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Healthcare-seeking behaviours in Singaporean women with urinary incontinence

Tristan Manalac
10 Oct 2017

Despite being common, less than half of Singaporean women have sought medical attention for urinary incontinence (UI) for fear of surgery, embarrassment and other misconceptions, a new study from Singapore has found

“Misconceptions and barriers to treatment were found to be common, so it is important for government and medical practitioners to develop programmes to increase the public’s awareness of UI as well as access to UI treatment,” said researchers.

In the study, 230 female outpatients of the ear-nose-throat clinic of the Changi General Hospital in Singapore were made to accomplish questionnaires designed to collect information on UI and its effect on quality of life.

Responses showed that 96 respondents (mean age 47.32±1.39 years) had prior histories of UI, resulting in an overall prevalence rate of 41.47 percent. The mean age of those without UI (n=134) was 37.59±1.19 years, with the between-group difference reaching statistical significance (p=0.001). [Int Urogynecol J 2017;doi:10.1007/s00192-017-3488-z]

The currently reported prevalence rate of UI in Singaporean women has inflated from 4.8 percent 20 years ago. The difference in sampling method and UI definition potentially play a role in this difference, according to researchers. [Age Ageing 1991;20:262-266]

“Great changes in life expectancy and lifestyle were also associated with the sharp increase in UI prevalence,” they added.

Multivariate logistic models adjusted for potential confounders showed that age (adjusted odds ratio [OR], 1.03; 95 percent CI, 1.00 to 1.05; p=0.028), having a vaginal delivery (adjusted OR, 2.67; 1.43 to 4.97; p=0.002) and being sexually active (adjusted OR, 2.41; 1.31 to 4.43; p=0.005) were all significant risk factors for UI.

In terms of attitudes toward UI, only the view that UI is a normal part of ageing differed significantly, with more women without UI regarding it as normal than those with UI (65.32 vs 44.44 percent, respectively; p=0.003).

Notably, only very few women from either group thought of UI as untreatable (4.84 and 1.11 percent, respectively), while majority said that they would seek medical attention if they had UI (79.84 and 75.56 percent, respectively).

However, less than half of the 81 symptomatic patients had consulted a doctor for their UI (n=33; 40.74 percent). Majority (55.32 percent) of the women who had not sought medical attention reported being too embarrassed to talk about UI to a medical professional.

Other barriers to seeking healthcare included the fear of needing surgery (44.81 percent) and not considering the symptoms to be severe enough (27.66 percent).

Because the last nationwide survey on UI in Singapore was conducted almost 20 years ago, the current study offers important new updates and insights on the disease prevalence and attitudes toward it. Of particular interest is the difference in prevalence and healthcare-seeking behaviours.

To address this disparity, the researchers recommended using the information obtained from the present research in nationwide education programmes.

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