--- title: "Health care utilization in women with UI is low. | Sutter Health" description: "Only a minority with UI appears to seek care and a fraction sees a pelvic floor specialist. It's important to educate women and PCPs." url: "https://www.sutterhealth.org/research/publications/health-care-utilization-in-women-with-ui-is-low-1055312611" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Health care utilization in women with UI is low. # The iceberg of health care utilization in women with urinary incontinence. Minassian VA, Yan X, Lichtenfeld MJ, Sun H, & Stewart WF. _Int Urogynecol J. 23(8):1087-93. doi: 10.1007/s00192-012-1743-x. Epub 2012 Apr 12._ 2012-08-01 ## Abstract INTRODUCTION AND HYPOTHESIS: The objective of the study was to estimate prevalence of urinary incontinence (UI) health care utilization in women from the population up to specialty care. METHODS: The General Longitudinal Overactive Bladder Evaluation-UI (GLOBE-UI) is a population-based study on the natural history of UI in women  ≥  40 years of age. Prevalence of UI was estimated by using the Bladder Health Survey (BHS). Survey data were linked with electronic health records to build the different steps of the iceberg of disease. Descriptive statistics were used to estimate the prevalence estimates at all levels of the iceberg. RESULTS: A total sample of 7,059 women received the BHS. Of those, 3,316 (47 %) responded. Prevalence of UI was 1,366 (41 %). Women with or without UI did not differ by age or marital status. However, women with versus without UI were more parous (91 vs 87 %), significantly more overweight or obese (74 vs 61 %), and more likely to have a college education or higher (54 vs 46 %), P < 0.01. Nine hundred fifty-eight (73 %) women with UI reported duration of more than 2 years and 72 % reported moderate to severe UI symptoms. Of all 1,366 women with BHS UI diagnosis, only 339 (25 %) sought care, 313 (23 %) received some care, and 164 (12 %) received subspecialty care. CONCLUSIONS: UI is a highly prevalent disease. Only a minority with UI appears to seek care and a fraction sees a pelvic floor specialist. It is important not only to educate women, but also primary care providers about this highly prevalent yet treatable condition. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/22527544) ![Xiaowei (Sherry) Yan, Ph.D.](https://dyn.mktgcdn.com/p/NTWox_hkmxIRiqJEc5PXKeBkfR_WMtpSQbEI4J69Xls/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Xiaowei (Sherry) Yan, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/xiaowei-sherry-yan-phd-1049681042) ## Research topics - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) - [Urologic Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Urologic+Diseases%5C%22%22) - [Women's Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Women%27s+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Clinical validation of the Bladder Health Survey for urinary incontinence in a population sample of women.](https://www.sutterhealth.org/research/publications/clinical-validation-of-bladder-health-survey-for-ui-1055312569) Minassian VA, Yan XS, Sun H, Platte RO, Stewart WF. Int Urogynecol J. 27(3):453-61. doi: 10.1007/s00192-015-2849-8. Epub 2015 Sep 19. 2016 Mar 01 - Publication ### [Predictors of care seeking in women with urinary incontinence.](https://www.sutterhealth.org/research/publications/predictors-of-care-in-women-with-urinary-incontinence-1055312738) Minassian VA, Yan X, Lichtenfeld MJ, Sun H, Stewart WF. Neurourol Urodyn. 31(4):470-4. doi: 10.1002/nau.22235. Epub 2012 Feb 29. 2012 Apr 01 - Publication ### [The interaction of stress and urgency urinary incontinence and its effect on quality of life.](https://www.sutterhealth.org/research/publications/stress-vs-urgency-ui-and-effect-on-qol-1055312598) Minassian VA, Sun H, Yan XS, Clarke DN, Stewart WF. Int Urogynecol J. 26(2):269-76. doi: 10.1007/s00192-014-2505-8. Epub 2014 Oct 3. 2015 Feb 01 - Publication ### [Does transition of urinary incontinence from one subtype to another represent progression of the disease?](https://www.sutterhealth.org/research/publications/urinary-incontinence-subtype-transition-disease-progression-1055312746) Minassian VA, Yan X, Pilzek AL, Platte R, Stewart WF. Int Urogynecol J. 29(8):1179-1185. doi: 10.1007/s00192-018-3596-4. Epub 2018 Mar 13. 2018 Aug 01 - Publication ### [Mixed incontinence masked as stress induced urgency urinary incontinence.](https://www.sutterhealth.org/research/publications/mixed-incontinence-masked-as-stress-induced-urgency-ui-1055312723) Minassian VA, Yan XS, Pitcavage J, Stewart WF. J Urol. 196(4):1190-5. doi: 10.1016/j.juro.2016.04.084. Epub 2016 May 6. 2016 Oct 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/health-care-utilization-in-women-with-ui-is-low-1055312611#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Health care utilization in women with UI is low."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/health-care-utilization-in-women-with-ui-is-low-1055312611#medicalscholarlyarticle","name":"The iceberg of health care utilization in women with urinary incontinence.","headline":"Health care utilization in women with UI is low.","abstract":"INTRODUCTION AND HYPOTHESIS: The objective of the study was to estimate prevalence of urinary incontinence (UI) health care utilization in women from the population up to specialty care. METHODS: The General Longitudinal Overactive Bladder Evaluation-UI (GLOBE-UI) is a population-based study on the natural history of UI in women ≥ 40 years of age. Prevalence of UI was estimated by using the Bladder Health Survey (BHS). Survey data were linked with electronic health records to build the different steps of the iceberg of disease. Descriptive statistics were used to estimate the prevalence estimates at all levels of the iceberg. RESULTS: A total sample of 7,059 women received the BHS. Of those, 3,316 (47 %) responded. Prevalence of UI was 1,366 (41 %). Women with or without UI did not differ by age or marital status. However, women with versus without UI were more parous (91 vs 87 %), significantly more overweight or obese (74 vs 61 %), and more likely to have a college education or higher (54 vs 46 %), P \u003c 0.01. Nine hundred fifty-eight (73 %) women with UI reported duration of more than 2 years and 72 % reported moderate to severe UI symptoms. Of all 1,366 women with BHS UI diagnosis, only 339 (25 %) sought care, 313 (23 %) received some care, and 164 (12 %) received subspecialty care. CONCLUSIONS: UI is a highly prevalent disease. Only a minority with UI appears to seek care and a fraction sees a pelvic floor specialist. It is important not only to educate women, but also primary care providers about this highly prevalent yet treatable condition.","description":"Only a minority with UI appears to seek care and a fraction sees a pelvic floor specialist. 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