Familial risk of urinary incontinence in women: population based cross sectional studyBMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7471.889 (Published 14 October 2004) Cite this as: BMJ 2004;329:889
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The article by Hannestad et al on population based cross sectional
study on frequency of all types of urinary incontinence in sisters and
daughters of women affected by urinary incontinence is not surprising but
raises certain questions.Higher familial incidence of urinary incontinence
in close relatives of such patients is well known (1).But in such a
population based study where the diagnosis was made from patients' own
account and not confirmed by urodynamic studies, there may be some amount
of reporting bias as the daughters and younger sisters of patients
suffering from urinary incontinence are very aware of the condition and
are likely to report the symptoms of urinary incontinence much more often
than the daughters and sisters of normal women as they become much more
sensitive about it and ask for help much earlier(2,3). This is like the
relatives of breast or ovarian cancer report to doctors for screening much
earlier than normal women or the daughters of women with kyphosis due to
osteoporosis report to doctors much more often to start hormone
replacement therapy to avoid the fate of their mothers.
daughters or sisters who have seen the suffering of their mothers or
sisters about urinary incontinence are more likely to report and seek
treatment to avoid the similar fate. Moreover there may be other common
factors in the families like the use of similar diets, smoking or toilet
habits which may have a bearing on the prevalence of urinary incontinence
like use of Indian type of toilet seat where a woman is forced to sit in a
squating posture each time she goes to the toilet with forced perineal
floor exercises each time is known to have partial preventive effect on
the prevalence of urinary incontinence as all the members of the house
shall have to use the similar type of toilet seat. However, a higher
incidence of urinary incontinence by the relatives of such patients should
be used as an oppurtunity to visit their doctors to seek help for urinary
incontinence as most of these conditions can be easily treated and they
should not suffer in silence thinking it to be a natural and ageing
process, an ideology rampant in developing countries like India.
1. Elia G, Bergman J, Dye TD. Familial incidence of urinary
incontinence. Am J Obstet Gynecol 2002;187:53-5.
2. Rortvein G, Daltveit AK, Hannestad YS, Hunskar S. Urinary
incontinence after vaginal delivery or cesarean section. N Engl J Med
3. FitzGerald MP, Brubaker L. Urinary incontinence symptom scores and
urodynamic diagnoses. Neurourol Urodyn 2002;21:30-5.
Competing interests: No competing interests