Urinary incontinence in women in rural Pakistan: prevalence, severity, associated factors and impact on life

Objective To estimate the prevalence of urinary incontinence ( UI ) and its subtypes in women in rural Pakistan, associated factors, severity and impact on daily life. Design Population‐based, cross‐sectional study. Setting A rural community in Sindh Province, Pakistan. Population Randomly selected women aged 15 years or older. Methods A three‐level random sampling strategy was used to select women: a random sample of health centres; a random sample of Lady Health Workers ( LHW s) from each health centre; and a random sample of women in the LHW catchment areas. The LHW s used an interview‐based structured questionnaire to collect data from women. Main outcome measure Urinary incontinence reported by women. Results Among the 5064 participants (response rate 95.8%) the prevalence of any UI was 11.5% (581/5064; 95%  CI 10.6–12.3). The most common subtype was stress incontinence, with a prevalence of 4.7% (95%  CI  4.1–5.3), followed by urge incontinence, with a prevalence of 3.2% (95%  CI  2.7–3.7), mixed incontinence, with a prevalence of 2.8% (95%  CI  2.3–3.2), other incontinence, with a prevalence of 0.4% (95%  CI  0.2–0.5) and continuous incontinence, with a prevalence of 0.5% (95%  CI  0.3–0.6). Older age, higher parity and marriage at an early age were independently associated with UI . We found that 52% of women with UI reported leakage at least daily, and 45% reported a great or moderate impact on their daily life. Only 15.7% of women with UI had consulted a doctor. Conclusions The prevalence of UI reported in rural Pakistan was lower than is generally found in studies from the developed world, but among the women affected it commonly occurred on a daily basis and impacted on their everyday lives, yet few had obtained medical advice.