{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:27:29Z","timestamp":1790947649099,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Urinary incontinence (UI) is highly prevalent amongst women around the world. In this review article we explore UI, its consequences and treatment in sub\u2010Saharan Africa, providing specific examples from Uganda and Malawi. In sub\u2010Saharan Africa the prevalence of UI is difficult to assess because of the wide variation in reporting resulting from patients hiding their condition due to the associated stigma in many communities. Whilst much of the literature from low\u2010 or low\u2010middle\u2010income countries focuses on UI from pelvic floor fistula, recent evidence demonstrates that non\u2010fistulous stress, urgency and mixed UI are highly prevalent in sub\u2010Saharan Africa. Incontinence secondary to vesico\u2010vaginal fistula can be related to obstetric causes, mainly obstructed labour. The risk factors for non\u2010fistulous incontinence are similar to those identified in high\u2010income countries, including high parity, vaginal and assisted delivery, gestational age, constipation, obesity, chronic cough and ageing. Urinary incontinence has significant social and emotional consequences, with a high proportion of women in African countries reporting relationship problems, depression and suicidal ideation. There is poor understanding of the perceived aetiology of incontinence in sub\u2010Saharan Africa, which may, in part, act as a barrier for women to seek medical advice. Innovative solutions have been found to manage the large number of obstetric fistulas that are prevalent across Africa, but a lack of capacity in specialists trained to treat women with UI means that more doctors, medical officers and better resource prioritization will be required to help the, as yet unquantified, number of women with non\u2010fistulous leakage. Better patient peri\u2010natal education may reduce the incidence of fistula still further, especially if the stigma felt by women with incontinence is overcome and they are encouraged to seek treatment.<\/jats:p>","DOI":"10.1111\/bju.15903","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T05:12:55Z","timestamp":1664169175000},"page":"543-549","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Female urinary incontinence in\n                    <scp>sub\u2010Saharan<\/scp>\n                    Africa"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2889-5494","authenticated-orcid":false,"given":"Danielle","family":"Whiting","sequence":"first","affiliation":[{"name":"University Hospitals Sussex NHS Foundation Trust  Worthing UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asiimwe Ian","family":"Shane","sequence":"additional","affiliation":[{"name":"Arua Regional Referral Hospital  Arua Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Pope","sequence":"additional","affiliation":[{"name":"Cleveland Medical Center Urology Institute, University Hospitals"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5359-1877","authenticated-orcid":false,"given":"Stephen","family":"Payne","sequence":"additional","affiliation":[{"name":"Urolink, British Association of Urological Surgeons  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzie","family":"Venn","sequence":"additional","affiliation":[{"name":"University Hospitals Sussex NHS Foundation Trust  Worthing UK"},{"name":"Urolink, British Association of Urological Surgeons  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2010.09993.x"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-164"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1596\/978-1-4648-0346-8_ch6"},{"key":"e_1_2_13_5_1","unstructured":"ICS. 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