Epidemiological study of urge urinary incontinence and risk factors in China

Prevalence, Risk Factors, and Impact on Life of Female Urinary Incontinence: An Epidemiological Survey of 9584 Women in a Region of Southeastern China

Purpose

To investigate the prevalence, risk factors, and impact on quality of life (QOL) of female urinary incontinence (UI) in a region of southeastern China.

Patients and Methods

This cross-sectional study, conducted between June 2022 and March 2023, included 9584 women aged 20-70 years who completed a standardized questionnaire through face-to-face interviews. This sample size represents almost 10% of the population in the target area.

Results

The prevalence of female UI was found to be 24.8%, with stress UI being the most common subtype (12.7%), followed by mixed UI (8.0%) and urgency UI (4.1%). Notably, the prevalence of UI increased progressively with age and body mass index (BMI). The study also revealed several risk factors for UI, including urban residence, postmenopausal status, multiple vaginal deliveries, instrumental vaginal deliveries, previous delivery of macrosomia, and prior history of pelvic floor surgery as determined by multivariate analysis. Furthermore, the study showed that 89.5% of women who reported UI experienced varying degrees of negative impact on their QOL. The incontinence quality of life (I-QOL) scale had an average score of 79.70±19.03, which decreased with increasing severity of UI. Despite the adverse effects on QOL, only 20.6% of women with UI had sought medical help.

Conclusion

UI is common among women in the survey area. UI has been observed to have varying degrees of adverse effects on the QOL of those affected, but most of them do not seek treatment for several reasons, highlighting the urgent need for health authorities to develop effective UI intervention strategies.

Prevalence and severity of urinary incontinence and associated factors in Iranian postmenopausal women: a cross-sectional study

BACKGROUND

Urinary incontinence (UI) is one of the most common symptoms during menopause, leading to a decreased quality of life and limited social activities. This study aimed to determine the prevalence and severity of urinary incontinence and associated risk factors in postmenopausal women.

METHODS

It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021-2022. Data were collected using questionnaires of socio-demographic characteristics, Questionnaire for Urinary Incontinence Diagnosis (QUID), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF). Multivariate logistic regression was used to determine factors related to urinary incontinence.

RESULTS

The overall prevalence of urinary incontinence was 39.5%; 20.6% stress urinary incontinence (SUI), 10.4% urgency urinary incontinence (UUI), and 8.5% mixed urinary incontinence (MUI). Multivariate logistic regression analysis showed that the prevalence of SUI (aOR 0.38; 95% CI 0.18-0.77) and UUI (aOR 0.38; 95% CI 0.15-0.94) was significantly lower in women with three childbirths than the ones with fewer childbirths. Also, the odds of UUI increased significantly in women at the 50-55 age range (aOR 3.88; 95% CI 1.16-12.93) than those less than 50 years.

CONCLUSION

Due to the high prevalence of urinary incontinence in postmenopausal women, caregivers should screen for early diagnosis and appropriate treatment of urinary incontinence to prevent its destructive impact on the quality of life.

Prevalence and sociodemographic correlates of urinary incontinence in Japanese women: A web-based cross-sectional study

BACKGROUND

Epidemiological studies on urinary incontinence that used a validated international standard questionnaire are limited in Japan, and few studies have examined the sociodemographic and behavioral correlates of urinary incontinence.

OBJECTIVE

The aim of this study was to estimate the prevalence of urinary incontinence according to the Japanese version of the International Consultation on Incontinence Questionnaire-Short Form, and its sociodemographic and behavioral correlates among Japanese women.

DESIGN

A web-based cross-sectional study.

METHODS

A randomly sampled cross-sectional Internet survey was conducted in Japan among 3030 women aged 20-64 years. The International Consultation on Incontinence Questionnaire-Short Form score, sociodemographic, body mass index, medical and childbirth history, practice of pelvic floor muscle training, and medical care use were obtained. Descriptive statistics, the chi-square test, and forced-entry logistic regression analysis were used in data analysis.

