4th Riau Medical Scientific and Expo 2022 Volume 2022
http://dx.doi.org/10.11594/nstp.2022.2823
How to cite:
Fakhrizal, E., Rustam, R. P., & Maryuni, S. W. (2022). The prevalence of stress urinary incontinence in Coastal
Community from Riau Province. 4th Riau Medical Scientific and Expo 2022. NST Proceedings. pages 110-113. doi: 10.11594/
nstp.2022.2823
Conference Paper
The Prevalence of Stress Urinary Incontinence in Coastal Community from Riau Province
Edy Fakhrizal1*, Ruza Prima Rustam2, Sri Wahyu Maryuni2
1Student of Doctoral Program, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
2Urogynecology and Reconstructive Pelvic Floor Division, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Riau, Pekanbaru, Indonesia
*Corresponding author: ABSTRACT
Stress Urinary Incontinence (SUI) significantly affects women’s quality of life through physical and psychosocial limitations and sexual dysfunction. This condition may cause a huge individual and family burden, leading to a global burden. The coastal area is geographically located in islands confined by the sea, thus becoming the basis of health problems due to its limited access to healthcare facilities. No study has been conducted to identify the SUI prevalence rate. This study aims to help determine problems caused by SUI, eventually conceiving effective prevention and treatment strategies to be proposed to health policymakers. This research is a quantitative study with women of reproductive age (20 – 44 years old) and >44 years old in 4 coastal areas (Bengkalis, Dumai, Siak, and Rumbai Pesisir) as the key population. Of 320 patients, 178 (53,80%) were screened for urinary incontinence. Among 178 screened subjects, 152 (85%) were classified as stress urinary incontinence, with the highest incidence rate found at Dumai, with 59 (39%) cases. Bengkalis, Siak, and Pekanbaru had an incidence rate of 51 (33%), 33 (22%), and 9 (6%), consequently. This study found most women had urinary incontinence, with the most common type being stress urinary incontinence.
Based on this study, due to the high prevalence of SUI, the authors agreed that effective prevention and treatment strategies are needed to prevent SUI's severity and further development.
Keywords: Stress urinary incontinence, prevalence, island E-mail:
dredy_spog@yahoo.co.id
Introduction
Urinary incontinence (UI) is a highly prevalent condition that profoundly influences well-be- ing (Pizzol et al., 2021). According to population-based studies, UI is more common in women, with approximately 10% of all adult females suffering from UI (Milsom, 2019). The International Continence Society classified incontinence into three categories: stress, urge, and mixed (Junizaf
& Santoso, 2011). The prevalence of UI rises with age, with more than 40% of the female popula- tion affected. The reported prevalence of UI among women varies significantly across studies due to different definitions, the heterogeneity of diverse study populations, and population sampling procedures (Milsom, 2019) According to Fakhrizal et al., the prevalence of urge urinary inconti- nence among 400 postpartum primipara women ranges from 8.8 to 30%, with the likelihood of urinary incontinence increasing twofold in vaginal delivery versus cesarean delivery. Increased events are expected to follow the increase in the life expectancy of Indonesian women in the UI prevalence rate (Fakhrizal et al., 2016). To date, there has been no report on the overall prevalence of urinary incontinence and stress urinary incontinence (SUI) in Riau Province, one of Indonesia's coastal areas where most people work as fishermen and have low incomes.
4thRIME 2022
111
Material and Methods
This research is conducted in several coastal areas in Riau Province (Bengkalis, Dumai, Rumbai, Siak) since January 2022 and will be going on for a year. Reproductive women with an average of 20 – 44 years old and more than 44 years old in a coastal area as the key population.
All of the participants that met inclusion and exclusion criteria, and were willing to participate in the study will be the study sample. The only inclusion criterion is a participant is willing to fill out the questionnaire provided. As for the exclusion criteria, there was: a history of hysterectomy, gynecology malignancy history, and currently pregnant. This is an analytical quantitative study to identify the urinary incontinence prevalence rate, specifically urinary incontinence. Participants were asked to fill out the validated Questionnaire for Urinary Incontinence Diagnosis (QUID) in Bahasa Indonesia (Bradley et al., 2005). Data were collected by asking questions based on a vali- dated questionnaire provided to all the patients/visitors of healthcare facilities in the study set- tings. Urinary incontinence and its classification are assessed through validated QUID in Bahasa Indonesia (Bradley et al., 2010). For patients who are classified as having stress urinary inconti- nence, an in-depth influencing factors assessment will be carried out. Following the data collec- tion, data will be processed through editing, coding, and processing with statistical data pro- cessing program. Data will be analyzed in univariate to identify the characteristics of the popula- tion. The data processing program used is Statistical Program for Social Science (SPSS).
Results and Discussion
The study was conducted for 3 months in 4 coastal areas of Riau Province. 320 patients meet the inclusion and exclusion criteria and become the sample of this research. The characteristics of the population study are shown in Table 1.
