Article

Population-Based Survey of Urinary Incontinence, Overactive Bladder, and Other Lower Urinary Tract Symptoms in Five Countries: Results of the EPIC Study

University of Toronto, Toronto, Ontario, Canada
European Urology (Impact Factor: 12.48). 01/2007; 50(6):1306-14; discussion 1314-5. DOI: 10.1016/j.eururo.2006.09.019
Source: PubMed

ABSTRACT Estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) among men and women in five countries using the 2002 International Continence Society (ICS) definitions.
This population-based, cross-sectional survey was conducted between April and December 2005 in Canada, Germany, Italy, Sweden, and the United Kingdom using computer-assisted telephone interviews. A random sample of men and women aged >/= 18 yr residing in the five countries and who were representative of the general populations in these countries was selected. Using 2002 ICS definitions, the prevalence estimates of storage, voiding, and postmicturition LUTS were calculated. Data were stratified by country, age cohort, and gender.
A total of 19,165 individuals agreed to participate; 64.3% reported at least one LUTS. Nocturia was the most prevalent LUTS (men, 48.6%; women, 54.5%). The prevalence of storage LUTS (men, 51.3%; women, 59.2%) was greater than that for voiding (men, 25.7%; women, 19.5%) and postmicturition (men, 16.9%; women, 14.2%) symptoms combined. The overall prevalence of OAB was 11.8%; rates were similar in men and women and increased with age. OAB was more prevalent than all types of UI combined (9.4%).
The EPIC study is the largest population-based survey to assess prevalence rates of OAB, UI, and other LUTS in five countries. To date, this is the first study to evaluate these symptoms simultaneously using the 2002 ICS definitions. The results indicate that these symptoms are highly prevalent in the countries surveyed.

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    • "Some studies have sought to differentiate between the types of urinary incontinence symptoms observed in the elderly. In a study of 19,165 men and women from five European countries, nocturia (the need to wake and pass urine at night) was found to be the most prevalent lower urinary tract disorder with 24 % of women and 21 % of men subject to more than two episodes per night (Irwin et al. 2006). This study also determined that the prevalence of overactive bladder (urge incontinence manifest by sudden uncontrolled contractions of the detrusor muscle) was 11.8 % in both sexes and that this figure increased with ageing. "
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    ABSTRACT: The prevalence of both urinary and faecal incontinence, and also chronic constipation, increases with ageing and these conditions have a major impact on the quality of life of the elderly. Management of bladder and bowel dysfunction in the elderly is currently far from ideal and also carries a significant financial burden. Understanding how these changes occur is thus a major priority in biogerontology. The functions of the bladder and terminal bowel are regulated by complex neuronal networks. In particular neurons of the spinal cord and peripheral ganglia play a key role in regulating micturition and defaecation reflexes as well as promoting continence. In this review we discuss the evidence for ageing-induced neuronal dysfunction that might predispose to neurogenic forms of incontinence in the elderly.
    Biogerontology 02/2015; 16(2). DOI:10.1007/s10522-015-9554-3 · 3.01 Impact Factor
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    • "In addition to female gender and age, other risk factors include race, pregnancy, childbirth, giving birth to an infant of ≥4000 g, caesarean delivery, vaginal delivery , menopause, hysterectomy, obesity, functional or cognitive impairment, occupation and family history. In addition to such risk factors, pathologies such as diabetes mellitus (DM) and urinary tract infections could also lead to LUTS (Irwin et al., 2006; Altaweel and Alharbi, 2012). DM is becoming highly prevalent across the world. "
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    • "Overactive bladder (OAB) is a syndrome characterized by urinary urgency, with or without incontinence, usually with frequency and nocturia [1]. Population-based estimates suggest that OAB affects 12–17% of adults in Europe and the United States, and greatly affects the quality of life of those afflicted [2] [3] [4]. Until recently, antimuscarinics were the only compound class approved for treating OAB. "
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    ABSTRACT: Activation of β3-adrenoceptors has been shown to have a direct relaxant effect on urinary bladder smooth muscle from both rats and humans, however there are very few studies investigating the effects of β3-adrenoceptor agonists on nerve-evoked bladder contractions. Therefore in the current study, the role of β3-adrenoceptors in modulating efferent neurotransmission was evaluated. The effects of β3-adrenoceptor agonism on neurogenic contractions induced by electrical field stimulation (EFS) were compared with effects on contractions induced by exogenous acetylcholine (Ach) and αβ-methylene adenosine triphosphate (αβ-meATP) in order to determine the site of action. Isoproterenol inhibited EFS-induced neurogenic contractions of human bladder (pD2=6.79; Emax=65%). The effect of isoproterenol was selectively inhibited by the β3-adrenoceptor antagonist L-748,337 (pKB=7.34). Contractions induced by exogenous Ach (0.5-1μM) were inhibited 25% by isoproterenol (3μM) while contractions to 10Hz in the same strip were inhibited 67%. The selective β3-adrenoceptor agonist CL-316,243 inhibited EFS-induced neurogenic contractions of rat bladder (pD2=7.83; Emax=65%). The effects of CL-316,243 were inhibited in a concentration dependent manner by L-748,337 (pA2=6.42). Contractions induced by exogenous Ach and αβ-meATP were significantly inhibited by CL-316,243, 29% and 40%, respectively. These results demonstrate that the activation of β3-adrenoceptors inhibits neurogenic contractions of both rat and human urinary bladder. Contractions induced by exogenously applied parasympathetic neurotransmitters are also inhibited by β3-agonism however the effect is clearly less than on neurogenic contractions (particularly in human), suggesting that in addition to a direct effect on smooth muscle, activation of prejunctional β3-adrenoceptors may inhibit neurotransmitter release.
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