RESULTS

Participants' average age was 43.4 years, and the response rate was 32.9%. The prevalence of urinary incontinence was 25.5%, and it increased with age. Stress urinary incontinence was the most common subtype (57.4%), followed by urge urinary incontinence (20.3%) and mixed urinary incontinence (16.7%). Less than 5% of those with urinary incontinence had experience with pelvic floor muscle training and medical care use. Middle-aged and older (p < 0.001), overweight and obesity (p < 0.001), vaginal delivery status (p < 0.001), low back pain (p = 0.008), and previous pelvic floor muscle training engagement (p < 0.001) were significantly associated with urinary incontinence.

CONCLUSION

Increasing population awareness of urinary incontinence from an early age and developing effective interventions for the identified at-risk groups, such as the middle-aged and older, those with overweight and obesity, and those with previous pregnancies, are urgently needed.

Risk Factors for Urinary Incontinence in Chinese Women: A Cross-sectional Survey

OBJECTIVE

Urinary incontinence is highly prevalent among women, with a substantial effect on health-related quality of life. This article aimed to investigate the independent factors for urinary incontinence (UI) and the relative importance of each factor.

METHODS

This study was a cross-sectional survey of Chinese women in Guangzhou. Female 20 years and older were invited to participate. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form was used to determine whether respondents are experiencing UI. Univariate and multivariate unconditional logistic regression analyses were performed to determine the significant risk factors associated with UI.

RESULTS

A total of 2626 women were invited to participate in the survey. The response rate was 80.5% (2114/2626). The prevalence of UI among the study population was 31.2%. Old age, increased body mass index, childbirth, family history of any female pelvic floor disorders, symptoms of chronic cough or rhinitis, wearing a corset, and often drinking were independent risk factors for UI.

CONCLUSIONS

Urinary incontinence is common among Chinese women in Guangzhou. Among the factors that we are concerned with, old age and vaginal delivery are the two with greatest impact. Moreover, wearing a corset and drinking are the 2 lifestyle factors associated with UI.

Risk factors and prevalence of urinary incontinence in mid-life Singaporean women: the Integrated Women's Health Program

INTRODUCTION AND HYPOTHESIS

The objective was to identify the prevalence and risk factors for urinary incontinence (UI) in healthy midlife Singaporean women.

METHODS

Healthy women, aged 45-69 years, were assessed for UI and sociodemographic characteristics, including ethnicity, menopausal status, parity, and body mass index (BMI). UI subtypes corresponding to stress (SUI) alone, urge (UUI) alone, mixed (MUI), and leakage (drops only) incontinence were classified using the Urinary Distress Inventory 6 (UDI-6). Risk factors were examined using Chi-squared tests, followed by sequential multivariate logistic regression to estimate adjusted odds ratios (aOR and 95% confidence intervals).

RESULTS

A total of 1,119 women (mean age 56.2 ± 5.2) completed the UDI-6. 52.3% reported any UI; MUI and SUI were the most common, each affecting 20% of women. Post-menopausal women had a lower risk (aOR 0.5 [0.3-0.9]) of SUI, but a higher risk (aOR 4.4 [1.0-19.9]) of UUI compared with premenopausal women. Higher education was negatively associated (aOR 0.3 [0.2-0.7]) with UUI, but positively associated with MUI (aOR 2.3 [1.3-4.0]). Parity (1-2 children) increased the risk of SUI (aOR 1.8 [1.0-3.1]), but reduced the risk of UUI (aOR 0.4 [0.2-0.9]). Obesity was associated with increased risk for MUI (aOR 2.2 [1.4-3.4]) and leakage (aOR 2.0 [1.0-4.1]). Malays and Indians had a higher risk of MUI, having (aOR 2.1 (1.2-3.7) and 1.7 (1.1-2.7) respectively compared with Chinese, a difference mediated by higher BMI.

CONCLUSION

Urinary incontinence is a major morbidity prevalent in healthy midlife Asian women. Post-menopausal status, education level, parity, BMI (and its link with ethnicity) are independent risk factors in this population, and should be incorporated into counseling and targeted interventions.

