Female Urinary Incontinence Screening and Treatment

Professional societies, including AUGS and ACOG recommend Pelvic Floor Muscle Training (PFMT) as first-line treatment for stress, urgency, and mixed UI.  Findings from an overview of Cochrane Systematic Reviews further validate this, “There is high certainty evidence that undertaking pelvic floor muscle training can cure symptoms and improve quality of life for all types of urinary incontinence. There is moderate or high certainty evidence that these pelvic floor muscle exercises work better if they are more intense, have more support from a health care professional, and are combined with strategies to support continued use.

UI Prevalence by Decade of a Woman’s Life1

Urinary incontinence (UI) is a growing epidemic, affecting 78 million women in the U.S. alone.1 Over 28 million women report moderate or severe UI symptoms,1 yet only about 11 million women seek treatment.2 According to market research, women wait an average of 6.5 years before they bring this up with you, their provider, if they even bring it up at all.3

And if nothing is done… UI may progress over time.

  • UI symptoms may worsen over time7
  • Women with prior UI have a 25x greater odds of UI recurrence8
  • Negative impact on quality of life, physical function, cognitive performance, and associations with obesity, depression, and anxiety9-14
  • Women with UI are at a 30% greater risk of hospitalization15
  • Women with UI are 2x as likely to be admitted to a nursing facility15

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Recognized as a 2023 medical breakthrough in women’s health by AARP.

  1. Patel UJ, Godecker AL, Giles DL, Brown HW. Updated Prevalence of Urinary Incontinence in Women: 2015-2018 National Population-Based Survey Data. Female Pelvic Med Reconstr Surg. 2022 Apr 1;28(4):181-187. doi: 10.1097/SPV.0000000000001127. Epub 2022 Jan 12. PMID: 35030139.
  2. Waetjen LE (2018) Factors associated with reasons incontinent midlife women report for not seeking urinary incontinence treatment over 9 years across the menopausal transition. Menopause. 2018;25(1):29-37.
  3. Muller N. What Americans understand and how they are affected by bladder control problems: highlights of recent nationwide consumer research. Urol Nurs. 2005;25(2):109-115. http://www.ncbi.nlm.nih.gov/pubmed/15900979.
  4. Keyser LE, McKinney JL, Pulliam SJ, Weinstein MM. A digital health program for treatment of urinary incontinence: retrospective review of real-world user data [published correction appears in Int Urogynecol J. 2023 Jun 27;:]. Int Urogynecol J. 2023;34(5):1083-1089. doi:10.1007/s00192-022-05321-3.
  5. Shannon MB, Attendance at Prescribed Pelvic Floor Physical Therapy in a Diverse, Urban Urogynecology Population. PM&R. 2018;10(6):601-606
  6. Yeowell G, Smith P, Nazir J, Hakimi Z, Siddiqui E, Fatoye F. Real-world persistence and adherence to oral antimuscarinics and mirabegron in patients with overactive bladder (OAB): a systematic literature review. BMJ Open. 2018;8(11).
  7. Li Q, Cheng Y, Shi H, Xue K, Zhou F. Advances in the natural history of urinary incontinence in adult females. J Obstet Gynaecol. 2023;43(1):2171774. doi:10.1080/01443615.2023.2171774
  8. Komesu YM, Schrader RM, Ketai LH, Rogers RG, Dunivan GC. Epidemiology of Mixed, Stress & Urgency Urinary Incontinence in Mid-Aged/Older Women: Importance of Incontinence History. Int Urogynecol J. 2016;27(5):763-772. doi:10.1007/s00192-015-2888-1.Epidemiology
  9. Parker-Autry C, Houston DK, Rushing J, et al. Characterizing the Functional Decline of Older Women With Incident Urinary Incontinence. Obstet Gynecol. 2017;130(5):1025-1032. doi:10.1097/AOG.0000000000002322
  10. Ca Corrêa L, Pirkle CM, Vafaei A, Curcio CL, Câmara SM. Urinary incontinence is associated with physical performance decline in community-dwelling older women: results from the International Mobility in Aging Study (IMIAS). doi:10.1177/0898264318799223
  11. Griffiths D, Tadic SD. Bladder control, urgency, and urge incontinence: evidence from functional brain imaging. Neurourol Urodyn. 2008;27(6):466-474. doi:10.1002/nau.20549
  12. Lussier M, Renaud M, Chiva-Razavi S, Bherer L, Dumoulin C. Are stress and mixed urinary incontinence associated with impaired executive control in community-dwelling older women?. J Clin Exp Neuropsychol. 2013;35(5):445-454. doi:10.1080/13803395.2013.789483
  13. Siddiqui NY, Wiseman JB, Cella D, et al. Mental Health, Sleep and Physical Function in Treatment Seeking Women with Urinary Incontinence. J Urol. 2018;200(4):848-855. doi:10.1016/j.juro.2018.04.076
  14. Mendes A, Hoga L, Gonçalves B, Silva P, Pereira P. Adult women’s experiences of urinary incontinence: a systematic review of qualitative evidence. JBI database Syst Rev Implement reports. 2017;15(5):1350-1408. doi:10.11124/JBISRIR-2017-003389
  15. Thom DH, Haan MN, Van Den Eeden SK. Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality. Age and Ageing. 1997;26(5):367-374. doi:10.1093/ageing/26.5.367.