Epidemiology and natural history of urinary incontinence in women☆
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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