Skip to main content Skip to main navigation menu Skip to site footer

The Risk Factor Associated with Stress Urinary Incontinence (SUI) Severity: a Cross-Sectional Multi-centered Study

  • Surahman Hakim ,
  • Budi Iman Santoso ,
  • Harrina Erlianti Rahardjo ,
  • Siti Setiati ,
  • Widjajalaksmi Kusumaningsih ,
  • Joedo Prihartono ,


Background: Stress urinary incontinence is defined as involuntary loss of urine on effort or exertion or with coughing or sneezing. SUI affects as many as 75% of older women, 44-57% of middle-aged, and 25% of young women. Risk factors include age, parity, vaginal birth, menopause, obesity, body mass index, diabetes, hysterectomy, chronically increased abdominal pressure, genetic factors, physical activity level, smoking, diet, and family history. Our purpose was to determine which risk factors are associated with the severity of stress urinary incontinence using a 1-hour pad test.

Method: This cross-sectional multicentered study was performed on 178 women who complained of incontinence and had completed QUID for SUI. We collected data using a pad test, and we classified those women into two main groups, women with mild SUI with 1-hour pad test results 1-10 g and women with moderate and severe SUI with 1-hour pad test results more than 10 g. We use Phi and Cramer’s V to calculate the effect size of each risk factor.

Results: There were 20 women with moderate and severe SUI, and 158 had mild SUI. We analyzed the risk factors associated with moderate-severe SUI women and found that age (p=0.03), perineometer result (p = 0.04), and level of education (p=0.02) are statistically significant.

Conclusion: The severity of stress urinary incontinence is related to age, perineometer result, and level of education.


