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: 13.94). 01/2007; 50(6):1306-14; discussion 1314-5. DOI: 10.1016/j.eururo.2006.09.019
Source: PubMed


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 · 3.29 Impact Factor
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    • "Storage symptoms such as frequency, nocturia, urgency, and urge incontinence are more common and bothersome than voiding symptoms such as weak stream, intermittency, hesitancy, strain, and postvoid dribbling [6]. A previous study reported that 51% of LUTS patients have storage symptoms and 26% have voiding symptoms at age ≥18 years, and 74% of patients have storage symptoms and 37% have voiding symptoms at age ≥60 years [16]. Other studies showed that 28% of men aged ≥40 years had LUTS. "
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    ABSTRACT: Purpose To evaluate how much the improvement of lower urinary tract symptoms (LUTS) affects sexual function and which storage symptoms or voiding symptoms have the greatest effect on sexual function. Materials and Methods A total of 187 patients were enrolled in this study. Patients were randomly assigned to receive either tamsulosin 0.2 mg (group A) or tamsulosin 0.2 mg and solifenacin 5 mg (group B). At 4 weeks and 12 weeks, the LUTS and sexual function of the patients were evaluated by use of the International Index of Erectile Function-5 (IIEF5), International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS) questionnaire, uroflowmetry, and bladder scan. Results Both groups A and B showed statistically significant improvements in IPSS, OABSS, and quality of life (QoL). Group A showed improved maximum flow rate, mean flow rate, and residual urine volume by time. Group B did not show an improvement in flow rate or residual urine volume but total voiding volume increased with time. The IIEF5 score was not improved in either group. In group A, the IIEF5 score dropped from 13.66±4.97 to 11.93±6.14 after 12 weeks (p=0.072). Group B showed a decline in the IIEF5 score from 13.19±5.91 to 12.45±6.38 (p=0.299). Although group B showed a relatively smaller decrease in the IIEF5 score, the difference between the two groups was not significant (p=0.696). Conclusions Tamsulosin monotherapy and combination therapy with solifenacin did not improve erectile function despite improvements in voiding symptoms and QoL. The improvement in storage symptoms did not affect erectile function.
    Korean journal of urology 09/2014; 55(9):608-14. DOI:10.4111/kju.2014.55.9.608
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    • "The present study provides insights into the prevalence of LUTS among Korean men. The questionnaire used in this study was identical to that used in the EPIC study [20], which was the first large population-based examination of the prevalence of LUTS using the 2002 ICS definitions. "
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    ABSTRACT: Purpose The aim of this study was to evaluate the prevalence of lower urinary tract symptoms (LUTS) among Korean men aged ≥40 years. Methods We performed a population-based, cross-sectional door-to-door survey on a geographically stratified random sample of men aged ≥40 years. All respondents were asked about the presence of individual LUTS using a questionnaire based on 2002 International Continence Society definitions. For comparison, we also defined nocturia as two or more nocturnal micturitions per night. The International Prostate Symptom Score (IPSS) questionnaire was used to assess LUTS severity. Results Responses from 1,842 subjects were analyzed. The overall prevalence of LUTS was 83.4%. Storage LUTS (70.1%) were more prevalent than voiding (60.4%) or postmicturition LUTS (38.3%). When nocturia was defined as two or more nocturnal micturitions per night, voiding symptoms became most prevalent (storage, 39.7%; voiding, 60.4%; and postmicturition, 38.3%). More than 90% of our population described the severity of their urinary symptoms as moderate (8-19) or severe (20-35). The prevalence and severity of LUTS increased with age. Conclusions LUTS are highly prevalent among Korean men, and its prevalence increases with age. Increased public awareness and a larger number of treatment options are needed to appropriately manage symptoms and their consequences.
    International neurourology journal 09/2014; 18(3):126-32. DOI:10.5213/inj.2014.18.3.126 · 1.06 Impact Factor
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