Stress Urinary Incontinence in Younger Women in Primary Care: Prevalence and Opportunistic Intervention

Stress urinary incontinence (SUI) is prevalent in females, even among young adults. Though their quality of life (QOL) is impaired and pelvic floor exercise is an effective treatment, not many affected women seek medical help. This study aimed to evaluate the feasibility of case finding and opportunistic intervention of SUI at a public Well Women Clinic in Macau, China. A convenience sample of 408 consecutive female patients aged 30-50 years filled in the Urogenital Distress Inventory Short Form and the Incontinence Impact Questionnaire Short Form. They were also asked reasons for not seeking for medical help. The patients with incontinence were educated on pelvic floor muscle exercise during the gynecological examination. SUI was reported by 153 (37.5%) women, of whom 47 (30.7%) had impaired quality of life despite mild symptoms. Of the SUI patients, 52.9% thought that incontinence was inevitable with age, 22.2% believed that they should cope with the problem themselves, 13.7% thought that no useful treatment was available, and 3.9% had sought medical advice before. After learning pelvic floor muscle exercise for 4 to 6 months, 9.8% of SUI patients had complete relief of the symptoms, 47% partial improvement, and 17.6% no significant change. SUI with impaired quality of life was common before menopause. Very few affected women sought medical help. Opportunistic case finding and education about pelvic floor exercise in a Well Women Clinic were effective in the detection and treatment of the silent SUI.