Prevalence of Urinary Incontinence and Associated Gynecological Risk Factors Among Middle-Aged Women: A Cross-Sectional Study

Abstract

Background: Urinary incontinence is an underreported pelvic floor disorder that can impair quality of life. Middle-aged women may be vulnerable because of obstetric trauma, menopause, obesity, and pelvic organ prolapse.

Objective: To assess the frequency, intensity, classifications, and gynecological risk factors linked to urine incontinence in middle-aged females.

Methods: This cross-sectional study included 120 females aged 40 to 60 years who visited the Department of Gynecology and Obstetrics at Nishtar Medical University in Multan, Pakistan, between June 2022 and June 2023. Individuals were enlisted in a sequential manner. Urinary incontinence was evaluated utilizing the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form. Obstetric and gynecological parameters were documented, and multivariable logistic regression was employed to ascertain independent correlating factors.

Results: Urinary incontinence was detected in 43 individuals, resulting in a prevalence rate of 35.8%. Stress urine incontinence constituted the predominant subtype at 55.8%, followed by urgency at 25.6% and mixed urinary incontinence at 18.6%. Moderate symptoms were observed in 53.5% of the women impacted. Independent variables linked to urinary incontinence included advancing age (adjusted odds ratio [aOR] 1.08; 95% confidence interval [CI] 1.01–1.16), obesity (aOR 2.24; 95% CI 1.00–5.03), having three or more vaginal births (aOR 2.61; 95% CI 1.12–6.09), severe perineal laceration (aOR 4.32; 95% CI 1.01–18.52), and stage II or higher pelvic organ prolapse (aOR 4.89; 95% CI 1.41–16.95).

Conclusion: Urinary incontinence affected more than one-third of middle-aged women. Routine screening and early pelvic floor interventions are warranted, particularly for women with repeated vaginal deliveries, obesity, perineal trauma, or pelvic organ prolapse.

Keywords: urinary incontinence; middle-aged women; vaginal delivery; pelvic organ prolapse; obesity; perineal trauma