lead to continuous leakage or periodic uncontrolled emptying of the bladder.

Incontinence is a serious concern as evident by many countries around the world having established Continence Foundations, and annually promoting awareness campaigns to educate the public and professionals to the causes and treatments. Incontinence is an extremely prevalent disorder.³

In North America there are 33,000,000 people with an incontinence condition.⁴ In the United Kingdom in 2004 there were 6,600,000 women with a stress incontinence condition.⁵ Urinary leakage is a worldwide problem. urinary incontinence has three main subtypes including stress, urge and mixed, and is estimated to affect 100 million women in the seven major markets.⁶ The highest prevalence of urinary incontinence is in the female white American population and ranges from 23% to 41%.⁷

In 2000 there were 12 million Canadians between the age of 30 and 54 years of age, and 83 million American’s between the ages of 34-54 years of age, In U.K, France, Germany, Switzerland, and Italy in 2005 there were 98,925,000 Europeans between the ages of 30 and 54.⁸ Between the ages of 30 and 80+ there are 180,790,000 North Americans and 176,305,000 Europeans (U.K., France, Germany, Switzerland and Italy) for a total potential market of 357,095,000.

Prostate cancer is a very serious concern for men over the age 50. 1 in 8 men over the age of 50 will develop prostate cancer.⁹ In North America there are 38,637,000 men over 50 years of age and 89,772,000 under 50 years of age.¹⁰ In Europe (U.K., France, Germany, Switzerland and Italy) there are 43,789,000 males over the age of 50, and 88,233,000 males under the age of 50.¹¹

With the aging baby boomer population approaching middle age these numbers and usage will increase dramatically.

Incontinence has a marked effect on the quality of life of those suffering from it.

In 8-10% this results in social isolation (Angus Reid, 1997; Klag, 1999). Despite the negative effects of urinary incontinence, only about half have ever spoken to a physician about it (Angus Reid, 1997).¹²

The Canadian Continence Foundation confirms that in 1997 there were approximately 1.5 million Canadian’s with an incontinence condition, by 2003 this number has more than doubled to 3.3 million Canadians, in the United States there are approximately 30 million Americans with an incontinence condition.

A national poll (Angus Reid group, 1997) suggested that 1.5 million of community-dwelling Canadians (7%) had suffered from an incontinence episode during the previous year. More women than men were affected (12% versus 2.5%). Prevalence increased with age, from 2% in those under 35 y to 12% of those 55 years and over. In other Canadian surveys, 16% of seniors over 64 y, living at home, needed help for urinary incontinence (Reid, 1991), and 24% of men and women over 84 years of age reported daily incontinence (Canadian Study of Health and Aging: Hunskaar et al, private communication).¹³

It is anticipated that this number will continue to rise dramatically as the baby boomer generation progresses to mid life and senior citizen stages.