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Chinese Medical Journal, 2005, Vol. 118 No. 11 : 887-892
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Prevalence and risk factors of urinary incontinence in Fuzhou Chinese women
SONG Yan-feng, ZHANG Wen-ju, SONG Jian, XU Bo
SONG Yan-feng Department of Gynaecology and Obstetrics, Dongfang Hospital, Fuzhou 350025, China; ZHANG Wen-ju Department of Gynaecology and Obstetrics, Dongfang Hospital, Fuzhou 350025, China; SONG Jian Department of Gynaecology and Obstetrics, Dongfang Hospital, Fuzhou 350025, China; XU Bo Department of Gynaecology and Obstetrics, Dongfang Hospital, Fuzhou 350025, China

Correspondence to: SONG Yan-feng  Department of Gynaecology and Obstetrics, Dongfang Hospital, Fuzhou 350025, China  (Email:zhangwj91@hotmail.com )
Keywords: urinary incontinence, stress¡¤prevalence¡¤risk factors
Abstract:
Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence.
Methods The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire.
Results Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n=777), 10.0% (n=468), 7.7% (n=360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P<0.01). In multiple logistic models, age (OR, 1.3, 95%CI, 1.1£­1.4), vaginal delivery (3.0, 1.9£­4.7), parity >2 (2.1, 1.5£­2.9), hypertension (2.7, 1.4£­5.6), constipation (2.6, 1.8£­3.8), alcohol consumption (4.7, 1.1£­20.2), episiotomy (1.7, 1.4£­2.0), higher body mass index (BMI, 1.8, 1.5£­2.2) and unskilled worker (0.7, 0.5£­0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95%CI, 0.9£­1.3), menopause (1.6, 1.1£­2.4), Caesarean delivery (0.2, 0.1£­0.5), parity >2 (2.6, 1.8£­3.8), constipation (2.3, 1.4£­3.7), foetal birthweight (1.7, 1.1£­2.4), episiotomy (1.4, 1.1£­1.8), higher BMI (1.5, 1.2£­2.0) and unskilled worker (0.7, 0.5£­0.9).
Conclusions The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.

CMJ 2005;118(11):887-892
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ZHANG Wen-ju
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ZHANG WJ
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Urinary incontinence (UI) and associated lower urinary tract symptoms are widespread and troubling conditions affecting 11% to 57% of the adult women and it can severely compromise their social life.£Û1,2£Ý Urinary incontinence is defined by the International Continence Society as ¡°the complaint of involuntary leakage of urine¡±.£Û3£Ý Urinary incontinence is increasingly recognized as a health and economic problem, which affects the physical, psychological, social and economic wellbeing of individuals and their families and poses a substantial economic burden on health and social services.£Û4,5£Ý The trend in studying urinary incontinence is to place more emphasis on primary health care, because prevention is much less costly than cure.£Û6£Ý Understanding the prevalence, the natural history and the risk factors of urinary incontinence may help direct treatment resources and provide preventive steps in the future.

The prevalence of urinary incontinence has rarely been studied in a community, rather in selected age groups or communities based on convenient samples. The reported prevalence of urinary incontinence among studies of selected age groups or communities varies widely,£Û1,2£Ý The variation is due to differences in definitions, target populations, study design, data collection, and study settings.£Û5£Ý

From recent work by Bump£Û7£Ý and Carol et al,£Û8£Ý it is clear that racial differences exist in risk factors and in prevalence of subtypes of incontinence. However, the relationship of racial and ethnic difference and the occurrence of urinary incontinence in Asia have not been well understood. There have been few epidemiologic studies conducted on urinary incontinence in Asian women. Chan£Û9£Ý reported that 4.8% of elderly Singaporean women had urinary incontinence and that the prevalence was not significantly different among Chinese, Malay or Indian women. A community based study of 362 Chinese women in Hong Kong showed that 34% of the women had experienced at least one episode of urinary incontinence as adults, and 18.5% reported persistent incontinence.£Û10£Ý Chen et al£Û11£Ý reported 53.7% of the women in Taiwan sampled suffered from urinary incontinence and related symptoms. But there are few reports on prevalence of urinary incontinence in the mainland of China.

In April 2002, we conducted a large scale survey, which was the first of its kind in mainland China. The purposes of this study were (1) to evaluate the prevalence in Fuzhou, China of urinary incontinence in women; (2) to clarify the potential risk factors that predispose the occurrence of urinary incontinence and identify the risk factors of urinary incontinence in Chinese women; (3) to compare risk factors between stress urinary incontinence and urge incontinence.

METHODS

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