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Definition of overactive bladder and epidemiology of urinary incontinence

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      Abstract

      Objectives

      To review the definition of the overactive bladder and to summarize the results of epidemiologic studies on this specific disorder as well as urinary incontinence (UI) in general.

      Methods

      From a literature search covering the time period from 1954 through 1995, 48 epidemiologic studies and several other publications dealing with the prevalence and natural history of UI were reviewed. A metaanalysis of reported data was performed with respect to incontinence definitions, investigation methods, home country of survey, sex, and age groups.

      Results

      Differences in definitions of incontinence, target populations, and study design in different investigations resulted in inhomogeneity and difficulties of comparing the available data. By grouping the studies with respect to similarities in the above-mentioned criteria and analyzing the results for each group of studies, an attempt was made to understand the great variation of reported results. Differences in prevalence of incontinence were identified for all examined groups of studies and for distinct ethnic populations. Scarce information about incidence, spontaneous remission rates, and risk factors was used to elucidate the natural history of UI in women and men.

      Conclusions

      Although generally accepted definitions of the overactive bladder specifically and UI in general are highly desirable, they have not yet been established. Such definitions should comprise aspects of severity and demonstrability of the condition, bother factor, and impact on quality of life. Moreover, basic requirements for epidemiologic surveys of incontinence, such as validation of questionnaire results, need to be defined and standardized to create a sensible basis for useful epidemiologic studies in the future.
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      References