Profile of physically active elderly women with urinary incontinence

Objective: To design the profile of active elderly women with urinary incontinence (UI) participating in a physical activity program according to sociodemographic characteristics, health conditions, life habits and conditions associated with urinary loss. Methods: A quantitative, cross-sectional, non-probabilistic study of 59 active elderly women. The elderly woman whose score was ≥ 3 according to the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) was considered incontinent. A descriptive analysis was performed by calculating the absolute and relative frequencies. Results: Predominant age between 70 and 79 years (44.1%), widows (32.2%), white (59.3%), complete high school (40.6%) and living alone (52.5%) . The largest proportion never smoked (64.4%) or drank (47.5%), it did not fall in the last year (64.4%), hypertensive (55.9%), had between one and three births (71.2%), were overweight (42.4%) and it did not use an intimate protector (67.8%). Urgency UI was more frequent (50.9%), small amount losses (54.3%), frequency ≤ 1 time per week (42.6%), complaint of nocturia (81.4%) and time of UI between 1 and 4 years (64.4%). Conclusion: The study made it possible to design the profile of active elderly women with UI, which in this study resemble those found in the literature. It is important to emphasize the importance of multidisciplinary work in the search for preventive actions and specialized treatments, aiming to maintain and/or improve the quality of life of incontinent elderly.

Perfil de idosas fisicamente ativas com incontinência urinária

Objetivo: Traçar o perfil de idosas ativas com incontinência urinária (IU) participantes de um programa de atividade física segundo características sociodemográficas, condições de saúde, hábitos de vida e condições associadas à perda urinária. Métodos: Estudo quantitativo, transversal, não probabilístico, composto por 59 idosas ativas. Foi considerada incontinente a idosa cujo escore foi ≥ 3 segundo o International Consultation on Incontinence Questionnaire – Short Form (ICIQ-SF). Realizou-se análise descritiva pelo cálculo das frequências absoluta e relativa. Resultados: Idade predominante entre 70 e 79 anos (44,1%), viúvas (32,2%), brancas (59,3%), ensino médio completo (40,6%) e morando sozinhas (52,5%). A maior parcela nunca fumou (64,4%) ou bebeu (47,5%), não sofreu queda no último ano (64,4%), era hipertensa (55,9%), teve entre um e três partos (71,2%), tinha sobrepeso (42,4%) e não usava protetor íntimo (67,8%). Foi mais frequente a IU de urgência (50,9%), perdas em pequenas quantidades (54,3%), frequência ≤ 1 vez por semana (42,6%), queixa de noctúria (81,4%) e tempo de IU entre 1 e 4 anos (64,4%). Conclusão: O estudo possibilitou traçar o perfil de idosas ativas com IU que, neste estudo, assemelha-se aos encontrados na literatura. Salienta-se a importância da atuação multiprofissional na busca por ações preventivas e tratamentos especializados, visando manter e/ou melhorar a qualidade de vida de idosos incontinentes.

URINARY INCONTINENCE IN ELDERLY PEOPLE: CARE PRACTICES AND CARE PROPOSAL IN PRIMARY HEALTH CARE

ABSTRACT Objective: identify the knowledge and care practices concerning urinary incontinence in elderly women and develop a care proposal for these women for the purpose of health promotion in Primary Health Care. Method: a qualitative, convergent care research was undertaken. The data were collected between August and October 2014 through semistructured interviews and thematic workshops with 14 physiotherapists and ten nurses. The analysis involved apprehension, synthesis, theorization and transference processes, revealing two thematic axes: the professionals' perception of urinary incontinence in elderly women; and the conception of a care proposal for elderly women with urinary incontinence. Results: the professionals' limited knowledge of urinary incontinence was verified, as well as the lack of information on the possible orientations for self-care concerning the urinary symptoms. Conclusion: training actions should be implemented for these professionals with a view to health promotion for self-care.

