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Urinary incontinence among Jordanian women: Prevalence, types, and associated factors |
Ismaiel Abu Mahfouza,*( ),Marco H. Blankerb,Fida Asalic,Lama Al Mehaisena,Hamza Al-Amooshc,Salem Abu Mahfouzc
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aDepartment of Obstetrics and Gynaecology, Faculty of Medicine, Al-Balqa Applied University, Al Salt, Jordan bDepartment of Primary and Longterm Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands cDepartment of Obstetrics and Gynaecology, Faculty of Medicine, The Hashemite University, Zarka, Jordan |
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Abstract Objective: Urinary incontinence (UI) is a prevalent condition with a negative impact on women's quality of life. Data about UI among Jordanian women are lacking; therefore, we aimed to investigate the prevalence, types, and associated factors. Methods: A cross sectional nationwide survey was conducted between 1 March 2020 and 15 April 2020. Women were included if they were 18 years of age or more and had access to the internet. Data collected included women's characteristics, UI types, and associated factors. UI was inventoried by asking women if they have UI (yes/no), and the Arabic language validated International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form was used. Age-group specific prevalence rates of UI were estimated, and associated factors were studied using logistic regression analyses. Results: Data from 2118 women were analysed. The median age was 40 (range 18-85) years; 58.3% gave birth three or more times; and 64.1% consistently reported having UI. Limited mobility and being multiparous increased the likelihood of reporting UI. Compared to women with normal body mass index, overweight and obese women were 1.9 times and 4.4 times more likely to report UI, respectively. Conclusion: The prevalence of UI among Jordanian women is 64.1%, with mixed UI and stress UI being the more prevalent types in women younger than 60 years old. Age, parity body mass index, and limited mobility are all associated factors with UI. The results of this study provide healthcare policy makers with the necessary information to increase awareness and knowledge regarding UI.
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Received: 23 May 2023
Available online: 20 October 2024
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Corresponding Authors:
*E-mail address: Ismaiel.mahfouz@bau.edu.jo (I. Abu Mahfouz).
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Factor | Respondent, n (%) | Age, year | 2058 | <30 | 478 (23.2) | 30-39 | 483 (23.5) | 40-49 | 644 (31.3) | 50-59 | 375 (18.2) | ≥60 | 78 (3.8) | Marital status | 2078 | Single | 450 (21.7) | Married | 1465 (70.5) | Separated | 86 (4.1) | Widow | 77 (3.7) | Currently employed | 2073 | Yes | 876 (42.3) | Smoking | 2089 | Yes | 382 (18.3) | Body mass index, n (mean±SD, kg/m2) | 2022 (28.4±5.7) | Body mass index category | 2022 | Underweight | 39 (1.9) | Normal weight | 576 (28.5) | Overweight | 662 (32.7) | Obese | 745 (36.8) | Types of comorbidity | 2118 | Yes (any) | 784 (37.0) | ∙ Hypertension | 276 (13.0) | ∙ Diabetes mellitus | 124 (5.9) | ∙ Chronic cough | 100 (4.7) | ∙ Chronic constipation | 172 (8.1) | ∙ Depression | 112 (5.3) | Limited mobility | 2093 | Yes | 730 (34.9) | Parity | 2117 | 0 | 503 (23.8) | 1 | 139 (6.6) | 2 | 241 (11.4) | 3 | 656 (31.0) | 4 or more | 578 (27.3) | Number of caesarean sections | 2048 | 0 | 1443 (70.5) | 1 | 297 (14.5) | 2 or more | 308 (15.0) | Postmenopausal | 2082 | Yes | 499 (24.0) | Had hysterectomy | 2080 | Yes | 80 (3.8) | Had pelvic radiotherapy | 2084 | Yes | 13 (0.6) | Had large bowel resection | 2085 | Yes | 31 (1.5) |
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Characteristics of the 2118 non-pregnant survey participants.
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Variable | Value, % | Consistency of reporting UI | • Consistent reporting the presence of UI | 64.1 | • Consistent reporting the absence of UI | 26.9 | • Inconsistent reporting | 9.0 | Prevalence of UI based on the three questions | • Do you currently have UI?a | ∙ No | 35.0 | ∙ Yes | 65.0 | • How often do you have UI?b | ∙ Never | 28.9 | ∙ ≤1 per week | 24.7 | ∙ 2-3 per week | 14.3 | ∙ 1 per day | 13.0 | ∙ Several times per day | 15.8 | ∙ All the times | 3.2 | • How much urine do you usually leak?c | ∙ None | 27.4 | ∙ Small | 55.3 | ∙ Moderate | 14.5 | ∙ Large | 2.7 | Age (year) specific prevalence rates of the different types of UId | • <30 (n=478) | 7.3/13.4/37.4 | • 30-39 (n=483) | 9.3/23.2/35.2 | • 40-49 (n=644) | 10.7/31.5/43.3 | • 50-59 (n=375) | 12.0/26.1/48.3 | • ≥60 (n=78) | 23.1/12.8/50.0 | • Totals (n=2058) | 10.3/23.7/41.2 |
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Consistency of reporting UI, prevalence of UI based on the three questions, and age-specific prevalence rates.