        • Abrams PH
        • Blaivas JG
        • Stanton SL
        • Andersen JT
        Standarization of terminology of lower urinary tract function.
        Neurourol Urodyn. 1988; 7: 403-427
        • Diokno AC
        • Brock BM
        • Brown MB
        • Herzog AR
        Prevalence of urinary incontinence and other urological symptoms in the noninstitutionalized elderly.
        J Urol. 1986; 136: 1022-1025
        • Thomas TM
        • Plymat KR
        • Blanni J
        • Meade TW
        Prevalence of urinary incontinence.
        Br Med J. 1980; 281: 1243-1245
        • International Continence Society
        First report on the standardisation of terminology of lower urinary tract function.
        Br J Urol. 1976; 48: 39-42
        • Hörding U
        • Pedersen KH
        • Sidenius K
        • Hedegaard L
        Urinary incontinence in 45-year-old women.
        Scand J Urol Nephrol. 1986; 20: 183-186
        • Lee KS
        • Chan CJ
        • Merriman A
        • Tan EC
        • Osborn V
        Clinical profile of elderly urinary incontinence in Singapore: a community-based study.
        Ann Acad Med Singapore. 1991; 20: 736-739
        • Hansen FR
        • Thiessen KA
        • Krakauer R
        Urinary symptoms in elderly women in nursing homes.
        Ugeskr Laeger. 1990; 152: 3242-3244
        • Mohide EA
        • Pringle DM
        • Robertson D
        • Chambers LW
        Prevalence of urinary incontinence in patients receiving home care services.
        Can Med Assoc J. 1988; 139: 953-956
        • McLaren SM
        • McPherson FM
        • Sinclair F
        • Ballinger BR
        Prevalence and severity of incontinence among hospitalised, female psychogeriatric patients.
        Health Bull. 1981; 39: 157-161
        • Yarnell JWO
        • Richards CJ
        • Stephenson TP
        The prevalence and severity of urinary incontinence in women.
        J Epidemiol Comm Health. 1981; 35: 71-74
        • Sier H
        • Ouslander J
        • Orzeck S
        Urinary incontinence among geriatric patients in an acute-care hospital.
        JAMA. 1987; 257: 1767-1771
        • O'Brien J
        • Austin M
        • Sethi P
        • O'Boyle P
        Urinary incontinence: prevalence, need for treatment, and effectiveness of intervention by nurse.
        Br Med J. 1991; 303: 1308-1312
        • Ju CC
        • Swan LK
        • Merriman A
        • Choon TE
        • Viegas O
        Urinary incontinence among the elderly people of Singapore.
        Age Ageing. 1991; 20: 262-266
        • Milsom I
        • Ekelund P
        • Molander U
        • Arvidsson L
        • Areskoug B
        The influence of age, parity, oral contraception, hysterectomy and menopause on the prevalence of urinary incontinence in women.
        J Urol. 1993; 149: 1459-1462
        • Molander U
        • Milsom I
        • Ekelund P
        • Mellström D
        An epidemiological study of urinary incontinence and related urogenital symptoms in elderly women.
        Maturitas. 1990; 12: 51-60
        • Sandvik H
        • Hunskaar S
        • Seim A
        • Hermstad R
        • Vanvik A
        • Bratt H
        Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey.
        J Epidemiol Community Health. 1993; 47: 497-499
        • Campbell AJ
        • Reinken J
        • McCosh L
        Incontinence in the elderly: prevalence and prognosis.
        Age Ageing. 1985; 14: 65-70
        • Lagro-Janssen T
        • Smits A
        • van Weel C
        Urinary incontinence in women and the effects on their lives.
        Scand J Prim Health Care. 1992; 10: 211-216
        • Nemir A
        • Middleton RP
        Stress incontinence in young nulliparous women.
        Am J Obstet Gynecol. 1954; 68: 1166-1168
        • Wolin LH
        Stress incontinence in young, healthy nulliparous female subjects.
        J Urol. 1969; 101: 545-549
        • Feneley RCL
        • Shepherd AM
        • Powell PH
        • Blannin J
        Urinary incontinence: prevalence and needs.
        Br J Urol. 1979; 51: 493-496
        • Lagace EA
        Prevalence and severity of urinary incontinence in ambulatory adults: an UPRNet study.
        J Fam Pract. 1993; 36: 610-614
        • Burgio KL
        • Matthews KA
        • Engel BT
        Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women.
        J Urol. 1991; 146: 1255-1259
        • Lam OW
        • Foldspang A
        • Elving LB
        • Mommsen S
        Urinary incontinence in women aged 30–59 years.
        Ugeskr Laeger. 1990; 152: 3244-3246
        • Elving LB
        • Foldspang A
        • Lam OW
        • Mommsen S
        Descriptive epidemiology of urinary incontinence in 3100 women age 30–59.
        Scand J Urol Nephrol. 1989; 125 (suppl): 37-43
        • Brocklehurst JC
        Urinary incontinence in the community—analysis of a MORI poll.
        Br Med J. 1993; 306: 832-834
        • Bayer H
        Weibliche Harninkontinenz und Schwangerschaft.
        Zentralblatt Gyn. 1963; 84: 732-740
        • Foldspang A
        • Mommsen S
        • Lam OW
        • Elving L
        Parity as a correlate of adult female urinary incontinence prevalence.
        J Epidemiol Community Health. 1992; 46: 595-600
        • Foldspang A
        • Mommsen S
        Overweight and urinary incontinence in women.
        Ugeskr Laeger. 1995; 157: 5848-5851
        • Iosif CS
        • Bekassy Z
        • Rydhström H
        Prevalence of urinary incontinence in middle-aged women.
        Int J Gynaecol Obstet. 1988; 26: 255-259
        • Herzog AR
        • Fultz NH
