Epidemiological Investigation Of Adult Female Urinary Incontinence In Hangzhou Area

Objective:Urinary incontinence(UI) is a group of urinary system's Symptoms which troubled the women.It affects women's physical-mental health and quality of life.The incidence of UI increases with the increase of age and it is a common disease in older women.So, it has been formally classified as a residency training of Obstetrics and Gynecology in Europe and America.According to international continence society,the definition of UI is as the involuntary outflow of urine which results in social and health problems. Usually,UI is classified into four types:stress urinary incontinence(SUI),urge urinary incontinence(UUI),mix urinary incontinence(MUI) and overflow urinary incontinence(OUI).Among all,SUI is the most common one in the middle and old aged women.The characteristic of SUI is that there is no urine outflow normally,but there will be urine outflow when abdominal pressure increases suddenly.Although SUI is not a life-threatening diseases,it will severely affect normal social activities,physical exercise and sexual life of patients,and even causes mental depression,loneliness, psychological barriers,which will further initiate a series of social and health problems. The main conception of Epidemiological study on female UI are including prevalence,incidence,disease severity,Pathogen etiology,risk factors,quality of Life,understanding of diseases,clinic-visiting and so on.The research significance are different with the difference of research purposes,design,methods and study population. In addition,epidemiologic studies are also covering all aspects of the social economy, including the concept,culture,economy influence,behavior criterion etc.Undoubtedly, epidemiological studies are important for disease prevention and control.In the beginning of 20th century,the aging population of China is becoming evident.The number of women who are suffering from urogynecological disease is increasing.It is urgent to enhance the prevention and treatment.Hangzhou is located in the Yangtze River Delta area where is with prosperous economy,frequent cultural exchanges, fast-paced job and heavy work pressure.Women often have problem in urogynecological system,such as SUI.It has gradually become a prominent problem in social life and what's more,it was considered to be one of the five major diseases in the mid-1990s.Neversless,there is no systematic investigation in epidemiology of UI in Hangzhou till now,.The purposes of this study are:1)To investigate the epidemiological characteristics and associated risk factors of SUI;2)To make clear of the prevalence rate of female UI;3)To show the characteristics of various types of Incontinence.This study will be benefit for us to formulate prevention and treatment measures of SUI.Methods:This study is a kind of random and multi-centers questionnaire survey.From March 2008 to December 2008,5117 adult females who are more than 20 ages were enrolled in our study.Whole women were from 30 grass-roots health organizations and Maternal and child health care institutions in Jiande,Tonglu,Chunan.The Survey of《Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module, ICQ-FLUTS》were filled.SUI was identified as that urine leak out uncontrolled when sneezing,laughing,coughing or carrying heavy objects in recent four weeks.UI was identified as that non-random urine leakage which occurred around Urgency symptoms appears.And MUI was identified as with both SUI and UI.40 questions are in our survey including age,education level,index of body mass,pregnancy history, gynecological diseases,chronic diseases,prevalence and treatment of UI and so on.The questionnaire is thought to be invalid when the prevalence data of UI are missed or obvious logic error is in it.From the age of 20,each for a 10-year-old age group,The investigated women were divided into 8 groups.X~2 test and T-test was used to analyze the female stress urinary incontinence-related factors,Multi-factor method logistic regression was used to analysis odds ratio(OR) values and 95%confidence interval (CI)and identify risk factors UI-related;Epi6.0 software was used to establish databases and error process.Spss10.0 statistical software was used to analysis the datas.Results:We have access to complete information 5036 copies of the questionnaire,256 women were unmarried,4780 women have married.The Age of the women who were investigated was 20-95 years old,and the average age was(45±17) years old.The urinary incontinence Prevalence rate of adult female in Hangzhou was 39.8% (2002/5036).And the prevalence rates of SUI,urge incontinence and mixed urinary incontinence were 24.8%(1249/5036),3.0%(151/5036)and 11.7%(590/5036).The mixed urinary incontinence prevalence rate increased significantly with age.The proportion of stress,urgency,mixed and other types of urinary incontinence were 62.4% (1249/2002),7.5%(151/2002),29.5%(590/2002),0.6%(12/2002).The urinary incontinence prevalence rate of nullipara and primipara cesarean section are 24.5% (174/710),48.5%(848/1750),36.2%(478/1320),there are significant difference (X~2=201.04,p＜0.05)between vaginal delivery and no production,no production and cesarean section,vaginal delivery and cesarean section.The body mass index of the person suffering stress urinary incontinence was significantly higher than non-urinary incontinence;Multivariate logistic regression showed that:age,chronic cough,old perineum laceration,repeated urinary tract infections,constipation and chronic pelvic pain are the stress urinary incontinence factors of adult female in Hangzhou area.Conclusion:1,The prevalence rate of urinary incontinence is relatively high and it is the major disease which affects life's quality of adult women in Hangzhou area.2,Stress urinary incontinence is the most common classification of urinary incontinence,which followed by mixed urinary incontinence and urgency,old age,chronic cough,old perineum laceration,repeated urinary tract infections, constipation,chronic pelvic pain are the risk factors of adult female's stress urinary incontinence in Hangzhou.3,The visiting rate of UI in Hangzhou is still low,which reminder us to pay high attention of this disease.