Women's perceptions about the etiology of urinary incontinence.
OBJECTIVE
Incontinent women have low rates of care seeking and treatment, some of which may be explained by their beliefs about the causes of their own urine loss. As little is known about these beliefs, our aim was to qualitatively assess what women perceive as the etiology of their urinary incontinence (UI).


METHODS
In a written survey on urinary symptoms administered to female HMO enrollees aged 30-90 years, incontinent women were asked the open-ended question: "Why do you think you lose urine?" Qualitative analyses of the responses identified themes, which were quantified and organized into major categories. Subjects were assigned multiple themes/categories as indicated. Relationships between major categories and subject/incontinence characteristics were explored.


RESULTS
Of the 1458 women with incontinence who completed the survey, 1192 (82%) responded to the open-ended question. Qualitative analyses identified 23 themes, with 5 themes cited by >or=10% of subjects: pelvic floor/bladder muscles (31%), pregnancy/childbirth (18%), age (14%), exertional triggers (12%), and waiting too long to void (10%). The 23 themes were organized into 5 major categories: pelvic floor/bladder related (53%), uncontrollable factors (23%), part of being female (21%), personal/lifestyle attributes (21%), and don't know (12%). Subjects expressed a range of 1-4 themes/categories. Major categories differed by age, and significant associations were seen between major categories and incontinence severity.


CONCLUSIONS
Women attribute their UI to a number of causes, which can be condensed into workable themes and categories. By understanding women's beliefs about the etiology of incontinence, clinicians may improve their ability to educate, counsel, and treat women with incontinence.
Melville
Jennifer L
JL
Department of Obstetrics & Gynecology, University of Washington, Seattle, Washington 98104-2499, USA. jmelvi@u.washington.edu
Wagner
Lauren E
LE
Fan
Ming-Yu
MY
Katon
Wayne J
WJ
Newton
Katherine M
KM
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D014861:Washington / Q000453:epidemiology; D014930:Women / Q000523:psychology*; D016387:Women's Health
J Am Geriatr Soc. 2001 Apr;49(4):462-5
11347792
Acta Obstet Gynecol Scand. 2001 Nov;80(11):1051-5
11703207
Maturitas. 2005 Jan 10;50(1):58-65
15590215
N Z Med J. 1988 Nov 9;101(857):756-8
3263595
Obstet Gynecol. 1987 Sep;70(3 Pt 1):378-81
3627585
Arch Intern Med. 2005 Mar 14;165(5):537-42
15767530
Scand J Prim Health Care. 1994 Sep;12(3):180-3
7997696
Med Anthropol Q. 1999 Sep;13(3):267-85
10509310
J Am Geriatr Soc. 1991 Apr;39(4):378-82
2010587
J Epidemiol Community Health. 1993 Dec;47(6):497-9
8120507
BJU Int. 2004 Feb;93(3):324-30
14764130
Neurourol Urodyn. 2000;19(2):137-45
10679830
J Womens Health (Larchmt). 2003 Sep;12(7):687-98
14583109
Am J Obstet Gynecol. 2006 Mar;194(3):729-37
16522405
Urology. 1999 Jan;53(1):71-6
9886591
BJU Int. 2006 Apr;97(4):752-7
16536767