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Variable | Univariate | Multivariate | OR | 95% CI | R2 | OR | 95% CI | Age category (year) | | | 0.092 | | | <30 (reference) | | | | | | 30-39 | 1.56 | 1.11-1.92 | | 0.77 | 0.55-1.10 | 40-49 | 3.71 | 2.62-4.60 | | 1.50 | 1.03-2.19 | 50-59 | 4.26 | 2.89-5.74 | | 1.27 | 0.72-2.25 | ≥60 | 3.82 | 1.67-6.06 | | 0.82 | 0.35-1.90 | Marital status | | | 0.077 | | | Single (reference) | | | | | | Married | 3.01 | 2.41-3.76 | | 0.99 | 0.61-1.61 | Separated | 6.59 | 3.32-13.07 | | 2.16 | 0.97-4.80 | Widowed | 5.20 | 2.68-10.11 | | 1.05 | 0.45-2.43 | Employed (yes) | 0.99 | 0.81-1.20 | 0.000 | | | Smoking (yes) | 0.89 | 0.69-1.13 | 0.001 | | | Body mass index category | | | 0.095 | | | Normal weight (reference) | | | | | | Underweight | 1.03 | 0.54-2.00 | | 1.24 | 0.62-2.49 | Overweight | 1.87 | 1.47-2.34 | | 1.35 | 1.03-1.75 | Obese | 4.43 | 3.40-5.78 | | 2.66 | 1.97-3.60 | Comorbidity | Hypertension | 2.30 | 1.63-3.26 | 0.018 | | | Diabetes mellitus | 2.80 | 1.62-4.84 | 0.012 | | | Chronic cough | 3.45 | 1.78-6.68 | 0.013 | | | Chronic constipation | 2.07 | 1.36-3.16 | 0.009 | | | Depression | 1.73 | 1.06-2.84 | 0.004 | | | Limited mobility | 2.73 | 2.17-3.44 | 0.055 | 1.81 | 1.40-2.35 | Obstetric history | Parity | | | 0.074 | | | 0 (reference) | | | | | | 1 or more | 3.14 | 2.54-3.89 | | 2.06 | 1.31-3.23 | Caesarean section | | | 0.017 | | | 0 (reference) | | | | | | 1 | 2.03 | 1.45-2.82 | | | | 2 or more | 0.84 | 0.64-1.10 | | | | Postmenopausal | 2.49 | 1.90-3.26 | 0.035 | 1.14 | 0.72-1.80 | Had hysterectomy | 2.10 | 1.13-3.91 | 0.004 | | | Had pelvic radiotherapy | 2.00 | 0.44-9.05 | 0.001 | | | Had large bowel resection | 2.48 | 0.86-7.12 | 0.002 | | |
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Factors associated with the presence of UI (both consistent and inconsistent reporting UI).
