title: Analysis of the usage of continence pads and help-seeking behavior of women with stress urinary incontinence in Poland.
abstract: BACKGROUND
  Urinary incontinence (UI) in women is a chronic disorder which has a negative impact on health-related quality of life. Only 45 % of the affected individuals report the problem with continence to their doctor. The aim of the study was to assess the duration of stress urinary incontinence (SUI), time from disease onset to the first medical consultation and in-depth diagnosis, as well as the need for using continence pads in various grades of SUI.
  
  
  METHODS
  We conducted a cross-sectional study in women who presented at the urogynecologic ambulatory center and reported urinary incontinence. A total of 420 subjects were interviewed and underwent urogynecologic and urodynamic examinations. A group of 147 patients with urodynamic SUI was enrolled in the study.
  
  
  RESULTS
  All women were graded according to the Stamey severity score: grade 1 - 56 (38.1 %), grade 2 - 68 (46.3 %), and grade 3 - 23 (15.6 %). Mean time elapsed between disease onset and presentation at the urogynecologic ambulatory center was 17.4 ± 11.8 years (grades 1, 2 and 3 for 11.6 ± 11.8, 14.9 ± 10.8, and 22.2 ± 12.1 years, respectively; p = 0.0002). Patients with SUI started perceiving their condition as a problem 4.7 ± 5.4 years before referral to urodynamics; 58.3 % of the SUI patients reported their problems with continence to a physician. Average time between the onset of UI symptoms and seeking medical help was 13.28 ± 12.3 years. Mean duration of using continence pads during the day was 4.2, 5.4 and 10.2 years in grades 1, 2 and 3, respectively (p = 0.0002). The number of patients using continence pads in and outside the home, as compared to outside only, was: grade 1 - 44.6 % vs. 28.6 %, grade 2 - 77.6 % vs. 13.4 %, and grade 3 - 86.4 % vs. 9.1 % (p = 0.004). Mean use of continence pads at night was 3.3, 6.1, and 9.1 years in grades 1, 2 and 3, respectively. The differences were not statistically significant. Protective continence products were used at night by 26.7 % of the SUI patients: 16.1 %, 25 % and 59.1 % in grades 1, 2 and 3, respectively (p = 0.004).
  
  
  CONCLUSIONS
  Women with SUI delay seeking medical help for over a decade. The severity of SUI is associated with duration and increased use of continence pads.
authors.affiliation: Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdańsk, Kliniczna 1a, 80-402, Gdańsk, Poland. mlgrzybowska@wp.pl.
authors.forename: Magdalena Emilia
authors.initials: ME
authors.lastname: Grzybowska
authors.affiliation: Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdańsk, Kliniczna 1a, 80-402, Gdańsk, Poland. dwydra@uck.gda.pl.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Wydra
authors.affiliation: Department of Perinatology, Medical University of Gdańsk, Kliniczna 1a, 80-402, Gdańsk, Poland. jerzysmutek@gmail.com.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Smutek
mesh_terms: D041342:Absorbent Pads / Q000706:statistics & numerical data*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D000066505:Help-Seeking Behavior; D006801:Humans; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011044:Poland; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000150:complications* / Q000523:psychology*