Prevention of Urinary Incontinence in Women
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FEMALE UROLOGY (L COX, SECTION EDITOR)
Prevention of Urinary Incontinence in Women Amanda R. Swanton 1 & E. Ann Gormley 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Despite available treatments for urinary incontinence, the data regarding prevention is less established. This review sought to identify prevention measures and discuss their underlying evidence base with an attempt to include the most recent updates in the field. Recent Findings Urinary incontinence is a prevalent issue among women, particularly surrounding pregnancy and menopause. Interventions regarding pregnancy include not only general health promotion but also potentially interventions such as pelvic floor muscle training and decisions regarding method of delivery. With regard to menopause, the literature suggests avoiding treatments that have adverse effects on continence. Lastly, promoting healthy life style and reducing effects of co-morbid conditions can impact a woman’s continence. Summary The literature indicates that preventative strategies exist for urinary incontinence, though the data is limited in this area. Further work is needed to determine the impact of prevention measures and how best to implement them. Keywords Urinary incontinence . Incontinence prevention
Introduction
Maternal Antenatal Factors
Urinary incontinence is a common condition that many women will experience in their lives. Population-based studies estimate the prevalence of urinary incontinence at 28.8–46% among adult females [1–3], though the prevalence has been estimated to be 10% in women prior to pregnancy [4]. While treatments exist for incontinence once it develops [5], the strategies for preventing incontinence are less well established. Additionally, certain time period’s in a woman’s life, namely, pregnancy [6, 7], childbirth [4], and menopause [8], make her more vulnerable to developing incontinence and warrant special consideration. The goal of this review is to examine the most recent literature specifically pertaining to incontinence prevention and evaluate the evidence base in the scope of clinical practice.
Pregnancy is a major event that drastically increases the risk of urinary incontinence for young women. Although there are features of pregnancy and childbirth that contribute to risk, there are also maternal characteristics that may play a role in incontinence [6]. Older maternal age has been shown to be associated with increased risk for urinary incontinence both during pregnancy and post-partum. The rate of incontinence increases during pregnancy with one study showing incontinence in 26.2% of women before pregnancy compared with 58.1% at 30 weeks [7]. The risk of incontinence during pregnancy was higher for mothers greater than 30 years old after adjustment for parity and BMI [7]. In a review by Hijaz et al., advanced maternal age (defined at > 30 or > 35) was shown to be associated with an increased risk for post-partum urinary incontinence in both short- and long-term prospective studi
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