Urinary Incontinence in New Zealand - Everyone's Problem

Urinary incontinence has recently been identified by the World Health Organisation as a major health issue in developed and developing nations. 

New Zealand needs to take action to address this health issue.

Urinary incontinence affects all age groups. Urinary incontinence is an important problem in children. This is a problem so common it is given its own name, enuresis. Excellent New Zealand information gives the prevalence of nocturnal enuresis of around 13% of children between age 5 and 10 and 5% of children between the age of 11 and 15. Based on the 2013 Census over 45,000 children over the age of 5 have nocturnal enuresis.

Urinary incontinence is also very common in women with excellent New Zealand information to show that 17% of adult women have bothersome urinary incontinence. Based on the population estimates from the 2013 Census over 175,000 women have bothersome urinary incontinence. The prevalence is even higher in adult Māori women at 47%. Only a small proportion of women with urinary incontinence seek health professional assistance and Māori women in particular do not seek health care assistance. A small proportion of adult men have urinary incontinence but this still represents 47,000 people.

Urinary incontinence affects all age groups.

A face to face survey of older residents in Gisborne found that 7.4% of people over age 65 had urinary incontinence more than two to three times a week or had an indwelling urethral catheter. Based on the 2013 Census over 45,000 New Zealanders over the age of 65 have severe urinary incontinence. A report on all residents in residential care in Auckland in 1993 showed about 50 % had urinary incontinence. Based on the 2013 Census this means that over 15,000 people living in residential care have urinary incontinence.

For Māori and Muslim women strong cultural taboos make seeking access to health care even more difficult.

Urinary incontinence is not a lethal condition but it is certainly not a glamorous one. It is strongly associated with poor quality of life and self esteem, social isolation and depression. Women with urinary incontinence avoid sex.

Current services in New Zealand are inadequate, inequitable and fragmented. Continence NZ is conducting a sample survey of current services. There are no national written standards for continence services in New Zealand. Health professionals feel they have inadequate training in the assessment and management of urinary incontinence. The financial cost for urinary incontinence has been estimated at 3,565 US dollars per year per person.

Continence NZ has been promoting public awareness of urinary incontinence in New Zealand for a number of years. The New Zealand Continence Association strongly believes now is the time for health agencies, and in particular the Health Funding Authority, to develop a national strategy to address this health problem that affects at least 1.1 million New Zealanders.

Bibliography

1. Abrams P, Khoury S, Wein A
Incontinence: Proceedings of the first international consultation on incontinence.

2. Broad JB, Richmond DE, Bonita R, Baskett JJ
Changes in long term care of older people in Auckland between 1988 and 1993 Auckland: Academic Section of Geriatric Medicine, University of Auckland, 1995

3. Campbell AJ, Reinken J, McCosh L
Incontinence in the elderly: Prevalence and prognosis Age Ageing 1985;14:65-70

4. Disability Counts
Statistics New Zealand
Statistics New Zealand, Wellington, 1998

5. Dovey S, McNaughton T, Tilyard M, Jolleys J, Wilson D
General practitioner's opinions of continence care training
NZ Med J 1996;109:340-3

6. Feehan M, McGee R, Stanton W, Silva PA
A 6 year follow-up of childhood enuresis: Prevalence in adolescence and consequences for mental health
J Paediatr Child Health 1990;26:75-79

7. Fergusson DM, Horwood LJ, Shannon FT
Factors related to age of attainment of nocturnal bladder control: An 8 year longitudinal study
Pediatrics 1986;78:884-890

8. Holst K, Wilson PD
The prevalence of female urinary incontinence and reasons for not seeking treatment
NZ Med J 1988;101:756-758

9. Lara C, Nacey J
Ethnic differences between Māori, Pacific Island and European New Zealand women in prevalence and attitudes to urinary incontinence
NZ Med J 1994;107:374-376

10. New Zealand Now: 65 plus
Statistics New Zealand
Statistics New Zealand, Wellington, 1998

11. Rutchik SD, Resnick MI
The epidemiology of incontinence in the elderly
British Journal of Urology 1998;82:S1-S4

12. Scott D
Summary of aged residential care utilisation and expenditure July 1995-June 1998
A report to the National Health Committee, February 1999