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Get Laid Adaptation Singlewomenadultservice N S S Single Women Adult Service Service De Nfl Jerseys Denver Broncos Jerseys C 1 127 Single Women Adult Service Prevalence and risk factors of urinary incontinence in Fuzhou Chinese women

Get Laid Adaptation Singlewomenadultservice N S S Single Women Adult Service Service De Nfl Jerseys Denver Broncos Jerseys C 1 127 Single Women Adult Service

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The results of a multiple logistic regression analysis are presented in Table 4 . 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 BMI (1.8, 1.5－2.2), and unskilled worker (0.7, 0.5－0.8) are potential risk factors for stress incontinence. Urge incontinence is 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), fatal 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).

DISCUSSION

Urinary incontinence remains a worldwide problem affecting women of all ages across different cultures and races. In our survey, urinary incontinence was selfreported and diagnosis was based on simple questions. Likewise, diagnosis of the type of UI and history of gynaecology were based on anamnesis. Thus, some misclassification may have occurred. One strength of this survey is that data was obtained from almost all of a large sample of a single community. Ideally, a high response rate from populations sampled in a certain geographical location does estimate the prevalence of UI more accurately than samples with a low response rate taken from doctors' offices.

The range of prevalence among the published studies is wide. This variation could be due to differences in definitions used, population surveyed, survey type, response rate, age and other factors.［5,12］ Five definitions of urinary incontinence have been used in the literature. These definitions include any UI in the previous 12 months (Definition Ⅰ), more than one episodes of UI in a month (Definition Ⅱ), two or more episodes of UI in a week (Definition Ⅲ), involuntary UI that is a social or hygienic problem and is objectively demonstrable (Definition Ⅳ), and any UI, past or present (Definition Ⅴ).［13］According to BFLUTS questionnaire, we defined urinary incontinence as “more than one episode of UI in a month (Definition Ⅱ)” in our study. This definition is used in most of previous studies of this kind so that it facilitates comparison of results.

In Asia, Chan et al［9］ reported that only 4.8% of 919 elderly women were incontinent in Singapore; Kondo et al［14］ reported that 27.1% of Japanese community dwelling women experienced stress urinary incontinence. In a community based study of Chinese women aged 18 and older in Hong Kong, Ma［10］ reported that 34% of women experienced at least one episode of urinary incontinence and 18.5% of women had persistent incontinence. The target populations of Ma's study included 1018 females, but only 362 women were interviewed (response rate 35.6%). Chen et al［9］ reported that 53.7% of the women sampled in Taiwan suffered from urinary incontinence and related symptoms and 35.0% had urinary incontinence. In their community based survey, 1253 women were interviewed using the BFLUTS Questionnaire. However, BFLUTS questionnaire was originally designed to be mailed to the patient who completed it, so data collected from patients using interview could be biased.［11］ Prevalence estimates made by using mail surveys are especially lower than those made by using face to face interviewing.［15］ Fultz and Herzog showed that the use of an introduction and followup probe question about UI resulted in a doubling of the prevalence rate.［16］ Our study found that 19.0% of the women in Fuzhou had urinary incontinence. The prevalence of urinary incontinence in Fuzhou is higher than that (4.8%) reported in Singapore,9 lower than that (35.0%) reported in Taiwan, but it is similar to that (18.5%) reported by Ma in Hong Kong.［10］ In our study, the prevalence of stress urinary incontinence (16.6%) is specially lower than that of occidental females (50.0%),［13］ but similar to that (18.0%) of Taiwanese women reported by Chen et al.［9］ Based on the comparison of the pelvic supporting tissues of Chinese women with those of occidental females, Zacbarin claimed that stress urinary incontinence was extremely rare in Chinese women.［17］

In our study, the prevalence of three types of urinary incontinence increases steadily with age, which is consistent with some reports. Simeonova et al［18］ discovered a linear increase in the prevalence of urinary incontinence from 3% in the 20 to 29 year cohort to 32% in the cohort of women over 80 years. But there are conflicting opinions regarding the pattern of this increase. Harrison et al［19］ found an increase in prevalence of urinary incontinence with age up to the fifth decade of life followed by a decline thereafter.

From many epidemiologic studies on incontinence in various populations, a number of risk factors have been identified. Some chronic medical conditions, such as diabetes, hypertension and constipation also increase the occurrence of urinary incontinence. A univariate analysis and a multiple logistic regression analysis provided further information to show that risk factors predisposed the subjects to stress urinary incontinence and urge incontinence. Some evidence suggests that the risk of incontinence is increased after vaginal delivery compared with Caesarean delivery. Rortveit et al［20］ reported the risk of incontinence was higher among women who had Caesarean delivery compared with nulliparous women, and was even higher among women who had vaginal delivery. In our study, vaginal delivery increases the occurrence of stress incontinence (OR, 3.0, 95%CI, 1.9－4.7), but Caesarean delivery is associated with lessurge incontinence (OR, 0.2, 95%CI, 0.1－0.5). Our findings were not consistent with other reports, for example, Viktrup et al［21］ stated that Caesarean delivery protected against the development of stress incontinence after delivery. Whether this difference is a result of race, ethnicity, or cultural differences is difficult to determine and controversial. In addition, age, parity >2, hypertension, const-ipation, alcohol consumption, episiotomy, and higher BMI are potential risk factors for stress incontinence, and urge incontinence is associated with age, menopause, parity >2, constipation, foetal birthweight, episiotomy, higher BMI.

Among these risk factors, hypertension, const-ipation, alcohol consumption are modifiable risk factors. The control of hypertension, therapy of constipation and decrease in alcohol consumption should improve the condition of patients with urinary incontinence. Others are not easily modifiable risk factors. However, because estimates suggest that less than one third of Chinese women with incontinence seek medical care,［11］ these characteristics may be of great value for physicians in identifying and advising women most likely to experience urinary incontinence.

REFERENCES

1.Burgio KL, Zyczynski H, Locher JL, et al. Urinary incontinence in the 12-month postpartum period. Obstet Gynecol 2003;102:1291-1298.
2.Sampselle CM, Harlow SD, Skurnick J, et al. Urinary incontinence predictors and life impact in ethnically diverse perimenopausal women. Obstet Gynecol 2002;100:1230-1238.
3.Abrams P, Cardozol L, Fall M, et al. The standardization of terminology of lower urinary tract function: Report from the Standardisation Sub-committee of the International Continence Society. Urology 2003;61:37-49.
4.Cheater FM, Castleden CM. Epidemiology and classification of urinary incontinence. Bailliere Clin Obstet Gynecol 2002;14:183-205.
5.Hampel C, Artibani W, Espuna M, et al. Understanding the burden of stress urinary incontinence in Europe: a qualitative review of the literature. Euro Urol 2004;46:15-27. eGet Laid Adaptation Singlewomenadultservice N S S Single Women Adult Service Service De Nfl Jerseys Denver Broncos Jerseys C 1 127 Single Women Adult Service Prevalence and risk factors of urinary incontinence in Fuzhou Chinese womenb t Single Women Adult Service Single Women Adult Service Bikini kGet Laid Adaptation Singlewomenadultservice N S S Single Women Adult Service Service De Nfl Jerseys Denver Broncos Jerseys C 1 127 Single Women Adult Service Prevalence and risk factors of urinary incontinence in Fuzhou Chinese womenc Single Women Adult Service Women Single Women Adult Service