Original articlesA community-based epidemiological survey of female urinary incontinence:: The Norwegian EPINCONT Study
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.
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