The purpose of the study is to identify the occurrence of urinary incontinence in patients referred to physiotherapy OPD and this rate of incontinence will further increase the research area to evaluate the risk factors. The screening will identify about which factor is more commonly affect the pelvic floor area like multiple pregnancy, obesity and constipation.

The main objective is to find out the occurrence of urinary incontinence in patients who referred to physiotherapy OPD in a tertiary care hospital of Karachi city.

This study is cross sectional and descriptive in nature, the study was conducted at physiotherapy OPD of the tertiary care hospital where data was collected through simple survey based questionnaire . Patients visited the out-patient department are enrolled in the study. The sample was randomly selected who have either symptoms of incontinence or not. All the participants explained about the purpose of study. Informed consent will be taken before collecting the data. While collecting the data, the privacy and confidentiality will be maintained.
      
STUDY SETTING & POPULATION
The study will be conducted at physiotherapy OPD , participants will be referred by the urologist. After taking consent, the data will be collected to check the chance of urinary incontinence in the population who visit the Outpatient service of the physiotherapy department with different problems.

SAMPLE SELECTION: 
1.	Inclusion criteria
Male and female participants
Age between 20 to 60 years
Well oriented
No active urine infection
Mobile without any assistance


2.	Exclusion criteria
Pregnant women
Immobile participants
Nulliparous
age below 18 years old
Perineal tear
Immediate post-partum
BMI above 35
Chronic arthritis
Neurological disorders

 Sample size
     The sample size is 380 which is calculated by the Rao Soft calculator. The confidence interval was taken at 95% and the margin of error was 5%. 

The data of the study is collected in one time setting. The cohort type study , asked these questions through the Cozean Pelvic Dysfunction Screening Protocol (Cozean). The Cozean score was obtained from administrating the Cozean survey. The Cozean survey was established in 2018 by Nicole Cozean and Jesse Cozean and includes ten questions regarding signs and symptoms of PFD .11 If applicable, the participant checks the box next to the related statement and the sum of the total number of boxes checked equals a score (0-10). The Cozean was utilized in this study as there is a 91% specificity indicating possible PFD in individuals who score greater than or equal to 3 at the end of the survey. The data is collected in single visit at Physiotherapy clinic referred by Urologist

The data interpret that the total 380 population was subjected for data collection, the risk factors were obesity, High BMI, women, multigravida, radiation therapy, post partum phase, age , prostate surgery and others.
the results conclude the data that there is correlation between prostate surgery and abdominal surgery with incontinence.

among 380 people, 70people(18%) have total incontinence due to prostate surgery and 100patients(26%) have stress incontinence and urge incontinence, 20 people have sexual dysfunction. among them the most common is urge incontinence mainly in females.
also it was observed that patients with TURP have 80% chance of incontinence.
 the common cause is age and female gender with multigravida women.

among the risk factors the age , gender and multigravida is common factor of incontinence which is not reported to Urologist and under rated. hence undiagnosed.
The Cozean questionnnaire found the incontinence rate among general population of patients who are coming to Physiotherapy OPD.

.D’Ancona CD, Haylen BT, Oelke M, Herschorn S, Abranches-Monteiro L, Arnold EP, Goldman HB, Hamid R, Homma Y, Marcelissen T, Rademakers K, Schizas A, Singla A, Soto I, Tse V, de Wachter S. An International Continence Society (ICS) Report on the Terminology for Adult Male Lower Urinary Tract and Pelvic Floor Symptoms and Dysfunction. Neurourol Urodyn. 2019 DOI: 10.1002/nau.23897
Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300:1311–6
Bushnell DM, Martin ML, Summers KH, Svihra J, Lionis C, Patrick DL. Quality of life of women with urinary incontinence: Cross-cultural performance of 15 language versions of the I-QOL. Qual Life Res 2005;14:1901-13.