Long-term Impact of Mode of Delivery on Stress Urinary Incontinence and Urgency Urinary Incontinence: A Systematic Review and Meta-analysis

Context

Stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) are associated with physical and psychological morbidity, and large societal costs. The long-term effects of delivery modes on each kind of incontinence remain uncertain.

Objective

To investigate the long-term impact of delivery mode on SUI and UUI.

Evidence acquisition

We searched Medline, Scopus, CINAHL, and relevant major conference abstracts up to October 31, 2014, including any observational study with adjusted analyses or any randomized trial addressing the association between delivery mode and SUI or UUI ≥1 yr after delivery. Two reviewers extracted data, including incidence/prevalence of SUI and UUI by delivery modes, and assessed risk of bias.

Evidence synthesis

Pooled estimates from 15 eligible studies demonstrated an increased risk of SUI after vaginal delivery versus cesarean section (adjusted odds ratio [aOR]: 1.85; 95% confidence interval [CI], 1.56–2.19; I² = 57%; risk difference: 8.2%). Metaregression demonstrated a larger effect of vaginal delivery among younger women (p = 0.005). Four studies suggested no difference in the risk of SUI between spontaneous vaginal and instrumental delivery (aOR: 1.11; 95% CI, 0.84–1.45; I² = 50%). Eight studies suggested an elevated risk of UUI after vaginal delivery versus cesarean section (aOR: 1.30; 95% CI, 1.02–1.65; I² = 37%; risk difference: 2.6%).

Conclusions

Compared with cesarean section, vaginal delivery is associated with an almost twofold increase in the risk of long-term SUI, with an absolute increase of 8%, and an effect that is largest in younger women. There is also an increased risk of UUI, with an absolute increase of approximately 3%.

Patient summary

In this systematic review we looked for the long-term effects of childbirth on urinary leakage. We found that vaginal delivery is associated with an almost twofold increase in the risk of developing leakage with exertion, compared with cesarean section, with a smaller effect on leakage in association with urgency.

Impact of overactive bladder on quality of life and resource use: results from Korean Burden of Incontinence Study (KOBIS)

Background

To evaluate the impact of overactive bladder (OAB) on quality of life (QOL), resource use and productivity loss in patients recruited from six hospitals in Korea.

Methods

This cross-sectional survey recruited 625 OAB patients between July to December 2013. Patients were categorised into four groups based on the average number of urinary incontinence (UI) episodes over the past three days (0, 1, 2–3 and ≥4 UI/day). QOL was measured using the Incontinence-Specific Quality of Life Instrument (I-QOL), the Overactive Bladder Questionnaire (OAB-q), and a generic health-related utility instrument (EQ-5D). Information on hospital and clinic visit frequency, and continence pads use were also collected. Work productivity was assessed using the Work Productivity and Activity Impairment (WPAI) questionnaire. Between group differences were assessed using ANOVA. Multivariable regression analyses were performed to examine the independent effects of OAB symptoms on QOL.

Results

Severity of UI showed a significant linear relationship with QOL, with clinically meaningful differences between each UI severity category. Compared to the dry category, patients in the most severe category (≥4 UI/day) had significantly lower I-QOL scores (69.8 vs 42.6; p < 0.0001), greater symptom bother on the OAB-q (30.4 vs 64.6; p < 0.0001), and poorer EQ-5D utility (0.848 vs 0.742; p < 0.001). Multivariable analyses showed that UI severity, frequency, urgency, and nocturia are independently associated with poorer QOL. Incontinence severity is also significantly associated with cost of incontinence pads (p < 0.0001), and a greater interference with work and regular activities (p = 0.001), however, no significant difference in hospital and clinic visits were observed.

Conclusion

Severity of UI is a key contributor to the disease burden of OAB in Korean patients, even after taking into account the impact of other symptoms associated with OAB.

Electronic supplementary material

The online version of this article (doi:10.1186/s12955-015-0274-9) contains supplementary material, which is available to authorized users.

A Population-based Survey of the Prevalence, Potential Risk Factors, and Symptom-specific Bother of Lower Urinary Tract Symptoms in Adult Chinese Women

BACKGROUND

Epidemiological studies of lower urinary tract symptoms (LUTS) are few in China, and none has been conducted nationwide.

