Black Women Have Urinary Incontinence Less Than Half As Often As White Women

The bad news: When they get it, the condition tends to be worse than in white women. The amount of urine they lose during each episode of incontinence is larger, with half of black incontinent women reporting that they lose urine to the point of noticeably wetting their underwear or a pad, compared with a third of white women.

The significance: The study confirms some common beliefs, and refutes others. The medical community has long held the belief that black women don't experience a type of urinary incontinence known as "stress incontinence," in which urine is lost during activities such as exercising, coughing and laughing. In fact, the study found, black women do experience stress incontinence. The study is in the current issue of the Journal of Urology.

"This is a population that may have been neglected because it was believed for so long that black women did not have stress urinary incontinence," says lead author Dee E. Fenner, M.D., Furlong Professor of Women's Health, and director of gynecology, at the U-M Health System.

"In truth, black women suffer from the social embarrassment of urinary incontinence, and the medical community needs to remember this when diagnosing and treating all women."

The study indicates that black women experience "urge incontinence" twice as often as white women, which supports other research on the subject. This type of incontinence involves a strong and sudden need to urinate, followed by leakage.

Additionally, it has been thought in the past that the other medical conditions associated with urinary incontinence are different between black and white women. This study suggests, however, that those conditions -- such as diabetes, constipation, depression, obesity and chronic lung disease -- occur at similar rates between the two races.

By the numbers:

• About 27 percent of all women surveyed had the condition.
• This study found that 14.6 percent of black women and 33.1 percent of white women have urinary incontinence.
• Black women with incontinence reported having stress incontinence in about 25 percent of instances, compared with 39 percent of white women.
• Black women with incontinence reported urge incontinence in 24 percent of cases, compared with 11 percent of white women. The remaining numbers had a combination of both types.
• The women in the study ranged from 35 to 64 years old, with an average age of 42. Most of the women -- nearly 70 percent -- had delivered at least one baby vaginally; vaginal deliveries are often associated with urinary incontinence.

The study involved 1,922 black women and 892 white women from three southeastern Michigan counties. Data were collected through a telephone survey.

In addition to Fenner, authors of the study are senior author John O.L. DeLancey, M.D., Elisa R. Trowbridge, M.D., Divya L. Patel, Ph.D. and Nancy H. Fultz, Ph.D., all of the U-M Department of Obstetrics and Gynecology and the U-M Pelvic Floor Research Group; Janis M. Miller, Ph.D., RNC, of the U-M School of Nursing and the Pelvic Floor Research Group; and Denise Howard, M.D., MPH, of Georgia Urogynecology.

Disclosures: DeLancey has an advisory relationship with Johnson & Johnson, and Howard has an advisory relationship with Novartis and Novasys.

The research was sponsored by the National Institutes of Health through a grant from the National Institute of Child Health and Human Development.

Journal reference: The Journal of Urology, Vol. 179, 1455-1460, April 2008. "Establishing the Prevalence of Incontinence Study: Racial Differences in Women's Patterns of Urinary Incontinence."