Table 1. Distribution of UI population characteristics (n = 320)
Variable n %
Age
20 – 44 186 58,1
>44 134 41,9
Parity
0 9 2,8
1 – 2 148 46,4
3 – 5 149 46,7
> 5 13 4,1
Occupation
Housewife 118 37
Employee 105 33
Merchant 47 14,7
Self-employed 49 15,3
Educational Status
Low (primary to high school) 198 61,9
High (beyond high school) 116 38,1
The distribution of cases in each coastal area is presented in Figure 1. Of 320 subjects, there are 152/320 (47,50%) cases of stress urinary incontinence.
4st RIME 2022
112
Figure 1. Urinary incontinence case percentage per coastal area in Riau Province
Out of 320 women that met the inclusion and exclusion criteria, 178 (55,60%) of them had urinary incontinence (UI) symptoms. In general, women are approximately three times more likely than men to have UI. Urinary incontinence has a prevalence rate of 20% to 30%, according to The Asia Pacific Continence Board (APCB). In a review of population studies from various stud- ies, the prevalence of UI ranged from 5 to 70%, with most studies reporting a prevalence of any UI in the range of 25-45%. Milsom et al., 2019; Acar et al., 2021). The prevalence of UI ranged from 5 to 70% in a study of population studies from other research, with the majority reporting a fre- quency of any UI in the range of 25–45% (Milsom & Gyhagen, 2019; Acar & Aslan, 2021).
Among 178 urinary incontinence subjects, 152 (85%) of them were screened as stress uri- nary incontinence (SUI), with 93,2% of subjects complaining of mild disturbing symptoms. Urine leakage during physical activity that increases abdominal pressure, such as coughing, sneezing, or exercise, is known as stress urinary incontinence (SUI). SUI is the most common type of urinary incontinence, with a prevalence rate of 14.7% - 52% across all countries studied, followed by mixed UI and urge UI. Despite the differences in results between this study and the study con- ducted by Chesor A., who discovered that the prevalence rate of urinary incontinence is higher in moderate and severe cases, this could be due to different data collection on this study, there could be false positives based on the questionnaire filled out. The risk of SUI is also independently in- creased by parity and childbirth, with vaginal delivery being the most prevalent. According to this study, 62,3% of all cases of stress urinary incontinence had three or more parties. This might re- sult from numerous hormones changing during pregnancy and the pelvic floor tissues stretching to accommodate those changes. Pelvic floor issues may develop from pelvic floor diseases caused by damage to the levator ani musculature (nerves, muscles, and fascia) during vaginal delivery.
The average life expectancy is increasing globally, and 25% of the population in some nations is over 65. Future predictions indicate that the number of women requiring UI treatment will climb as UI prevalence rises. According to Milsom et al. (2019) As a result of this study, the authors of this study concur that to lessen the severity and progression of SUI, preventative initiatives, as well as efficient treatment approaches, are required.
Conclusion
Urinary incontinence is becoming more common as average life expectancy increases world- wide. According to this study, the prevalence of urine incontinence in the Riau coastal community
36%
58%
68%
80%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Siak Bengkalis Dumai Rumbai Pesisr Case Percentage
4thRIME 2022
113
is 55,6%, with SUI being the most prevalent kind (47,5%), even though the symptoms are typically mild (93.2%).
Demands for healthcare services related to UI management are anticipated to rise in the com- ing years. Therefore, government policies and measures are required to stop the worldwide bur- den and prevalence rate of SUI from rising.
Acknowledgment
The authors say thanks to the Obstetrics and Gynecology Department, Faculty of Medicine, Riau University
References
Acar, Z., & Aslan, E. (2021). The burden and cost in urinary incontinence. The New Journal of Urology; 16(1), 65-74.
Bradley, C. S., Rahn, D. D., Nygaard, I. E., Barber, M. D., Nager, C. W., Kenton, K. S., et al. (2010). The questionnaire for urinary inconti- nence diagnosis (QUID): Validity and responsiveness to change in women undergoing non-surgical therapies for treatment of stress predominant urinary incontinence. Neurourology and urodynamics, 29(5), 727-34. doi: 10.1002/nau.20818
Bradley, C. S., Rovner, E. S., Morgan, M. A., Berlin, M., Novi, J. M., Shea, J. A., et al. (2005). A new questionnaire for urinary incontinence diagnosis in women: Development and testing. American journal of obstetrics and gynecology,192(1), 66-73. doi:
10.1016/j.ajog.2004.07.037.
Fakhrizal, E., Priyatini, T., Santoso, B. I., et al. (2016). Prevalence and risk factors of persistent stress urinary incontinence at three months postpartum in Indonesian women. Med J Indonesia; 163-170. Doi: 10.13181/mji.v25i3.1407
Junizaf & Santoso. (2011). Buku ajar uroginekologi Indonesia, Himpunan Uroginekologi Rekonstruksi. Indonesia: Jakarta.
Milsom, I., & Gyhagen, M. (2019). The prevalence of urinary incontinence. Climacteric, 22(3), 217-22. Doi:
10.1080/13697137.2018.1543263.
Pizzol, D., Demurtas, J., Celotto, S., Maggi, S., Smith, L., Angiolelli, G., et al. (2021). Urinary incontinence and quality of life: a systematic review and meta-analysis. Aging Clin Exp Res., 33(1), 25-35. Doi: 10.1007/s40520-020-01712-y.
