13. Urinary incontinence
Age 0-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-79 >80
No evidence for screening general population
There is no evidence for screening for urinary incontinence in the general population. Instead, GPs should case-find those at higher risk (B).
Within the general population, up to 19% of children,1 13% of men and 37% of women may be affected by some form of urinary incontinence.2 While urinary incontinence is most common in women and increases with age, bedwetting (enuresis) is common in children (5.5% of children also report daytime wetting).1 In men, uncomplicated lower urinary tract symptoms do not appear to be associated with an increased risk of prostate cancer.3 Of those sitting in a GP waiting room, 65% of women and 30% of men report some type of urinary incontinence, yet only 31% of these people report having sought help from a health professional.4 Primary care professionals are in a position to take a more proactive approach to incontinence treatment by asking about urinary symptoms in at-risk groups during routine appointments. There remains considerable health decrement due to urinary incontinence in those not receiving help in a population readily accessible to primary care services.5
The Continence Foundation of Australia (CFA) has a helpline available for consumers and healthcare professionals at 1800 33 00 66. Consumers can ask for specific help or for contact details of their nearest continence professional. The CFA website has many evidence-based resources available for consumers
- Bower W, editor. An epidemiological study of enuresis in Australian children. Sydney: Wells Medical, 1995.
- Continence Foundation of Australia. What is incontinence: Key statistics. Brunswick, Vic: CFA, 2015. Available here [Accessed 2015 September].
- Martin RM, Vatten L, Gunnell D, Romundstad P, Nilsen TI. Lower urinary tract symptoms and risk of prostate cancer: The HUNT 2 Cohort, Norway. Int J Cancer 2008;123(8):1924–28.
- Byles J, Chiarelli P, Hacker A, Bruin C. Help seeking for urinary incontinence: A survey of those attending GP waiting rooms. Aust Continence J 2003;9(1):8–15.
- Shawa C, Gupta RD, Bushnell DM, Passassa R, Abrams P, Wagg A. The extent and severity of urinary incontinence amongst women in UK GP waiting rooms. Fam Pract 2006;23(5):497–506.
- Martin JL, Williams KS, Sutton AJ, Abrams KR, Assassa RP. Systematic review and meta-analysis of methods of diagnostic assessment for urinary incontinence. Neurourol Urodyn 2006;25(7):674–83.
- Staskin D, Kelleher C, Avery K, et al, editors. Committee 5: Initial assessment of incontinence. Proceedings of the fourth international consultation on incontinence. Paris: Health Publication Ltd, 2009.
- Brown J, Bradley C, Subak L, Richter H, Kraus S, Brubaker L. The sensitivity and specificity of a simple test to distinguish between urge and stress incontinence. Ann Intern Med 2006;144:715–23.
- Hess R, Huang AJ, Richter HE, et al. Long-term efficacy and safety of questionnaire-based initiation of urgency urinary incontinence treatment. Am J Obstet Gynecol 2013;209(3):244, e1–9.