Urinary Incontinence May Take a Toll on Mental Health

By Megan Brooks

July 12, 2021

NEW YORK (Reuters Health) - Urinary incontinence may contribute to depression and low levels of self-worth among women, new findings suggest.

"Although we had the sense that women with urinary incontinence were more depressed, we really did not have epidemiological evidence such as this study provides," lead researcher Dr. Margarida Manso of the University Hospital Centre of Sao Joao, in Portugal, told Reuters Health by email.

Addressing urinary incontinence "may result in happier patients, with a lower global healthcare burden," she said.

The researchers, who presented their results at the virtual European Association of Urology Congress (EAU) 2021, analyzed data from a population-based survey of more than 10,000 Portuguese women aged 18 and older. They compared the prevalence of depression, mental-health visits and smoking and alcohol use between women who did and did not report urinary incontinence.

One in 10 women (9.9%) reported having urinary incontinence, increasing to four in 10 (41%) for those aged 75 to 85 years old.

Women who reported incontinence had a 66% (95% confidence interval, 43% to 92%) higher adjusted prevalence of diagnosed depression and saw their doctor more often for mental-health reasons.

They were also 65% more likely to describe their health status as bad, had greater difficulty concentrating and had more feelings of guilt and lower self-worth than women without urinary incontinence.

There were no substantial differences in smoking or alcohol consumption between women with and without urinary incontinence.

"The high levels of depression and low self-worth in women who reported having incontinence are very concerning," Dr. Manso said in a conference statement.

"Urinary incontinence can be treated and although there are some potential side effects from treatment, for some women these may be preferable to the mental health impacts of the condition," she added.

"We believe the conversation between patients and their urologists needs to change. Clinicians should be asking patients about their mental health when discussing treatments because treating their physical challenges could help with the psychological cost of the condition," Dr. Manso said.

"Urinary incontinence is an extremely important clinical condition which is often not recognized by doctors until patients have been suffering for some time," EAU Secretary General Dr. Christopher Chapple of Sheffield Teaching Hospitals NHS Foundation Trust, in the U.K., said in the statement.

Urinary incontinence has a "devastating impact on anyone affected by it - predominantly women but also some men. However, in the majority of cases, urinary incontinence can be significantly improved or cured by the right treatment, based on clinical evaluation as detailed in the European Association of Urology 2021 Guidelines. It is important that patients with urinary incontinence are identified at an early stage after it develops and investigated and treated appropriately," Dr. Chapple said.

SOURCE: https://bit.ly/3wgM6MZ European Association of Urology Congress (EAU21), held July 8 to 12, 2021.