  1. Ströher RLM. Metabolic syndrome in women with and without stress urinary incontinence. International Urogynecology Journal. 2019.doi:
  2. Stangel-Wojcikiewicz K. Urogynecology Section of the Polish Society of Gynecologists and Obstetricians guidelines on the management of stress urinary incontinence in women. Ginekologia Polska. 2021;92:822-8.doi:10.5603/GP.a2021.0206.
  3. Yazdany T. American Urogynecologic Society Systematic Review: The Impact of Weight Loss Intervention on Lower Urinary Tract
  4. Symptoms and Urinary Incontinence in Overweight and Obese Women. Female Pelvic Medicine & Reconstructive Surgery. 2020;26:16-29.doi:10.1097/SPV.0000000000000802.
  5. Milsom I. The prevalence of urinary incontinence. Climacteric. 2019;22:217-22.doi:10.1080/13697137.2018.1543263.
  6. Pelvic Floor Disorders. Second ed. Ian Milsom MG, editor. Switzerland: Springer Nature Switzerland AG; 2021.
  7. Sharma N, Chakrabarti S. Clinical Evaluation of Urinary Incontinence. J Midlife Health. 2018;9(2):55-64.doi:10.4103/jmh.JMH_122_17.
  8. Krhut J, Zachoval R, Smith PP, Rosier PF, Valansky L, Martan A, et al. Pad weight testing in the evaluation of urinary incontinence. Neurourol Urodyn. 2014;33(5):507-10.doi:10.1002/nau.22436.
  9. Moegni F, Wengkang IFO. Correlation of levator ani muscle strength measurement between Modified Oxford Grading Scale and perineometer on pelvic organ prolapse patient. Urogynaecologia. 2021;33(1).doi:10.4081/uij.2021.268.
  10. Steeves JA, Tudor-Locke C, Murphy RA, King GA, Fitzhugh EC, Harris TB. Classification of occupational activity categories using accelerometry: NHANES 2003-2004. Int J Behav Nutr Phys Act. 2015;12:89.doi:10.1186/s12966-015-0235-z.
  11. Pizzol D, Demurtas J, Celotto S, Maggi S, Smith L, Angiolelli G, et al. Urinary incontinence and quality of life: a systematic review and meta-analysis. Aging Clin Exp Res. 2021;33(1):25-35.doi:10.1007/s40520-020-01712-y.
  12. McKellar K, Abraham N. Prevalence, risk factors, and treatment for women with stress urinary incontinence in a racially and ethnically diverse population. Neurourol Urodyn. 2019;38(3):934-40.doi:10.1002/nau.23930.
  13. Hallock JL, Handa VL. The Epidemiology of Pelvic Floor Disorders and Childbirth: An Update. Obstet Gynecol Clin North Am. 2016;43(1):1-13.doi:10.1016/j.ogc.2015.10.008.
  14. Milsom I, Ekelund P, Molander U, Arvidsson L, Areskoug B. The Influence of Age, Parity, Oral Contraception, Hysterectomy and Menopause on the Prevalence of Urinary Incontinence in Women. Journal of Urology. 1993;149(6):1459-62.doi:10.1016/s0022-5347(17)36415-7.
  15. Gasquet I, Tcherny-Lessenot S, Gaudebout P, Bosio Le Goux B, Klein P, Haab F. Influence of the severity of stress urinary incontinence on quality of life, health care seeking, and treatment: A national cross-sectional survey. Eur Urol. 2006;50(4):818-25.doi:10.1016/j.eururo.2006.03.052.
  16. Sharma T. Risk Factors for Stress Urinary Incontinence in Women. International Journal of Contemporary Medical Research 2017;4(10):2031-5
  17. Elliott AM. Incongruous consultation behaviour: results from a UK-wide population survey. 2012;13(21)
  18. Akkus Y. Evaluation of the prevalence, type, severity, and risk factors
  19. of urinary incontinence and its impact on quality of life
  20. among women in Turkey. Int Urogynecol 2015.doi:10.1007/s00192-015-2904-5.
  21. Kolodynska G, Zalewski M, Rozek-Piechura K. Urinary incontinence in postmenopausal women - causes, symptoms, treatment. Prz Menopauzalny. 2019;18(1):46-50.doi:10.5114/pm.2019.84157.
  22. Barnas E, Baranska E, Gawlik B, Zych B. Factors most significantly affecting quality of life in women with urinary incontinence. HYGEIA Public Health. 2015;50:643-8
  23. Zhang RQ, Xia MC, Cui F, Chen JW, Bian XD, Xie HJ, et al. Epidemiological survey of adult female stress urinary incontinence. BMC Womens Health. 2021;21(1):172.doi:10.1186/s12905-021-01319-z.
  24. Townsend MK, Curhan GC, Resnick NM, Grodstein F. BMI, waist circumference, and incident urinary incontinence in older women. Obesity (Silver Spring). 2008;16(4):881-6.doi:10.1038/oby.2008.14.
  25. Jackson SL. Urinary Incontinence and Diabetes in Postmenopausal Women. Diabetes Care. 2005;28(7):1730–8
  26. FitzGerald MP. Pelvic-Floor Strength in Women With Incontinence as
  27. Assessed by the Brink Scale. Physical Therapy. 2007;87(10):1316 –24
  28. Mostwin J. Patophysiology of SUI in Women: Urethral Stucture, Support and Function In: Bourcier A, editor. Pathophysiology of Urinary Incontinence, Fecal Incontinence and Pelvic Organ Prolapse. 3rd ed: Plymouth: Health Publication Ltd; 2005. p. 436-62.
  29. Amaro JL, Moreira EC, De Oliveira Orsi Gameiro M, Padovani CR. Pelvic floor muscle evaluation in incontinent patients. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16(5):352-4.doi:10.1007/s00192-004-1256-3.

How to Cite

Hakim, S., Santoso, B. I. ., Rahardjo, H. E. ., Setiati, S. ., Kusumaningsih, W. ., & Prihartono, J. . (2023). The Risk Factor Associated with Stress Urinary Incontinence (SUI) Severity: a Cross-Sectional Multi-centered Study. Bali Medical Journal, 12(1), 631–635.




Search Panel

Surahman Hakim
Google Scholar
BMJ Journal

Budi Iman Santoso
Google Scholar
BMJ Journal

Harrina Erlianti Rahardjo
Google Scholar
BMJ Journal

Siti Setiati
Google Scholar
BMJ Journal

Widjajalaksmi Kusumaningsih
Google Scholar
BMJ Journal

Joedo Prihartono
Google Scholar
BMJ Journal