Platinum Priority – Female Urology – IncontinenceEditorial by Hann-Chorng Kuo on pp. 792–793 of this issueA Longitudinal Population-based Survey of Urinary Incontinence, Overactive Bladder, and Other Lower Urinary Tract Symptoms in Women
Introduction
Female urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) are highly prevalent conditions with a profound influence on well-being and quality of life (QoL) [1], [2], [3], [4]. There has been a growing interest in these symptoms in recent years as a consequence of the increased awareness of the human and social implications for the individual sufferer.
The reported prevalence of UI among women varies widely in different studies due to the use of different definitions, to the heterogeneity of different study populations, and to population sampling procedures. Large cross-sectional population-based samples, however, have shown that the prevalence of female UI ranges from approximately 20% in young adults to 50% in older women [5], [6], [7]. In recent years, several epidemiologic studies have been conducted to better understand the prevalence and the impact of OAB and other LUTS. The estimated prevalence of OAB is approximately 17% in both men and women, whereas the frequency of other problems related to bladder control vary according to symptom and severity [4], [7], [8], [9], [10].
LUTS are not static but dynamic, and many factors may contribute to incidence, progression, or remission. There are a few studies describing progression as well as remission, in the short term, of UI in the general population as well as in selected groups. The mean annual incidence of UI seems to range from 1% to 9%, while estimates of remission vary from 4% to 30% [1], [11], [12], [13], [14]. Presently, there are very few population-based studies describing the natural course of other LUTS in the same women, and there are no long-term longitudinal studies [8], [15], [16].
In 1991, we initiated a longitudinal population-based study composed of women aged ≥20 yr residing in Gothenburg, Sweden, regarding the prevalence of UI and other LUTS. The aim of the present study was to assess the prevalence of UI, OAB, and other LUTS in the same women studied prospectively over time and, thus, to reveal possible regression or progression in the same participant.
Section snippets
Participants
In 1991, a prospective longitudinal study was initiated to assess LUTS in a random sample of women from an urban Swedish population [17]. Every fourth woman (n = 2911) was randomly selected from the total population of women aged ≥20 yr residing in the Central District of Gothenburg (n = 11 644) who were listed in the Swedish National Population Register. The women were invited by letter to complete a questionnaire regarding UI and other LUTS (eg, urgency, frequency, and nocturia). The women's QoL
Results
In 2007, the questionnaire was returned by 1081 of the 1408 women still available for reassessment (response rate: 77%).
Discussion
In this 16-yr follow-up of 1081 women randomly selected from the general population, changes in the prevalence of UI, OAB, and other LUTS were assessed over time. To our knowledge, this is the first population-based long-term longitudinal study determining the natural course of LUTS in women aged ≥20 yr. There was a marked overall increase in the prevalence of UI, urgency, OAB, and nocturia from 1991 to 2007. The cumulative incidences of UI, urgency, and OAB were 21%, 20%, and 20%,
Conclusions
UI and other LUTS constitute dynamic conditions. In this study, there was a marked overall increase in the prevalence of UI, OAB, and nocturia in the same women from 1991 to 2007. Both incidence and remission of most symptoms, however, were considerable.
References (22)
- et al.
A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of Incontinence in the County of Nord-Trondelag
J Clin Epidemiol
(2000) - et al.
Epidemiology and natural history of urinary incontinence in women
Urology
(2003) - et al.
Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study
Eur Urol
(2006) - et al.
Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women
J Urol
(1991) - et al.
Five-year incidence and remission rates of female urinary incontinence in a Swedish population less than 65 years old
Am J Obstet Gynecol
(2000) - et al.
Incidence and remission of urinary incontinence in middle-aged women
Am J Obstet Gynecol
(2007) - et al.
The natural history of lower urinary tract symptoms in females: analysis of a health screening project
Eur Urol
(2007) - et al.
Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study
Obstet Gynecol
(2001) - et al.
Urinary incontinence and age at the first and last delivery: the Norwegian HUNT/EPINCONT study
Am J Obstet Gynecol
(2006) - et al.
Changes in urinary incontinence and quality of life after four years. A population-based study of women aged 22–50 years
Scand J Prim Health Care
(2004)
Impact of overactive bladder symptoms on employment, social interactions and emotional well-being in six European countries
BJU Int
Cited by (139)
A Prospective Study of Bladder Function Following Endometriosis Surgery With Up to Eight years Follow-up
2024, Journal of Minimally Invasive GynecologyThe three-year evolution of overactive bladder syndrome in community-dwelling female residents aged 40 years and above
2022, Taiwanese Journal of Obstetrics and GynecologyCitation Excerpt :The OABSS evaluated the frequency and severity of the symptoms. This was different from previous longitudinal studies, which used a single question to define OAB [3,21]. OAB was defined as “a positive answer to the question on urinary urgency, with or without subsequent urinary leakage” in a previous study [24].
Placebo Response in Patients with Oral Therapy for Overactive Bladder: A Systematic Review and Meta-analysis
2022, European Urology FocusCitation Excerpt :The reasons underlying the placebo response remain heterogeneous and not fully elucidated. Potential factors, among others, underlying the placebo response in OAB patients include behavioral aspects, use of voiding diaries, neuropsychological aspects, contextual factors, education of and information given to the patients, as well as the nature of the condition [1,26–29]. For instance, the use of voiding diaries in the management of OAB can be a form of behavior therapy for patients, leading to unconscious changes in their voiding habits resulting in improvement of outcomes [30].
Definition, epidemiology and impact of non-neurogenic overactive bladder
2020, Progres en Urologie