OBJECTIVE

To estimate the prevalence and potential risk factors of LUTS and the bother they impose on adult women in China.

DESIGN, SETTING, AND PARTICIPANTS

This is the second analysis of a population-based cross-sectional survey on urinary incontinence conducted between February and July 2006 in six regions of China. Cluster samples were randomly selected for interviews.

INTERVENTIONS

No intervention was implemented.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

A modified Chinese Bristol Female Lower Urinary Tract Symptoms questionnaire was administered. The participants were asked about the presence of individual LUTS and rated their symptom bother. Descriptive statistics, χ(2) tests, receiver operating characteristic curves, and multivariate logistic regressions were used for data analysis.

RESULTS AND LIMITATIONS

A total of 18 992 respondents (94.96%) were included. The prevalence of any LUTS, storage symptoms, or voiding symptoms was 55.5%, 53.9%, and 12.9%, respectively, and increased with age. Nocturia was the most common symptom (23.4%), followed by urgency (23.3%) and stress urinary incontinence (SUI; 18.9%). Nocturia was most frequently rated as bothersome (93.0%) but was generally minor (80.5%). Urgency and urgency urinary incontinence (UUI) were most frequently reported as severe (11.5% and 10.8%) or moderate (18.5% and 16.8%) bothers. Any LUTS were more prevalent in urban women (57.1% vs 53.9%). Multiple factors increased the odds of bother and individual LUTS, and older age and coexisting pelvic organ prolapse were strong predictors (p<0.05). This survey was conducted 8 yr ago and did not assess all LUTS.

CONCLUSIONS

Half of adult women suffered with LUTS; nocturia, urgency, and SUI were more prevalent. Urgency and UUI were most frequently reported as severe or moderate bothers. Multiple factors influenced bother and individual LUTS.

PATIENT SUMMARY

The prevalence of lower urinary tract symptoms is high and increases with age in adult women in China. Urgency and urgency urinary incontinence were most frequently regarded as severe or moderate bothers and should be targeted for medical intervention.

Effect of electroacupuncture versus pelvic floor muscle training plus solifenacin for moderate and severe mixed urinary incontinence in women: a study protocol

Background

In women with mixed urinary incontinence, pelvic floor muscle training and solifenacin is the recommended conservative treatment, while electroacupuncture is a safe, economical and effective option.

Methods/Design

In this prospective, multi-center, randomized controlled trial, five hundred women with mixed urinary incontinence, from 10 centers will be randomized to receive either electroacupuncture or pelvic floor muscle training plus solifenacin. Women in the acupuncture group will receive electroacupuncture for 3 sessions per week, over 12 weeks, while women in the control group will receive pelvic floor muscle training plus solifenacin (5 mg once daily) for 36 weeks. The primary outcome measure is the proportion of change in 72-hour incontinence episode frequency from baseline to week 12. The secondary outcome measures include eleven items, including proportion of participants with ≥50% decrease in average 72-h incontinence episode frequency, change from baseline in the amount of urine leakage and proportion of change from baseline in 72-h incontinence episode frequency in week 25–36, and so forth. Statistical analysis will include covariance analysis, nonparametric tests and t tests.

Discussion

The objective of this trial is to compare the efficacy and safety of electroacupuncture versus pelvic floor muscle training plus solifenacin in women with moderate and severe mixed urinary incontinence.

Trial registration

ClinicalTrials.gov Identifier: NCT02047032

Global prevalence and economic burden of urgency urinary incontinence: a systematic review

CONTEXT

The prevalence and economic burden of urgency urinary incontinence (UUI) are difficult to ascertain because of overlap with data on overactive bladder and other types of incontinence.

OBJECTIVE

To summarize the evidence on the global prevalence and economic burden of UUI.

EVIDENCE ACQUISITION

A PubMed search was performed used the following terms: (urgency urinary incontinence OR urge incontinence OR mixed incontinence OR overactive bladder) AND (burden OR cost OR economic OR prevalence). A similar search was conducted using Embase. English-language articles published from 1991 through 2013 on non-neurogenic UUI were retained.

