title: Beyond incontinence: the stigma of other urinary symptoms.
abstract: OBJECTIVE
  This paper is a report of a study conducted to characterize the stigma of urinary frequency and urgency and differentiate it from the stigma of incontinence and to describe race/ethnic and gender differences in the experience of stigma among a diverse sample of individuals.
  
  
  BACKGROUND
  Lower urinary tract symptoms, including frequency, urgency and incontinence, are susceptible to stigma, but previous stigma research has focused almost exclusively on incontinence.
  
  
  METHODS
  The Boston Area Community Health Survey is a population-based, random sample epidemiological survey of urologic symptoms (N = 5503). Qualitative data for this study came from in-depth interviews conducted between 2007 and 2008 with a random subsample of 151 black, white and Hispanic men and women with urinary symptoms.
  
  
  RESULTS
  Respondents reported stigma associated with frequency and urgency - not just incontinence. The stigma of frequency/urgency is rooted in social interruption, loss of control of the body, and speculation as to the nature of a non-specific 'problem'. Overall, the stigma of urinary symptoms hinged upon whether or not the problem was 'perceptible'. Men felt stigmatized for making frequent trips to the bathroom and feared being seen as impotent. Women feared having an unclean body or compromised social identity. Hispanic people in particular voiced a desire to keep their urinary symptoms a secret.
  
  
  CONCLUSIONS
  The stigma of urinary symptoms goes beyond incontinence to include behaviours associated with frequency and urgency. Healthcare practitioners should assess for stigma sequelae (e.g. anxiety, depression) in individuals with frequency and urgency, and stress treatment options to circumvent stigmatization.
authors.affiliation: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA. emelstad@gmail.com
authors.forename: Emily A
authors.initials: EA
authors.lastname: Elstad
authors.forename: Simone P
authors.initials: SP
authors.lastname: Taubenberger
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Botelho
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Tennstedt
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001900:Boston / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009812:Odorants; D018907:Privacy / Q000523:psychology; D036301:Qualitative Research; D012737:Sex Factors; D057545:Social Stigma; D013315:Stress, Psychological / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D014549:Urinary Incontinence / Q000208:ethnology / Q000523:psychology; D014555:Urination Disorders / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology*; D044465:White People / Q000706:statistics & numerical data