[Urinary and anal incontinence: a taboo subject]

Abstract

The prevalence of urinary incontinence is estimated at about 6 % in the overall population and may be as high as 40 % in women after menopause. For many women with stress incontinence, the new vaginal tape operations appear to offer cure rates comparable to those achieved with conventional procedures, but with less invasiveness and a shorter hospital stay. Pelvic organ prolapse and stress incontinence are two separate conditions which frequently coincide. Correcting prolapse alone may not cure stress incontinence - and may even unmask latent incompetence of the urethral sphincter. Depending on which definition is used, the prevalence of anal incontinence is between 1 and 5 %. In women, injuries sustained at vaginal delivery appear to be the most important risk factor. The prevalence of combined urinary and anal incontinence may approach 5-10 %. All women we see as gynecologists and obstetricians should be asked about symptoms of incontinence, and women with symptoms should be evaluated specifically and offered appropriate measures to improve their quality of life.