Abstrict

To find out how common urine incontinence is in Pakistan and how it affects women's quality of life. One hundred female patients with urine incontinence at the Department of Urology MMC Mardan, Pakistan participated in this prospective observational Study from January 2022 to January 2023. Patients were chosen from the Urology Department. A validated questionnaire was used to evaluate each patient's quality of life. The prevalence of urine incontinence and the resultant variation in quality of life in this cohort was assessed statistically. A total of 100 patients were enrolled. The overall mean (SD) impact on the women's quality of life was 53.4 (6). The prevalence of mild, moderate and severe urinary Incontinence was 22%, 40% and 38%. This Study shows that urine incontinence substantially affects women's quality of life and is rather common in Pakistan.

Keywords

Urinary Incontinence, Prevalence, Quality of Life, women, Pakistan

Introduction

Among the most prevalent health issues globally, urological illnesses are a significant source of morbidity and death in Pakistan (Amanullah, Malik, & Zaidi, 2022; Olowu, Adefehinti, & Aladekomo, 2013). One such urological disorder is urinary incontinence, which causes women with it to have a worse quality of life burden (Hofstetter et al., 2023; Petrican & Sawan, 1998). Over 200 million individuals are thought to be affected by urinary incontinence globally, but there is little information on its incidence, clinical features, and effects in the Pakistani population (Mushtaq et al., 2023; Pilankar & Parle). Rather than being influenced by local evidence, examination, diagnosis, and therapy of urine incontinence frequently rely on standards and data from other nations (Lau et al., 2023; Pradhan, Jain, & Latthe, 2012). To guide clinical treatment and provide national recommendations, a trustworthy estimation of the burden and quality of life caused by urine incontinence in the Pakistani population is required (Culberson, Kopel, Sehar, & Reddy, 2023; Tarkowska et al., 2022; Tham et al., 2023; Zhou et al., 2022). No local study has been carried out on this issue. This study was therefore carried out to determine the prevalence of urine incontinence and its effects on the quality of life of women in Pakistan.

Methodology

From January 2022 to January 2023, 100 female patients with urinary incontinence were included in prospective observational research at the urology department at MMC Mardan, Pakistan. Patients' demographics, comorbid conditions, personal medical histories, and responses to therapy for pee incontinence were collected using a standardized patient interview form. Each patient's QoL was measured using a scientifically validated QoL questionnaire. We used statistical methods to evaluate the frequency of urinary incontinence and the associated range in quality of life among this sample. The International Society for Urological Quality of Life gave its stamp of approval to the Study's questionnaires before they were utilized. (2019 ISUQOL)

Data Collection

Patients were surveyed on the impact of urine incontinence on their quality of life. Frequency, urgency, leaking, pad use, lack of control, and sleep difficulties all fall into this category. Patients were polled on their demographic information, medical history, and current course of therapy. 




Statistical Analysis

SPSS 22 was used to examine the data. In this descriptive Study, we look at basic information about our patients. Chi-square and binary logistic regression analysis were used to identify predictors of 

urine incontinence and its effect on quality of life. The results were considered significant if the p-value was less than 0.05.




Ethical Considerations

MTI Mardan's Research Ethics Board has examined and given its approval to the project. Before participating in the research, every individual gave their written informed permission. No individual's anonymity was compromised during data gathering, and no individual data would be sold or given to any other parties.

Results

In the current study, a total of 100 female patients were enrolled. The patient's demographics and co-morbidities are given in Table 1 and Table 2.  The overall mean (SD) impact on the women's quality of life was 53.4 (6). The prevalence of mild, moderate and severe urinary Incontinence was 22%, 40% and 38%.

 

Table 1

Patient Demographics

Demographics	Frequency (%)
Age
0-30 years	22%
31-50 years	53%
51-65 years	22%
> 65 years	3%
Ethnicity
Pakistani	92%
Other	8%

 

Table 2

Comorbidities

Comorbidities	Frequency (%)
Diabetes	19%
Hypertension	27%
Cardiovascular disease	11%
Urological conditions	10%
Other medical conditions	33%

 

Table 3

Impact of Urinary Incontinence on Quality of Life

Variable	Mean	Standard Deviation
Physical Impact	22.5	3.2
Emotional Impact	14.7	2.4
Social Impact	16.2	2.6
Total Impact	53.4	6.0




