Female Stress Urinary Incontinence: An Evidence-Based, Case Study Approach

Jamie Knarr, DNP, MSN, RN; Carol Musil, PhD, RN, FAAN; Camille Warner, PhD; Jack R. Kless, PhD, CRNA; Jaime Long, MD


Urol Nurs. 2014;34(3):143-151. 

In This Article

Abstract and Introduction


Over half of all women are affected by urinary incontinence at some point during their lives. Due to patients' embarrassment and health care providers' reluctance to discuss this sensitive subject, many women may go untreated, and in turn, suffer with disruptive symptoms and co-morbid complications associated with urinary incontinence. This article highlights a literature review of the evaluation and management of female stress urinary incontinence using a corresponding case study example. Increasing awareness and implementing evidence-based, nonsurgical treatment options are essential components of high-quality care for women with stress urinary incontinence. Urologic nurses and other health care professionals are in an ideal position to evaluate and identify strategies for the treatment of female stress urinary incontinence.


Urinary incontinence (UI) is a common medical problem that affects numerous wo men throughout the United States. Nearly 50% of women suffer from some form of UI during their lifetime, which can have a significant impact on a woman's quality of life (Melville, Katon, Delaney, & Newton, 2005). Social, psychosocial, physical and sexual health can all be compromised for incontinent women. UI can result in a disruption of social relationships (Dugan et al., 2000), and women with UI are shown to have higher rates of depression and social isolation than those without UI (Fultz & Herzog, 2001). Psychological distress can occur be cause of the embarrassment, anxiety, or decreased self-esteem associated with the incontinent episodes (Dugan et al., 2001). In severe cases of UI, hospitalization may occur as a result of skin ulcers, infection, or falls (Magon, Kalra, Malik, & Chauhan, 2011). Lastly, UI may also contribute to sexual dysfunction due to urinary leakage with intercourse (Barber, Dowsett, Mullen, & Viktrup, 2005).

Not only does this common medical problem cause personal difficulty for the female patient, it is also quite costly to the American health care system. The estimated annual cost per patient is $750, which includes routine care items for incontinence, such as peripads and laundry (Subak et al., 2008). This personal cost translates into a societal cost of $12 billion to $20 billion annually when including medical treatment, nursing home admissions, and complications associated with UI (Chong, Khan, & Anger, 2011; Subak et al., 2008).

The prevalence of UI and its significant impact on women's lives is substantial. The consequences of UI are numerous and can affect patients' health and quality of life on many levels. It is imperative that health care providers become knowledgeable on the evaluation of female UI so they may better serve their patient population. In addition, increasing provider awareness on the non-surgical, evidence-based treatment options existing for stress UI will significantly im prove the quality of life for many suffering women (Melville et al., 2005).