EVIDENCE SYNTHESIS

We retained 54 articles (50 studies); 22 large-scale, population-based surveys indicated varying UUI prevalence estimates with ranges of 1.8-30.5% in European populations, 1.7-36.4% in US populations, and 1.5-15.2% in Asian populations, with prevalence dependent on age and gender. Nineteen smaller-scale studies supported these findings. Despite varying methods, 11 studies estimating the costs of UUI worldwide consistently concluded that the economic burden is substantial and will increase markedly as the population ages. In a 2005 multinational study, the annual cost-of-illness estimate for UUI in Canada, Germany, Italy, Spain, Sweden, and the United Kingdom was €7 billion. A US cost-of-illness study reported a total cost of $66 billion in 2007 US dollars. The costs of routine care and nursing home admissions for UUI were major contributors to the cost.

CONCLUSIONS

UUI affects millions of men and women worldwide. Current evidence demonstrates the substantial economic burden of UUI to patients and society. Worldwide public health and clinical management programs are needed to improve UUI awareness and highlight the need for early diagnosis and management.

A prática de exercícios físicos é um fator modificável da incontinência urinária de urgência em mulheres idosas

INTRODUÇÃO: A literatura aponta que alguns fatores de risco para incontinência urinária podem ser modificados por um estilo de vida saudável; no entanto, pouco se conhece sobre os fatores associados à incontinência urinária de urgência (IUU), cuja prevalência aumenta com a idade. OBJETIVO: Analisar os fatores de risco modificáveis da IUU em mulheres idosas. MÉTODOS: A amostra foi composta por 200 idosas (60 anos ou mais) com média de idade de 69,06 ± 6,26 anos. Foram identificadas a presença de IUU e os fatores de risco comportamentais (consumo de café, consumo de bebidas alcoólicas, hábito de fumar e presença de constipação). Também foi aplicado o Domínio 4 do Questionário Internacional de Atividade Física (IPAQ) para identificação do nível de atividade física e mensurados Índice de Massa Corporal e Circunferência da Cintura. Os dados foram tratados por meio de estatística descritiva e inferencial, com nível de significância de 5%. RESULTADOS: A prevalência de IUU na amostra foi de 15,5%. Entre os fatores modificáveis, apenas o nível de atividade física associou-se com a ocorrência de IUU, sendo que a prática de exercícios físicos apresentou-se como um fator de proteção entre mulheres muito ativas (OR = 0,288) e pouco ativas (OR = 0,356). CONCLUSÃO: Os sintomas de urgência miccional podem ser amenizados com a prática regular de exercícios físicos. Através de um estilo de vida saudável é possível minimizar uma série de fatores modificáveis na gênese da incontinência urinária de urgência.

Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study

CONTEXT AND OBJECTIVE

There is uncertainty in the literature regarding the theory that obstetric events and pelvic floor injuries give rise to lower risk of subsequent urinary incontinence among women delivering via cesarean section than among women delivering vaginally. The objective of this study was to assess the two-year postpartum prevalence of urinary incontinence and pelvic floor muscle dysfunction and the factors responsible for them.

DESIGN AND SETTING

Cross-sectional study, conducted in a public university.

METHODS

220 women who had undergone elective cesarean section or vaginal childbirth two years earlier were selected. Their urinary incontinence symptoms were investigated, and their pelvic floor muscle dysfunction was assessed using digital palpation and a perineometer.

RESULTS

The two-year urinary incontinence prevalences following vaginal childbirth and cesarean section were 17% and 18.9%, respectively. The only risk factor for pelvic floor muscle dysfunction was weight gain during pregnancy. Body mass index less than 25 kg/m 2 and normal pelvic floor muscle function protected against urinary incontinence. Gestational urinary incontinence increased the risk of two-year postpartum urinary incontinence.

