Nitti V W
Rev Urol. 2001;3 Suppl 1(Suppl 1):S2-6.
Urinary incontinence is a significant health problem with considerable social and economic impact. It is important to distinguish between prevalence and incidence with regard to incontinence, and prevalence-the probability of having incontinence within a defined population at a defined point in time-is the more important when considering its impact and the utilization of healthcare resources. There are large variations in the severity and impact of incontinence, and its severity, frequency, and predictability all need to be considered when evaluating its effects on patients, The degree of bother is particularly significant when determining who will need treatment. Incontinence may be a result of bladder dysfunction, sphincter dysfunction, or a combination of both, but large-scale studies are not designed to determine the etiology. In young women, the prevalence of incontinence is usually low, but prevalence peaks around menopause, with a steady rise there-after into later life. Although the prevalence of stress and mixed (stress and urge) incontinence is higher than urge incontinence, the latter is more likely to require treatment. In women, moderate and severe bother have a prevalence ranging from about 3% to 17%. Severe incontinence has a low prevalence in young women, but rapidly increases at ages 70 through 80. In men, the prevalence of incontinence is much lower than in women, about 3% to 11% overall, with urge incontinence accounting for 40% to 80% of all male patients. Stress incontinence accounts for less than 10% of cases and is attributable to prostate surgery, trauma, or neurological injury. Incontinence in men also increases with age, but severe incontinence in 70- to 80-year-old men is about half of that in women. The most effective therapy for incontinence will rely on targeting the correct populations to be treated, which depends on how data is collected on prevalence and severity.
尿失禁是一个重大的健康问题，具有相当大的社会和经济影响。在尿失禁方面，区分患病率和发病率很重要，而患病率（即在特定时间点特定人群中患有尿失禁的概率）在考虑其影响和医疗资源利用时更为重要。尿失禁的严重程度和影响存在很大差异，在评估其对患者的影响时，需要考虑其严重程度、频率和可预测性。在确定谁需要治疗时，困扰程度尤为重要。尿失禁可能是膀胱功能障碍、括约肌功能障碍或两者共同作用的结果，但大规模研究并非旨在确定病因。在年轻女性中，尿失禁的患病率通常较低，但在绝经前后达到峰值，此后在晚年稳步上升。虽然压力性和混合性（压力性和急迫性）尿失禁的患病率高于急迫性尿失禁，但后者更有可能需要治疗。在女性中，中度和重度困扰的患病率约为3%至17%。严重尿失禁在年轻女性中的患病率较低，但在70至80岁时迅速增加。在男性中，尿失禁的患病率远低于女性，总体约为3%至11%，急迫性尿失禁占所有男性患者的40%至80%。压力性尿失禁占病例不到10%，可归因于前列腺手术、创伤或神经损伤。男性尿失禁也随年龄增加，但70至80岁男性的严重尿失禁约为女性的一半。最有效的尿失禁治疗将依赖于针对正确的治疗人群，这取决于如何收集关于患病率和严重程度的数据。