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Factor | Univariable | Multivariable | OR | 95% CI | R2 | OR | 95% CI | Age category (year) | | | 0.079 | | | <30 (reference) | | | | | | 30-39 | 1.51 | 1.17-1.95 | | 0.86 | 0.62-1.21 | 40-49 | 2.92 | 2.27-3.74 | | 1.35 | 0.95-1.91 | 50-59 | 3.92 | 2.89-5.31 | | 1.58 | 0.95-2.64 | ≥60 | 3.41 | 1.97-5.89 | | 1.03 | 0.49-2.16 | Marital status | | | 0.057 | | | Single (reference) | | | | | | Married | 2.60 | 2.09-3.22 | | 1.04 | 0.65-1.65 | Separated | 4.21 | 2.45-7.25 | | 1.70 | 0.86-3.35 | Widowed | 3.65 | 2.10-6.23 | | 0.89 | 0.43-1.85 | Employed (yes) | 0.99 | 0.83-1.19 | 0.000 | | | Smoking (yes) | 0.95 | 0.76-1.20 | 0.000 | | | Body mass index category | | | 0.095 | | | Normal weight (reference) | | | | | | Underweight | 1.17 | 0.61-2.24 | | 1.32 | 0.66-2.63 | Overweight | 1.93 | 1.53-2.42 | | 1.48 | 1.16-1.90 | Obese | 4.12 | 3.24-5.24 | | 2.66 | 2.03-3.49 | Comorbidity | Hypertension | 1.80 | 1.35-2.40 | 0.011 | | | Diabetes mellitus | 2.20 | 1.41-3.42 | 0.009 | | | Chronic cough | 3.32 | 1.90-5.78 | 0.015 | | | Chronic constipation | 1.75 | 1.22-2.50 | 0.007 | | | Depression | 1.56 | 1.02-2.40 | 0.003 | | | Limited mobility | 2.42 | 1.98-2.97 | 0.050 | 1.70 | 1.35-2.48 | Obstetric history | Parity | | | 0.055 | | | 0 (reference) | | | | | | 1 or more | 2.64 | 2.15-3.24 | | 1.61 | 1.05-2.48 | Caesarean sections | | | 0.008 | | | 0 (reference) | | | | | | 1 | 1.48 | 1.12-1.95 | | | | 2 or more | 0.81 | 0.63-1.05 | | | | Postmenopausal | 2.21 | 1.75-2.79 | 0.032 | 1.00 | 0.67-1.47 | Had hysterectomy | 1.95 | 1.14-3.32 | 0.004 | | | Had pelvic radiotherapy | 1.25 | 0.38-4.06 | 0.000 | | | Had large bowel resection | 2.92 | 1.12-7.63 | 0.004 | | |
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Factors associated with the presence of UI (only consistent reporting UI).
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Factor | Univariable | Multivariable | OR | 95% CI | R2 | OR | 95% CI | Age category (year) | | | 0.092 | | | <30 (reference) | | | | | | 30-39 | 1.60 | 1.23-2.08 | | 0.80 | 0.57-1.14 | 40-49 | 3.74 | 2.83-4.93 | | 1.53 | 1.04-2.25 | 50-59 | 4.19 | 2.98-5.87 | | 1.28 | 0.72-2.29 | ≥60 | 4.38 | 2.26-8.50 | | 0.98 | 0.41-2.67 | Marital status | | | 0.078 | | | Single (reference) | | | | | | Married | 3.02 | 2.42-3.78 | | 0.93 | 0.39-2.20 | Separated | 6.97 | 2.41-14.25 | | 0.92 | 0.45-1.89 | Widowed | 5.46 | 2.74-10.88 | | 2.11 | 0.77-5.76 | Employed (yes) | 1.01 | 0.83-1.23 | 0.000 | | | Smoking (yes) | 0.90 | 0.70-1.15 | 0.001 | | | Body mass index category | | | 0.091 | | | Normal weight (reference) | | | | | | Underweight | 0.96 | 0.49-1.85 | | 1.15 | 0.57-2.31 | Overweight | 1.88 | 1.48-2.39 | | 1.35 | 1.03-1.76 | Obese | 4.34 | 3.31-5.68 | | 2.60 | 1.92-3.54 | Comorbidity | Hypertension | 2.53 | 1.75-3.64 | 0.020 | | | Diabetes mellitus | 2.83 | 1.61-4.98 | 0.011 | | | Chronic cough | 3.22 | 1.66-6.24 | 0.011 | | | Chronic constipation | 2.03 | 1.32-3.11 | 0.008 | | | Depression | 1.62 | 0.99-2.65 | 0.003 | | | Limited mobility | 2.68 | 2.12-3.39 | 0.052 | 1.74 | 1.33-2.26 | Obstetric history | Parity | | | 0.075 | | | 0 (reference) | | | | | | 1 or more | 3.21 | 2.59-3.97 | | 2.07 | 1.31-3.25 | Caesarean sections | | | 0.018 | | | 0 (reference) | | | | | | 1 | 2.19 | 1.55-3.10 | | | | 2 or more | 0.88 | 0.67-1.15 | | | | Postmenopausal | 2.49 | 1.89-3.28 | 0.034 | 1.10 | 0.69-1.76 | Had hysterectomy | 2.18 | 1.45-4.15 | 0.005 | | | Had pelvic radiotherapy | 1.87 | 0.41-8.45 | 0.001 | | | Had large bowel resection | 2.32 | 0.81-6.66 | 0.002 | | |
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Factors associated with the presence of UI based on International Consultation on Incontinence-Urinary Incontinence-Short Form.
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