ABSTRACT
Urinary incontinence [UI] is a common condition, but previous studies have shown that only about 20% of individuals with UI seek medical care for treatment of their symptoms. The determincnts of treatment seeking are not well understood. Little is known about the effect of gender on health care-seeking behaviors. The objective of this study was to determine gender differentials in factors associated with patients' decisions to seek treatment for urinary incontinence This was a descriptive, hospital based case series study. It was carried out during the first half of the year 2008 in the Urology and Obstetrics and Gynaecology departments of Main University Hospital and El-Shatby University Hospital, Alexandria. As part of purposeful sampling, all participants were selected from the clinic and admission lists. All studied subjects were enrolled by the investigators after signing informed consent and provided they complied with inclusion/exclusion criteria. Data were collected using pre-tested, precoded interview format. In-depth interview was carried out by the investigators themselves to answer the questions because the topic is poorly understood and the research is perception-oriented. We hypothesized that gender differences in treatment seeking for UI would not be explained only by socio-demographic factors, clinical presentation, and symptom impact, but also some important psychosocialfactors of the respondent as well. To test the hypothesis, we developed a multivariate logistic regression modelfor each gender. Information was collected from 353 UI patients out of a total of 374 patients registered in those clinics and admission list during the recruitment period of the study. Thus the response rate was 94.4%. There were 113 [32.0%] males and 240 [68.0%] females. Thus male to female ratio was 1: 2.12. The present study found differences in males and females regarding specific psychosocial factors motivating health care-seeking behaviour. Certain inequality was observed in hospital admission, use of diagnostic procedures, days of hospital stay and surgeries in thai they proved less frequent among women. More women suffered from at least one negative impact on their social lives compared to men. Additionally, the impact of UI on sexual life was not associating with seeking treatment for both men and women. The impact of symptoms on quality of life appears to be the main trigger for seeking help for UI in both men and women. After adjustment for confounders, women's decisions to seek treatment for urinary incontinence were significantly associated with mixed type of UI, severe UI, perceptions about underlying causes of UI, attitude towards health care use, worse social impact score and worse diseasespecific quality of life scores. However, illiteracy and self care practices were adversely affect women's care seeking behavior. In men help-seeking was related to the presence of co-morbid condition, severe UI, associated lower urological complaints, satisfaction with medical care offered, high expectation of benefit from treatment and worse disease-specific quality of life scores. Since the present results revealed gender differences in determinants of UI health care seeking behaviour, strategies to enhance care-seeking for urinary incontinence should consider the role of gender in personal knowledge, needs and behaviors for UI management in adults. Educating physicians and the public about the factors associated with treatment seeking as well as the available treatment options may help women and men to seek and receive more timely care for incontinence symptoms