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Prevention of Urinary Incontinence in Adults: Population-Based Strategies

Sampselle, Carolyn M.; Palmer, Mary H.; Boyington, Alice R.; O’Dell, Katharine K.; Wooldridge, Leslie


Background: Urinary incontinence (UI) affects large numbers of adults, especially older adults, with an estimated 200 million adults worldwide having this life-altering condition.

Objectives: To identify key populations at risk for urinary incontinence and propose population-based strategies to promote continence with a substantive focus on UI prevention.

Methods: Critical review of extant literature and iterative synthesis were undertaken to generate an action plan to guide future UI prevention research.

Results: Key populations identified to be at risk for UI are women in selected occupations, childbearing women, older adults with lifestyle risk factors, older adults with comorbid conditions, and nursing home residents. Population-based research activities are proposed. Growing evidence supports the benefit of pelvic floor muscle training to prevent childbirth and prostatectomy-related UI. Bladder training has demonstrated preventive capacity.

Conclusions: Because of its high prevalence and chronic but preventable nature, UI is most appropriately considered a public health problem. Nursing research is needed to test prevention programs for UI using a population-based public health focus.

Carolyn M. Sampselle, PhD, RNC, FAAN, is Carolyne K. Davis Collegiate Chair, Professor of Nursing, Associate Dean for Research, University of Michigan, Ann Arbor.

Mary H. Palmer, PhD, RNC, FAAN, is Helen W. and Thomas L. Umphlet Distinguished Professor in Aging; and Alice R. Boyington, PhD, RN, is Assistant Professor, University of North Carolina at Chapel Hill.

Katharine K. O’Dell, MSN, CNM, Doctoral Student, University of Massachusetts Graduate School of Nursing, Worcester.

Leslie Wooldridge, MSN, RNCS, GNP, Gerontological Nurse Practitioner, Urology Associations, Grand Rapids, Michigan.

Corresponding author: Carolyn M. Sampselle, PhD, RNC, FAAN, University of Michigan School of Nursing, 400 N. Ingalls, Room 4236, Ann Arbor, MI 48109-0482 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.