Table 4

Prevalence of Urinary Incontinence

Severity	Frequency (%)
Mild	22 %
Moderate	40 %
Severe	38 %

Discussion

The incidence and effects of urine incontinence in Pakistani women are well explained by this Study. The majority of participants in the study group had mild to moderate symptoms of urine incontinence, the data show (Lin et al., 2023; Nag, Gollapudi, Del Rio, Spudich, & McDowell, 2023). The average overall impact score of 53.4 shows a severe decline in these women's quality of life. These results indicate that various approaches are required to address urine incontinence in Pakistani women (Ali, Sami, Saeed, & Ali, 2021; Jokhio, Rizvi, Rizvi, & MacArthur, 2013; Reiss, de Levante Raphael, Chin, & Sinha, 2022; uz Zaman, 2022). To reduce the stigma presently associated with urine incontinence, promote early identification, and boost the likelihood of effective treatment(Tham et al., 2023), it is critical to raise knowledge of the condition among the general public and medical professionals. To guarantee that women get adequate and timely care, national standards for examining, diagnosing, and treating urine incontinence should be developed (Khan, Shehmar, & Gupta, 2014). To completely treat urine incontinence, interdisciplinary strategies should be developed. Public health initiatives should be created to reduce the negative effects of urine incontinence on women's quality of life (McDaniel, Ratnani, Fatima, Abid, & Surani, 2020; Zao & Romainoor, 2023). The outcomes of this Study will also influence how future Study is conducted. The findings of this Study support the need for further investigation into the prevalence, underlying causes, and treatment options for urine incontinence in Pakistan. The effectiveness of more contemporary therapeutic techniques, such as pelvic floor physiotherapy and urinary assistance (Panel & Policy, 1996), also needs more Study.

Conclusion

This Study shows that urine incontinence substantially affects women's quality of life and is rather common in Pakistan. The findings suggest that multimodal treatment and public health initiatives are required to reduce pee incontinence's negative effects on women's quality of life. The results of this Study have consequences for clinical practice and point to the need for future Study.

Limitations

The Study's limited sample size was a serious problem that may have endangered the validity of the findings. Just one site was utilized to recruit research participants to guarantee sample homogeneity. This may have reduced the findings' ability to be applied to other groups.

Future Finding

The evaluation of the epidemiology, diagnosis, and treatment of urine incontinence in Pakistan should be the main focus of future Studies. The effectiveness of more modern treatment approaches, such as pelvic floor physiotherapy and urinary assistance, also needs more Study. The costs and benefits of these interventions should also be evaluated since they may influence whether or not they are applied to the Pakistani community.




Advisory for Clinical Practice

Improve women's access to diagnosis and treatment through increasing public understanding of urinary incontinence. Use the most successful methods for evaluating, diagnosing, and treating urine incontinence. Create multidisciplinary incontinence diagnosis and treatment services. Changes to Pakistan's public health system for women with urinary incontinence will greatly improve their quality of life.

