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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    • "Epidemiological studies have shown an association between UI and several risk factors, including age, parity, mode of delivery, neonate birth weight, gravidity, menopause, overweight, obesity, and some medical comorbidities (particularly diabetes) [4] [17] [18]. Associations with other factors have been less consistent, with conflicting data on the possible role of education, hysterectomy, constipation, and smoking in the development of incontinence [4] [18] [19]. "
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    ABSTRACT: To identify risk factors for urinary incontinence (UI) and assess the quality of life (QoL) of affected women. A cross-sectional study was conducted of all women with UI who attended the urology and gynecology services of four hospitals in central Portugal between March and December 2012. Information was obtained from participants using questionnaires assessing sociodemographic, obstetric, gynecologic, and lifestyle variables. Among 505 participants, 351 (69.5%) had urgency UI, 107 (21.2%) stress UI, and 47 (9.3%) mixed UI. Stress UI was associated with smoking, alcohol consumption, constipation, gravidity, parity, and vaginal infections (P≤0.02 for all). Urgency UI was associated with age above 50years, employment, smoking, and sitting for 2hours or less per day (P≤0.02 for all). Mixed UI was associated with age 50years or younger, smoking, sitting for 2hours or less per day, and frequently carrying more than 3kg in weight (P<0.001 for all). A negative impact on QoL was reported by 501 (99.2%) women. Compared with younger participants, women older than 50years presented with more sleep/energy disturbances and performance limitations (P≤0.04 for both). UI is associated with several risk factors and has a negative impact on QoL. Appropriate investigation regarding the factors associated with the types of UI should be performed to diminish its impact on QoL. Copyright © 2015. Published by Elsevier Ireland Ltd.
    Full-text · Article · May 2015 · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
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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.
    Full-text · Article · Feb 2015 · Biogerontology
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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.
    Full-text · Article · Sep 2014 · International neurourology journal
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