Prevalence, Risk Factors and Costs of Female Urinary Incontinence: A Multicentre Cross-Sectional Study

Abstract

What is the prevalence of urinary incontinence and its main subtypes among middle-aged women in Northern Italy? How do urinary incontinence severity and subtypes correlate with risk factors and healthcare costs? Urinary incontinence is a common yet underreported condition among women. Despite its impact, recent data on prevalence, severity and risk factors in Italy, particularly among middle-aged women, remain scarce. This study aims to investigate the correlation between urinary incontinence severity, subtypes and healthcare costs to inform targeted interventions. Urinary incontinence is the involuntary leakage of urine, classified into stress, urgency and mixed types. Its multifactorial aetiology includes demographic, lifestyle, comorbid and obstetric-gynaecological risk factors. Urinary incontinence negatively influences physical, psychological, social and financial well-being. A multicentre cross-sectional study was conducted in four hospitals in Northern Italy, enrolling 722 women. Participants were selected based on eligibility criteria and informed consent was obtained. Data on sociodemographic factors, lifestyle and gynaecologic history were collected. Urinary incontinence severity and subtypes were assessed using the International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form (ICIQ UI-SF). Multiple logistic regression was performed to identify predictors, while Pearson's correlation test analysed the relationship between urinary incontinence severity and healthcare costs. The prevalence of urinary incontinence was 44.8%, with stress urinary incontinence being the most common subtype (39.1%). Among participants, 19.6% experienced mild leakage, while 4.3% reported severe cases. Identified risk factors included hypertension, sleep disorders, bladder emptying difficulties, higher body mass index, multiple vaginal deliveries, depression and smoking. A significant positive correlation was found between urinary incontinence severity and healthcare costs (r = 0.480, p < 0.001). Urinary incontinence affects nearly half of middle-aged women in Northern Italy. Addressing modifiable risk factors and implementing targeted interventions based on urinary incontinence subtypes are crucial to reduce urinary incontinence prevalence, severity and improve outcomes. Further longitudinal research is essential to better understand urinary incontinence in this demographic.