Prevalence, associated factors, and quality of life impact of urinary incontinence in heart failure patients: A multicenter cross-sectional study from a low- and middle-income country.

BACKGROUND

Urinary incontinence (UI) is a frequent yet often neglected issue in patients with chronic heart failure (HF), significantly impacting their quality of life (QoL) and possibly hindering adherence to treatment. However, there is limited research on its prevalence, risk factors, and effects in low- and middle-income countries. This study seeks to assess the prevalence of UI among individuals with HF, identify related demographic, clinical, and treatment factors, and evaluate its influence on the patients' QoL.

METHODS

This cross-sectional study included 148 HF patients from two major hospitals and used convenience sampling. Data on demographics, medical characteristics, and UI were obtained via the Urogenital Distress Inventory-6 (UDI-6) and the Incontinence Impact Questionnaire-7 (IIQ-7). Statistical methods were applied to determine associations between patient factors and UI severity.

RESULTS

The prevalence of UI among HF patients was 46.6% (69 out of 148 participants). Compared with male participants, female participants had significantly higher median UDI-6 scores (27.7 [16.6-38.8] vs. males, p = 0.007) and higher IIQ-7 scores (mean rank 84.36, p = 0.002). Diuretic use was significantly associated with greater UI severity, reflected by higher median UDI-6 scores (27.7 [11.1-33.3], p = 0.025) and higher IIQ-7 scores (p = 0.04). Nonsmoking status was significantly associated with higher UI burden, with a median UDI-6 score of 27.7 (16.6-38.8) and a higher IIQ-7 mean rank (83.77; both p < 0.05). Similarly, participants who did not consume caffeine demonstrated significantly higher UI scores, with a median UDI-6 score of 33.3 (19.4-54.1) and a higher IIQ-7 mean rank (98.53; both p < 0.05). In contrast, age, body mass index, duration of heart failure, hypertension, and diabetes mellitus were not significantly associated with UI severity.

CONCLUSIONS

UI is prevalent among HF patients and adversely affects their QoL. Recognizing associated factors such as sex and diuretic use can help clinicians design targeted management strategies.