Addressing the gender gap in urinary continence care
Urinary incontinence is a common condition that affects both men and women, and with profoundly negative effects. Prevalence figures do show that it is more common in younger women than men, but as people age the difference decreases, with research identifying that one in three older men have continence issues. However, even with this increase, there is little direct best practice guidance on addressing male urinary incontinence compared to that for women. Professionals seem to be unaware that men have known existing barriers to accessing health care and this would be especially true of such an embarrassing condition. There seems to be a lack of education in identifying symptoms and assessing and little thought to appropriate management if required. This can also be true of manufacturers that provide continence management equipment. This article will look at some of these themes and highlight the gender gaps and give guidance on how professionals may address these.
Urinary incontinence is a common condition that can affect both women and men of all ages, and it can have profoundly negative effects on quality of life (Nursing Times, 2019). Meeting the required needs of both male and female patients can be challenging, especially as incontinence is predominantly considered a female problem, with a ratio of nearly 2:1 female sufferers (approximately 55% cases are among females) (Helfand et al, 2018). This mindset has led to health inequalities and disparity in continence services provided for men with incontinence, with most male continence needs being unmet or neglected (Stenzelius, 2005; Nursing Times, 2019). The World Health Organization (WHO) defined health inequalities as differences in health status or in the distribution of health determinants among different population groups (NHS England, 2015). Health professionals are aware that men access healthcare less than women, with detrimental consequences (Lancet, 2019), and this is no different within continence care. Health professionals should not assume that guidance and clinical policies are adequate for addressing male incontinence, and this has been identified by the WHO, which now has a strategy to make health systems ‘gender responsive’ (Baker, 2019).
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