Anal and urinary incontinence in nulliparous women – Prevalence and associated risk factors

Abstract

Objective

To establish the prevalence and risk factors of urinary and anal incontinence in nulliparous women.

Study design

Thirty-one catholic convents were sent a validated questionnaire to determine the prevalence and severity of urinary incontinence, and a similarly structured questionnaire to assess anal incontinence. Multivariable regression models were used to determine independent risk factors associated with the likelihood of urinary incontinence or anal incontinence.

Main outcome measures

Urine/faecal/flatal incontinence and symptom severity.

Results

Of 202 nuns, 167 (83%) returned the questionnaire. Twenty-two women were excluded due to history of childbirth. Of 145 nulliparous women, 56.2% reported urinary incontinence and 53.8% reported anal incontinence. Women aged 66–76 years had significantly increased odds of experiencing urinary incontinence in comparison to women aged 40–65 years: OR: 2.35 (95% CI: 1.02–5.45) (p = 0.04). The risk of urinary incontinence was increased in women with a body mass index ≥ 30 in comparison to those with a body mass index < 19: OR: 6.25 (95% CI: 1.03–38.08) (p = 0.04). With regards to anal incontinence, although none of the differences with age and body mass index groups reached statistical significance, there was a trend towards women in higher body mass index groups having an increased prevalence of anal incontinence. Current/previous hormonal replacement therapy was also associated with significantly increased odds of experiencing urinary incontinence: OR: 2.53 (95% CI: 1.01–6.36), (p = 0.04). However, when adjusting for age and body mass index, there was no significant association with urinary incontinence.

Conclusions

This study highlights that while childbirth is an important risk factor, urinary incontinence and anal incontinence also occur in over 50% of nulliparous women. Additional studies are required to identify other risk factors that may be associated with incontinence in this population.