Prevalence of Stress Urinary Incontinence in Women from a Rural Community in the Brazilian Amazon

Research Article

Austin J Urol. 2021; 7(1): 1064.

Prevalence of Stress Urinary Incontinence in Women from a Rural Community in the Brazilian Amazon

Do Rego AD¹*, Morais ACM², Molisani JT², Nascimento LGA²

¹Gynecology-Obstetrics, Federal University of Amapá, Brazil

²Medicine Student of Federal University of Amapá, Brazil

*Corresponding author: Aljerry Dias do Rêgo, Gynecologist-Obstetrician, Specialist in Urogynecology and Professor of the Federal University of Amapá, Macapá, Amapá, Brazil

Received: March 17, 2021; Accepted: May 07, 2021; Published: May 14, 2021


Introduction: Stress urinary incontinence affects a significant number of women and causes great loss of Quality of Life (QoL). Its prevalence varies from 15 to 41.5%.

Objective: To assess the prevalence of Stress Urinary Incontinence (SUI) in women living in a rural community in Amapá, the main risk factors and quality of life assessment using a standardized questionnaire.

Methodology: A screening questionnaire was applied to 235 women residing in Igarapé da Fortaleza, in the city of Macapá, in 2015. Patients with SUI complaints were submitted to the King’s Health Questionnaire (KHQ) questionnaire. For statistical processing, BioEstat software version 5.3 was used.

Results: The prevalence of SUI was 28.9% (68 women). A significant age difference was found between women with SUI (44.2) and without SUI (37.9 ± 12.5 years). Childbirth, birth interval, smoking and Body Mass Index (BMI) showed to be statistically significant differences between groups. Variables such as number of deliveries, birth weight, menopause, education and race did not express a real difference.

Conclusion: The prevalence of SUI was 28.9%. There was a significant difference in the group with SUI in terms of age, smoking, parity, interval between births and BMI. In assessing QoL in patients with SUI using KHQ, we found the worst results in general health perception, impact of incontinence, personal relationships, sleep/mood and severity of symptoms.

Keywords: Urinary incontinence; Epidemiology; Amazon region; Rural area; Amazon


Urinary Incontinence (UI) is defined as the complaint of involuntary loss of urine [1]. UI can be divided into Stress Urinary Incontinence (SUI), which is defined as a complaint of urine loss due to some physical effort such as jumping, running and coughing. Urgency Urinary Incontinence (UUI) when there is a complaint of involuntary urine loss associated with urgency and Mixed Urinary Incontinence (MUI) when the involuntary loss of urine is associated with urgency and also with efforts [2,3].

There are few Brazilian epidemiological studies. A study in Campinas (São Paulo) and (Mato Grosso) showed a prevalence of 35% and 21.4% of women with SUI [4,5]. In Italy, 15.3% of the women interviewed reported urinary loss, while in China it was 23%; quite different from 41.5% in women from Saudi Arabia [6-8].

Several factors can contribute to the increase in the prevalence of UI, such as age, pregnancy, childbirth, vaginal delivery, menopause and obesity [9-11].

In Italian women with UI, 12.6% were nulliparous and 38.3% were secondary women. A study in Mexican women showed that UI was present in 58.1% in the group that had only normal delivery and 25.8% in the caesarean delivery group [12].

UI has a negative impact on women's Quality of Life (QoL), where social isolation, sexual disorders, family and work problems, anxiety, shame and depression are common. We can use standardized questionnaires to measure QoL. The King's Health Questionnaire (KHQ) has already been validated for Portuguese. It consists of 21 questions, divided into 8 (eight) domains: general health perception, impact of urinary incontinence, limitation of daily activities, physical and social limitations, social relationship, emotions and sleep/mood and two independent scales: one evaluates the severity of incontinence (measures of severity) and the other the presence and intensity of urinary symptoms. These scales are graded in 4 or 5 response options (Likert scale) [13,14].

KHQ is scored for each of its domains. Values range from 0 to 100 and the higher the score, the worse the quality of life for that domain [13-15].

There is a scarcity of epidemiological studies related to UI in the Amazon Region, so the objective of this study was to describe the prevalence of S.U.I in women living in a rural community in the city of Macapá - AP.


A cross-sectional study carried out to evaluate the prevalence of SUI and risk factors in women living in the Igarapé da Fortaleza community, 12 kilometers away by land from the city of Macapá/ AP. This community is divided by a small river (called the igarapé da Fortaleza), a direct tributary of the Amazon River (Figure 1). The female population at the time of the survey was 1,613 [16]. Most had low income and educational backgrounds, with a livelihood based on fishing and family farming. The houses are made of wood and the connection between them is made only by bridge [17,18].