Stress urinary incontinence (SUI) is a common condition among women of all ages, often with devastating
consequences, such as depression, anxiety and reduced quality of life. Researchers have largely
focused on its prevalence and clinical management, particularly in highly industrialized country settings.
In this article, drawing on epidemiological, clinical and qualitative research undertaken in Sri Lanka, we
discuss how stress incontinence affects women’s lives and how they personally manage the problem.
Quantitative data derive from a community-based descriptive cross-sectional study, conducted in 2006–
2007 with 1718 ever-married women, aged 15–49, of whom 9.8% reported problems of stress incontinence.
Six focus group discussions, eight key informant interviews and five case studies with women
with SUI were also undertaken to gain insight and depth. Although incontinence affected outdoor
activities, sexual life, and sense of wellbeing, women did not consider it a health problem, rarely discussed
it with others, and rarely sought treatment. Barriers to help seeking included fear of vaginal
examination, shame and embarrassment, and belief that SUI was a natural consequence of aging and
childbirth. Women’s reluctance to seek advice on their own initiative about managing incontinence
indicates the importance for health providers to pay greater attention to the condition and introduce
appropriate preventive measures for women. This might include creating greater public awareness of SUI
as preventable and treatable, ensuring a clinical environment conducive to discussing problems related
to bodily functions.