Int Urogynecol J. 2025 Oct 13. doi: 10.1007/s00192-025-06280-1. Online ahead of print.
ABSTRACT
INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is a significant health concern among women in the USA and is often underdiagnosed. Prevalence has increased over recent decades. The COVID-19 pandemic disrupted national survey data collection, creating a gap in updated prevalence estimates.
METHODS: We analyzed publicly available data from the 2021-2023 National Health and Nutrition Examination Survey. Our study included women aged ≥ 20 years who completed incontinence-related survey items (n = 2834). Outcomes included stress (SUI), urgency (UUI), and mixed incontinence (MUI). Analyses were weighted to provide nationally representative estimates. Multivariable logistic regression stratified by age (<50 vs ≥50 years) was used to identify independent risk factors.
RESULTS: The crude prevalence of UI was 63%, representing approximately 79.6 million US women. Age-adjusted prevalence was 47.6%. Over 40% of women with each UI subtype reported “moderate” to “very severe” UI symptoms. Functional dependence was a consistent predictor of all subtypes across age groups. Among younger women, SUI was associated with current pregnancy, multiparity, and obesity. In older women, chronic obstructive pulmonary disease predicted SUI and MUI, whereas cardiovascular conditions were linked to UUI and MUI. “Moderately severe” or “severe” depressive symptoms were associated with UUI in both age groups. Prediabetic hemoglobin A1c was associated with SUI and MUI in older women only.
CONCLUSION: Urinary incontinence remains prevalent and symptomatically burdensome among US women. Age-specific risk profiles underscore the importance of tailored screening and management. Addressing functional and mental health, as well as ensuring equitable access to urological care, will be critical priorities as the US population ages.
PMID:41081813 | DOI:10.1007/s00192-025-06280-1
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