Original articles
A community-based epidemiological survey of female urinary incontinence:: The Norwegian EPINCONT Study

https://doi.org/10.1016/S0895-4356(00)00232-8Get rights and content

Abstract

Objectives: The aim was to assess the prevalence of any urinary leakage in an unselected female population in Norway, and to estimate the prevalence of significant incontinence. Methods: The EPINCONT Study is part of a large survey (HUNT 2) performed in a county in Norway during 1995–97. Everyone aged 20 years or more was invited. 27,936 (80%) of 34,755 community-dwelling women answered a questionnaire. A validated severity index was used to assess severity. Results: Twenty-five percent of the participating women had urinary leakage. Nearly 7% had significant incontinence, defined as moderate or severe incontinence that was experienced as bothersome. The prevalence of incontinence increased with increasing age. Half of the incontinence was of stress type, 11% had urge and 36% mixed incontinence. Conclusions: Urinary leakage is highly prevalent. Seven percent have significant incontinence and should be regarded as potential patients.

Introduction

Urinary incontinence is a common condition among women [1]. The estimates of the prevalence of incontinence do, however, vary widely 2, 3, 4. The differing results can partly be attributed to the use of different definitions of incontinence [2]. Study samples selected on different criteria and variations in survey procedures also contribute to varying prevalence estimates.

In 1998 the 1st International Consultation on Incontinence recommended the development of standardized instruments for measuring the prevalence of incontinence in community surveys, including a screening question for any involuntary loss of urine, a measure of frequency, quantity, and duration [2].

The EPINCONT (Epidemiology of Incontinence in the County of Nord-Trøndelag) study was designed in accordance with these recommendations. It is a community-based survey performed in collaboration with the National Health Screening Service of Norway. As far as we know, it is the largest epidemiological survey carried out on urinary incontinence. In this article, we report the crude prevalence rates and emphasize analyses on age, severity, and type of incontinence.

Section snippets

Subjects and methods

The Nord-Trøndelag Health Survey 2 (HUNT 2) was a large survey performed in one county in Norway during the years 1995–97. This county has a geographical, demographical, and occupational structure fairly representative of Norway as a whole, although the average income and the prevalence of higher education is somewhat less than the average for Norway. Everyone aged 20 years or more (n = 94,197) residing in the county were invited to participate. The complete HUNT 2 survey covered many topics,

Results

Twenty-five percent of the women reported that they had involuntary loss of urine. The mean age of the incontinent women was 53.2 years versus 47.7 years for the continent women. The prevalence of incontinence increased with increasing age (Table 2). The lowest prevalence was observed in the younger age groups (12% for women <30 years), the highest was observed among the eldest (40% for women >90 years). However, there was also a peak around mid-age with a prevalence of 30% among women 50–54

Discussion

This survey confirms that involuntary loss of urine is highly prevalent among adult women. While one of four women experienced any leakage of urine only one of 15 had symptoms of significant incontinence.

One strength of this survey is that a whole community was invited. The overall response rate for our study was good. However, the youngest and the eldest women did not participate to the same degree as the middle-aged, and this may have introduced a bias. The young non-participants may

Conclusion

Involuntary loss of urine is a common symptom among adult community-dwelling Norwegian women. The prevalence of any incontinence is increasing with increasing age as is the prevalence of severe incontinence.

Seven percent of our study population had significant urinary incontinence, and we recommend that they should be regarded as potential patients while those with less problems should be offered information and advice on self-care.

Acknowledgements

The Nord-Trøondelag Health Study (The HUNT Study) was a collaboration between the National Health Screening Service of Norway, Oslo, The National Institute of Public Health, Community Research Unit, Verdal, The Nord-Trøndelag County Council, and The Norwegian University of Science and Technology (NTNU). The EPINCONT Study was also supported by a grant to Professor Hunskaar and Dr. Hannestad from the Research Council of Norway.

References (31)

  • S Hunskaar et al.

    Epidemiology and natural history of urinary incontinence (UI)

  • C Hampel et al.

    Prevalence and natural history of female incontinence

    Eur Urol

    (1997)
  • D Thom

    Variation in estimates of urinary incontinence prevalence in the communityeffects of differences in definition, population characteristics, and study type

    J Am Geriatr Soc

    (1998)
  • H Sandvik et al.

    Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey

    J Epidemiol Community Health

    (1993)
  • H Sandvik et al.

    A severity index for epidemiological surveys of female urinary incontinence. Comparison with 48-hour pad weighing tests

    Neurourol Urodyn

    (2000)
  • Cited by (1129)

    • Parsimony prevails: Botulinum toxin and the overactive rectum

      2024, The Lancet Gastroenterology and Hepatology
    View all citing articles on Scopus
    View full text