What are the racial predilections of urinary incontinence?

Updated: Sep 23, 2019
  • Author: Sandip P Vasavada, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Although data concerning urinary incontinence in people of different races are sparse, reports are emerging that race may play an important role in the prevalence and likelihood of reporting of incontinence. In addition, differences in anatomic morphology of the urinary sphincter mechanism in people of different races may affect the likelihood of developing incontinence.

Fultz et al found that 23.02% of white women reported incontinence, compared with 16.17% of black women. [42] In a study by Anger et al, based on the 1999-2000 NHANES data, the prevalence of urinary incontinence was higher in non-Hispanic white women (41%) than in non-Hispanic black (20%) or Mexican American women (36%). [43] In contrast, Freeman et al found that black women were significantly more likely than white women to report menopausal symptoms (46% vs 30%), urinary incontinence, and vaginal dryness. [44]

Howard et al described functional and morphologic differences in the urethral sphincteric and support system of nulliparous black and white women. Black women demonstrated a 29% higher average urethral closure pressure during a maximum pelvic muscle contraction. Paradoxically, a 36% greater bladder neck hypermobility was present as measured with the cotton-swab test (black women at 49° vs white women at 36°). [39]

Sears et al reported that, among patients with incontinence, urge incontinence was more common in black women (51.5%), whereas stress incontinence was statistically significantly more common in white women (66.2%). [45] Daneshgari et al found that Hispanic women reported stress incontinence and mixed incontinence more often than did non-Hispanic white women. However, the increased prevalence of incontinence in Hispanic women is likely due to higher prevalences of obesity, hysterectomy, and parity than in white women. [46]

Nygaard et al examined the prevalence of symptomatic pelvic floor disorders in women in the United States and found no difference among non-Hispanic whites (16%), Hispanics (15.9%), non-Hispanic blacks (13.8%), and other races (15%). [41] These authors did not differentiate urge from stress incontinence.


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