        Epidemiology of urinary incontinence: prevalence, incidence and correlates in community populations.
        Urology. 1990; 36 (suppl): 2-10
        • Herzog AR
        • Fultz NH
        Prevalence and incidence of urinary incontinence in community-dwelling populations.
        J Am Geriatr Soc. 1990; 38: 273-281
        • Koyano W
        • Shibata H
        • Haga H
        • Suyama Y
        Prevalence and outcome of low ADL and incontinence amoung the elderly: five years follow up in a Japanese urban community.
        Arch Gerontol Geriatr. 1986; 5: 197-206
        • Samsioe G
        • Jansson I
        • Mellström D
        • Svanborg A
        Occurrence, nature and treatment of urinary incontinence in an 70-year old female population.
        Maturitas. 1985; 7: 335-342
        • Simeonova Z
        • Bengtsson C
        Prevalence of urinary incontinence among women at a Swedish primary health care center.
        Scand J Prim Health Care. 1990; 8: 203-206
        • Teasdale TA
        • Taflet GE
        • Luchi RJ
        • Adam E
        Urinary incontinence in a community-residing elderly population.
        J Am Geriatr Soc. 1988; 36: 600-606
        • Harrison O
        • Memel D
        Urinary incontinence in women: its prevalence and management in a health promotion clinic.
        Br J Gen Pract. 1994; 44: 149-152
        • Seim A
        • Sandvik H
        • Hermstad R
        • Hunskaar S
        Female urinary incontinence—consultation behaviour and patient experiences: an epidemiological survey in a Norwegian community.
        Fam Pract. 1995; 12: 18-21
        • Jolleys JV
        Reported prevalence of urinary incontinence in women in a general practice.
        Br Med J. 1988; 296: 1300-1302
        • Sommer P
        • Bauer T
        • Nielson KK
        • Kristensen ES
        • Hermann GO
        • Steven K
        • Nordling J
        Voiding patterns and prevalence of incontinence in women. A questionnaire survey.
        Br J Urol. 1990; 66: 12-15
        • Crist T
        • Shingleton H
        • Koch OG
        Stress incontinence and the nulliparous patient.
        Obstet Gynaecol. 1972; 40: 13-17
        • Lara C
        • Nacey J
        Ethnic differences between Maori, Pacific Island and European New Zealand women in prevalence and attitudes to urinary incontinence.
        N Z Med J. 1994; 107: 374-376
        • Hoist K
        • Wilson PD
        The prevalence of female incontinence and reasons for not seeking treatment.
        N Z Med J. 1988; 101: 756-758
        • Fall M
        • Frankenberg S
        • Frisen M
        456000 Swedes may have urinary incontinence. Only every fourth seeks help for the problem.
        Läkartidningen. 1985; 82: 2054-2056
        • Shershan S
        • Ansari RL
        The frequency of urinary incontinence in Pakistani women.
        J Pak Med Assoc. 1989; 39: 16-17
        • Rekers H
        • Drogendijk AC
        • Valkenburg H
        • Riphagen F
        Urinary incontinence in women from 35 to 79 years of age: prevalence and consequences.
        Eur J Obstet Gynaecol Reprod Biol. 1992; 43: 229-234
        • Keskes J
        • Khairi H
        • Ben-Said A
        • Hidar M
        • Pigne A
        Stress urinary incontinence in women. Epidemiologic inquiry.
        J Gynecol Obstet Biol Reprod. 1988; 17: 453-460
        • Knobel J
        Stress incontinence in the black female.
        S Afr Med J. 1975; 49: 430-432
        • Jeffcoate TNA
        • Francis WJA
        Urgency incontinence in the female.
        Am J Obstet Gynecol. 1966; 94: 604-618
        • Herzog AR
        • Diokno AC
        • Brown MB
        • Normolle DP
        • Brock BM
        Two-year incidence, remission and change patterns of urinary incontinence in noninstitutionalized older adults.
        J Gerontol. 1990; 45: M67-M74
        • Rosenzweig BA
        • Pushkin S
        • Blumenfeld D
        • Bhatia NN
        Prevalence of abnormal urodynamic test results in continent women with severe genitourinary prolapse.
        Obstet Gynecol. 1992; 79: 539-542
        • Fianu S
        • Kjaeldgaard A
        • Larsson B
        Preoperative screening for latent stress incontinence in women with cystocele.
        Neurourol Urodyn. 1985; 4: 3-7
        • Bergman A
        • Koonings PP
        • Ballard CA
        Predicting postoperative urinary incontinence development in women undergoing operation for genitourinary prolapse.
        Am J Obstet Gynecol. 1988; 158: 1171-1175
        • Bump RC
        • Fanti JA
        • Hurt WO
        The mechanism of urinary continence in women with severe uterovaginal prolapse: results of barrier studies.
        Obstet Gynecol. 1988; 72: 291-295
        • Mommsen S
        • Foldspang A
        • Elving L
        • Lam OW
        Association between urinary incontinence in women and a previous history of surgery.
        Br J Urol. 1993; 72: 30-37
        • Yarnell JWO
        • Voyle GJ
        • Sweetnam PM
        • Milbank J
        • Richards CJ
        • Stephenson TP
        Factors associated with urinary incontinence in women.
        J Epidemiol Comm Health. 1982; 36: 58-63
        • Diokno AC
        Epidemiology and psychosocial aspects of incontinence.
        Urol Clin North Am. 1995; 22: 481-485
        • Klutke CO
        • Raz S
        Preface.
        Urol Clin North Am. 1995; 22: 479
        • National Institutes of Health
        National Institutes of Health Consensus Development Conference Statement: Urinary Incontinence. National Institutes of Health, Bethesda, MD1988: 1-11
      1. Urinary Incontinence Consensus Conference: Urinary incontinence in adults. JAMA. 261. 1989: 2685-2690