Conservative interventions for urinary incontinence in women: an overview of Cochrane systematic reviews

At least one-quarter of all adult women have urinary incontinence (UI), with prevalence increasing with age (Sandvik 2000). Around 20% of women with urinary problems seek professional help; this percentage increases with advancing age and is higher among women with other concomitant urogenital problems (Morrill 2007).

Evidence suggests that for the majority of women affected, UI impacts significantly on daily living. It has been shown to interfere with physical, psychological and social activities of women, reducing general health, wellbeing and quality of life (NICE 2013). It is associated with an increased prevalence of major depression (Melville 2009); and in older women is linked to social isolation and psychological distress (Bogner 2002). UI can cause a number of serious medical conditions, such as perineal rash, pressure ulcers and urinary tract infections and increases the risk of admission to long-term residential care (Hunskaar 2002). The annual cost to the NHS of treating clinically significant female UI has been estimated to be GBP 233 million (Perry 2000). This does not include the personal costs borne by the women affected, which have been estimated to be GBP 178 million (Turner 2004). UI is therefore prevalent and costly to healthcare providers; and to women both financially and in terms of physical and mental wellbeing.