CONCLUSION

Gestational urinary incontinence was a crucial precursor of postpartum urinary incontinence. Weight gain during pregnancy increased the subsequent risk of pelvic floor muscle dysfunction, and elective cesarean section did not prevent urinary incontinence.

Lower urinary tract symptoms from childhood to adulthood: a population based study of 594 Finnish individuals 4 to 26 years old

PURPOSE

We evaluated voiding habits and lower urinary tract symptoms by age and gender in a large population of individuals from childhood to adulthood.

MATERIALS AND METHODS

We studied a cross-sectional sample of 594 individuals 4 to 26 years old randomly selected from the population register of Finland. Participants anonymously answered a detailed postal questionnaire on lower urinary tract symptoms. Parents assisted respondents younger than 16 years. Results were analyzed by age group (4 to 7, 8 to 12, 13 to 17 and 18 to 26 years) and gender. A p value of less than 0.05 was considered statistically significant.

RESULTS

The prevalence of urge incontinence significantly decreased with age (45% in respondents 4 to 7 years vs 10% in respondents 13 to 17 years, p <0.05). Urinary tract infections and urge and stress incontinence were more common in females (16% to 32%) than in males (2% to 4%) older than 12 years (p <0.05). The occurrence of some type of minor daytime urinary incontinence was reported by approximately a fourth of the study population, with a significant decline in prevalence between ages 4 to 7 years and 8 to 12 years (p <0.05). Minor urinary incontinence was significantly more common in females older than 12 years. Frequent urinary incontinence affected only 4% of respondents, most of whom were younger than 12 years.

CONCLUSIONS

Bladder control and urinary function exhibit considerable variation with age and gender. Due to the imperfections in bladder control in the general population, the evaluation of urinary tract disorders and outcomes of surgery in children and adolescents should be conducted with reference to control data according to age and gender.

Body mass index, recreational physical activity and female urinary incontinence in Gansu, China

OBJECTIVE

To elucidate the influence of recreational physical activity, body mass index (BMI), and waist circumference on the risk of specific types of urinary incontinence.

STUDY DESIGN

We conducted a population-based cross-sectional survey in Gansu, China among 2603 women aged 20 years or older.

RESULTS

The study found that BMI was positively associated with urinary incontinence (P for trend=0.008) and the association was mainly observed for stress urinary incontinence (OR=1.4, 95% CI: 1.1, 1.9 for BMI=24.0-27.9 kg/m²; OR=2.3, 95% CI: 1.5, 3.6 for BMI ≥ 28.0 kg/m²; P for trend=0.0005). A positive association between stress incontinence (OR=1.7, 95% CI: 1.2, 2.5) and waist circumference was observed for women who had waist circumference between 70 cm and 75 cm compared to waist circumference less than 70 cm. Recreational physical activity was inversely associated with overall and mixed urinary incontinence (P for trend <0.0001 for both). A significant interaction between physical activity and waist circumference was found for overall (P=0.0007) and stress incontinence (P=0.001).

CONCLUSIONS

The findings that physical activity inversely associated with urinary incontinence and its interaction with waist circumference warrant further investigation, particularly in prospective studies.

Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors

INTRODUCTION AND HYPOTHESIS

Information on the prevalence, risk factors and social consequences of pelvic floor dysfunction (PFD) affecting women in 16 low-income and lower middle-income countries is reviewed.

METHODS

Medline searches were performed for articles dealing with prevalence of PFD.

RESULTS

Thirty studies were identified. The mean prevalence for pelvic organ prolapse was 19.7% (range 3.4-56.4%), urinary incontinence (UI) was 28.7% (range 5.2-70.8%) and faecal incontinence (FI) was 6.9% (range 5.3-41.0%). Risk factors for PFD are similar to those in more affluent countries particularly increased age and parity, but additionally, PFD is associated with other factors including poor nutrition and heavy work. The social consequences of PFD conditions can be devastating.

CONCLUSIONS

Pelvic organ prolapse and urinary and faecal incontinence are significant problems in developing countries. Access to health care to manage these conditions is often limited, and women usually have to live with the consequences for the rest of their lives.