Elsevier

Urology

Volume 62, Issue 4, Supplement 1, October 2003, Pages 16-23
Urology

Epidemiology and natural history of urinary incontinence in women

https://doi.org/10.1016/S0090-4295(03)00755-6Get rights and content

Abstract

Understanding the epidemiology (distribution and determinants) of urinary incontinence (UI), as well as its natural history is a very important issue. In this article, we discuss prevalence, incidence, natural history, and the variations that may be related to race and ethnicity. We focus on epidemiologic population comprising community-dwelling women who are not institutionalized. Our review clearly shows that there is a lack of advanced epidemiologic analyses. Variables that better characterize UI include frequency measure, quantity of urine loss, duration, type, and severity. These factors should be incorporated into basic study design so that more advanced and informative analyses may be conducted.

Section snippets

Basic epidemiologic considerations

Cohort studies and case-control studies are the most common types of observational studies in epidemiology. However, caution is always needed when interpreting the results from such studies because associations may not be the same as causes. Longitudinal designs are preferable but uncommon.

The levels of evidence used for therapeutic interventions cannot be used in epidemiologic studies because no uniform guidelines for assessing these results exist. The level of evidence in observational

Prevalence

Several reviews of epidemiologic studies of UI are available, including some fairly recent ones.2, 3, 4, 5, 6, 7, 8 Differences in sample, definition and measurement, and survey methodology continue to make reviews challenging. Table I lists some of the prevalence data reported for samples of women from community-residing populations, showing widely varying estimates.9, 10, 11, 12, 13, 14, 15, 16, 17, 18

More epidemiologic research is available on older women of all ages because UI is

Conclusions

Prevalence estimates for female incontinence across studies show a wide range of some degree of UI. The inconsistency may be explained by such factors as different definitions of UI, study sample and survey procedure variances, or variation in the effects of intervention. The median level of prevalence estimates gives a picture of increasing prevalence during young adult life (prevalence, 20% to 30%), a broad peak around middle age (30% to 40%), and then a steady increase in the elderly

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    Steinar Hunskaar has received consultation fees, unrestricted research grants, and funding for travel from Eli Lilly and Company Ltd., as well as other companies engaged in incontinence research

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