Urinary incontinence (UI) affects a significant number of women throughout the United States, but its impact on physicians has not been studied. This is the first study to assess the prevalence of UI in female physicians.

Female physicians across the nation were asked to fill out a questionnaire assessing urinary habits at work, and were asked to fill out the Urogenital Distress Inventory- 6 and Incontinence Impact Questionnaire- 7.  For the power analysis, the prevalence of UI was estimated to be 25% based on prior studies; this rate has not changed significantly over time [1]. To detect a 10% increased rate of UI in physicians, 156 participants would be needed to achieve a power of 80% and alpha of 0.05. Chi square test was used to compare the rate of UI to the general population. Crosstab tables were created to show the prevalence of UI, stress UI (SUI), urgency UI (UUI), and mixed UI (MUI) within age groups compared to the general population. Multiple logistic regression was used to investigate the association between UI and work related variables (surgical vs non-surgical specialty, work week length, time between voids, and delay in voiding).

A total of 197 women were included in the analysis and fully completed the survey.  Overall, 82 participants (41.6%) reported any UI, 43 (21.8%) reported SUI, and 16 (8.1%) reported UUI. These rates were statistically higher than the general population rates (all with p ≤ 0.01). This was largely due to the high rate of these conditions in female physicians in the 25-29 age group. The prevalence of MUI was similar to the general population in all age groups. There was no statistical association of work-related factors with UI (Table 1).

The participants in this study were overall healthy with no comorbidities, nulliparous (65.5%), and pre-menopausal (96.4%). Despite this, there was a higher prevalence of UI in this cohort compared to the general population. In addition, participants in the 25-29 age group had higher rates of UI overall (47.3%), SUI (25.5%) and UUI (10.9 %).  The majority of physicians sampled reported decreased frequency of voiding as a result of their work schedule and most reported intake of 1 or more bladder irritates. It is possible these factors contributed to an early onset of UI in this population.

Female physicians reported a higher rate of UI, SUI, and UUI than the general population but a similar rate of MUI. More studies are needed to determine why 25-29 year old female physicians in particular have a higher rate of these conditions.

Nitti VW. The prevalence of urinary incontinence. Rev Urol. 2001;3 Suppl 1:S2-6.