Can we prevent incontinence? ICI-RS 2011

Abstract

Aims: A review of the current state of research with regard to prevention of incontinence.

Methods: The search was limited to English language publications on the topic of incontinence prevention.

Results: Incontinence is associated with a range of risk factors, most of which are modifiable. Lifestyle changes with behavioral modifications that can prevent urinary incontinence (UI) need to be adopted from an early phase of life. Pregnancy per se for the woman, independent of labor and delivery practice, is a risk factor for UI. The influence of estrogen is still under discussion as to its direct influence to UI. For both men and women, there is a correlation between pelvic-floor related surgery and UI and fecal incontinence (FI). With further improvement in surgical techniques, UI is often only a transient symptom for most patients. Psychological illnesses and their treatment can induce or worsen incontinence and therefore should be evaluated especially with other necessary co-medications.

Conclusions: The evidence would suggest that in some cases incontinence can be prevented. Although the evidence base for UI is greater than that for FI, the conditions share many similarities with respect to risk and treatment, suggesting that similar benefits may derive from population-based prevention strategies. With primary prevention, actions taken early, even in the absence of incontinence, may avoid or delay its onset. There is also evidence that some risk factors for incontinence are modifiable, although not type specific, and can be reduced through preventive measures.