Updated 25 January 2018

Is urinary incontinence a predictor of death?

Urinary leakage does not only leave your pants wet and your face red, but new research suggests it can be an indicator of death.

Urinary incontinence is the involuntary loss of urine and whilst it’s an embarrassing problem, most people don’t think of it as deadly.  

But a recent and comprehensive study found urinary incontinence is “a predictor of higher mortality in the general and particularly in the geriatric population”.

Read: Urinary incontinence after prostate surgery

The study, conducted by researchers from Geneva University Hospitals in Switzerland, consisted of a systematic review and meta-analysis of observational studies that compared death rates among patients suffering from urinary incontinence to those without incontinence. It found the association with death increases with the severity of incontinence.

This review included 158 456 patients from 19 countries. All but three out of 38 studies found a positive association between urinary incontinence and death.

Many factors at play

According to the researchers, many factors are most likely at play in the link between urinary incontinence and death.

“Urinary incontinence and death is probably multifactorial. On the one hand, risk factors for the development of incontinence by themselves have a negative impact on survival,” the study found.

Read: How incontinence can mess with your mental health

Incontinence is not a disease in itself, but is often a symptom or indication of a more serious illness. As the incontinence increases, the potential threat of the underlying condition also increases. Some of these conditions are not noticeable until it’s too late, but not having control of your bladder can be an early warning sign of something sinister brewing.

The severity of urinary incontinence can range from a few drops of leaking urine when one coughs or sneezes to a complete emptying of the bladder. Usually the latter is an indication of a more serious underlying cause. According to the Mayo Clinic, some of the more serious causes of urinary incontinence are:

  • Neurological disorders. Several neurological disorders such as Parkinson's disease, a stroke, a brain tumour or even a spinal injury can disrupt nerve signals involved in bladder control, and this can lead to urinary incontinence.
  • An enlarged prostate. Benign prostatic hyperplasia is a condition in which the prostate is enlarged. This leads to more pressure on the urethra, and the bladder wall becomes thicker. Over time this weakens the bladder’s ability to retain urine.
  • Cancer or obstruction. An obstruction in the urinary tract such as urinary stones or even a cancerous tumour can obstruct normal flow and can lead to urine leakage.

Read: The 4 types of urinary incontinence

The study from Switzerland also indicates that urinary incontinence can increase the risk of falls and related injuries, depression and infections. The latter affects 20% of patients suffering from urinary incontinence and causes a mortality rate of 0.3%. Falls and depression increase mortality by 15% and 17% respectively.

Link remains controversial

Many experts agree that it’s controversial to attribute death to a condition such as urinary incontinence, because it does not directly cause death. One can’t die from incontinence, but many studies found it can be a reliable predictor of death due to another disorder.

“The exact interaction between [for instance] fall, depression, infection and incontinence is difficult to assess and must have multiple interconnections,” the study emphasises.

“Since all of those symptoms are frequent in the general elderly population and share many confounding factors, mortality is probably not entirely explained by those conditions.”

According to the study urinary incontinence should be used as a screening tool to avoid premature death, especially in the elderly. 

Read more:

Cigarette smoking a strong risk factor for urinary incontinence

How physiotherapy can reduce urinary incontinence


Ask the Expert

Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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