References

• Ali, T. S., Sami, N., Saeed, A. A., & Ali, P. (2020). Gynaecological morbidities among married women and husband’s behaviour: Evidence from a community-based study. Nursing Open, 8(2), 553–561. https://doi.org/10.1002/nop2.660
• Amanullah, F., Malik, A. A., & Zaidi, Z. (2022). Chronic kidney disease causes and outcomes in children: Perspective from a LMIC setting. PLOS ONE, 17(6), e0269632. https://doi.org/10.1371/journal.pone.0269632
• Culberson, J. W., Kopel, J., Sehar, U., & Reddy, P. H. (2023). Urgent needs of caregiving in ageing populations with Alzheimer’s disease and other chronic conditions: Support our loved ones. Ageing Research Reviews, 90, 102001. https://doi.org/10.1016/j.arr.2023.102001
• Hofstetter, S., Zilezinski, M., Wolf, A., Behr, D., Paulicke, D., Stoevesandt, D., Schwarz, K., Mühlstädt, S., & Jahn, P. (2022). Dfree ultrasonic sensor in supporting quality of life and patient satisfaction with bladder dysfunction. International Journal of Urological Nursing, 17(1), 62–69. https://doi.org/10.1111/ijun.12334
• Jokhio, A., Rizvi, R., Rizvi, J., & MacArthur, C. (2012). Urinary incontinence in women in rural Pakistan: prevalence, severity, associated factors and impact on life. BJOG: An International Journal of Obstetrics & Gynaecology, 120(2), 180–186. https://doi.org/10.1111/1471-0528.12074
• Khan, A., Shehmar, M., & Gupta, J. (2014). Uterine fibroids: current perspectives. International Journal of Women’s Health, 6, 95 . https://doi.org/10.2147/ijwh.s51083
• Lau, H.-H., Davila, G. W., Chen, Y., Ferreira, G., Katalin, I., Tsai, J.-M., Liu, Y., & Su, T. (2023). FIGO recommendations: Use of midurethral slings for the treatment of stress urinary incontinence. International Journal of Gynaecology and Obstetrics, 161(2), 367–385. https://doi.org/10.1002/ijgo.14683
• Lin, P. T., Wang, Y. F., Hseu, S. S., Fuh, J. L., Lirng, J. F., Wu, J. W., Chen, S. T., Chen, S. P., Chen, W. T., & Wang, S. J. (2023). The SIH-EBP Score: A grading scale to predict the response to the first epidural blood patch in spontaneous intracranial hypotension. Cephalalgia: An international journal of headache, 43(3), 3331024221147488. https://doi.org/10.1177/03331024221147488
• McDaniel, C., Ratnani, I., Fatima, S., Abid, M. H., & Surani, S. (2020). Urinary Incontinence in Older Adults Takes Collaborative Nursing Efforts to Improve. Cureus, 12(7). https://doi.org/10.7759/cureus.9161
• Mushtaq, K., Mushtaq, I., Bajwa, A., Waseem, A., Batool, S., & Rana, A. A. (2023). Prevalence of Urinary Incontinence among Post-Menopausal Females and Its Associated Factors: Urinary Incontinence among Post-Menopausal Females. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 3(4), 477-487.
• Nag, S., Gollapudi, S. K., Rio, C. del, Spudich, J. A., & McDowell, R. (2023). Mavacamten, a precision medicine for hypertrophic cardiomyopathy: From a motor protein to patients. Science Advances, 9(30). https://doi.org/10.1126/sciadv.abo7622
• Olowu, W. A., Adefehinti, O., & Aladekomo, T. A. (2013). Epidemiology and clinicopathologic outcome of pediatric chronic kidney disease in Nigeria, a single centre study. Arab journal of nephrology and transplantation, 6(2), 105-113.
• Petrican, P., & Sawan, M. (1998). Design of a miniaturized ultrasonic bladder volume monitor and subsequent preliminary evaluation on 41 enuretic patients. IEEE Transactions on Rehabilitation Engineering, 6(1), 66–74. https://doi.org/10.1109/86.662622
• Pilankar, N. N., & Parle, J. (n.d). Awareness and Prevalence of Urinary Incontinence among Menopausal Women–A Retrospective Study.
• Pradhan, A., Jain, P., & Latthe, P. M. (2012). Effectiveness of midurethral slings in recurrent stress urinary incontinence: a systematic review and meta-analysis. International Urogynecology Journal, 23(7), 831–841. https://doi.org/10.1007/s00192-012-1803-2
• Reiss, A. B., Raphael, D. de L., Chin, N. A., & Sinha, V. (2022). The physician’s Alzheimer’s disease management guide: Early detection and diagnosis of cognitive impairment, Alzheimer’s disease and related dementia. AIMS Public Health, 9(4), 661–689. https://doi.org/10.3934/publichealth.2022047
• Tarkowska, M., GÅ‚owacka-Mrotek, I., Skonieczny, B., Jankowski, M., Nowikiewicz, T., Jarzemski, M., Zegarski, W., & Jarzemski, P. (2022). Prospective Evaluation of the Quality of Life of Patients after Surgical Treatment of Rectal Cancer: A 12-Month Cohort Observation. Journal of Clinical Medicine, 11(19), 5912. https://doi.org/10.3390/jcm11195912
• Tham, K. W., Abdul Ghani, R., Cua, S. C., Deerochanawong, C., Fojas, M., Hocking, S., Lee, J., Nam, T. Q., Pathan, F., Saboo, B., Soegondo, S., Somasundaram, N., Yong, A. M. L., Ashkenas, J., Webster, N., & Oldfield, B. (2022). Obesity in South and Southeast Asia-A new consensus on care and management. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 24(2), e13520. https://doi.org/10.1111/obr.13520
• uz Zaman, M. (2022). ABSTRACTS-38th ANNUAL RSP CONFERENCE-KARACHI (25th-27th November 2022). PJR, 32(4). http://www.pakjr.com/ojs/index.php/PJR/article/view/1628
• Yi, Z., & Romainoor, N. H. (2023). A Systematic Literature Review for Interface Design of Pelvic Floor Muscle Training Mobile App Based on Health 2017-2022. Journal of Advanced Computing Technology and Application (JACTA), 5(1), 28-42. https://jacta.utem.edu.my/jacta/article/view/5280
• Zhou, M., Zhao, G., Zeng, Y., Zhu, J., Cheng, F., & Liang, W. (2022). Aging and Cardiovascular Disease: Current Status and Challenges. Reviews in Cardiovascular Medicine, 23(4), 135. https://doi.org/10.31083/j.rcm2304135