Minassian Vatche A, Stewart Walter F, Wood G Craig
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Geisinger Medical Center, Danville, Pennsylvania 17822, USA.
Obstet Gynecol. 2008 Feb;111(2 Pt 1):324-31. doi: 10.1097/01.AOG.0000267220.48987.17.
To understand variation in prevalence of urinary incontinence (UI) and risk factors, given different definitions.
The National Health and Nutrition Examination Survey 2001-2002 data on UI were used. Prevalence, severity, and associated risk factors of stress, urge, mixed, and any UI were estimated in 2,875 adult women. Severe UI was defined as incontinence a few times or more per week. Moderate UI was defined as an incontinence frequency of a few times per month only, and mild UI was defined as incontinence frequency of a few times per year only. Odds ratios for the association of potential risk factors were examined in a logistic regression model.
The overall prevalence of stress, urge, mixed, and any UI was 23.7%, 9.9%, 14.5%, and 49.2%, respectively. Prevalence of stress UI peaked at the fifth decade. Prevalence of urge and mixed UI increased with age. The largest number of risk factors and the strongest associations were found with severe UI. Age, ethnic background, and weight were significant risk factors common to all UI severity levels. Although parity and hysterectomy were risk factors for moderate and severe UI, they were not for mild UI.
Prevalence of UI varies substantially by type and case definition. The stronger associations of known risk factors with severe UI and the lack of risk factors with lesser UI severity types suggest that severe UI includes primarily clinically significant cases, whereas mild UI represents transient or nonpathologic states that may not be clinically significant.
III.
鉴于不同的定义，了解尿失禁（UI）患病率及危险因素的差异。
使用2001 - 2002年美国国家健康与营养检查调查中关于UI的数据。对2875名成年女性的压力性、急迫性、混合性及任何类型尿失禁的患病率、严重程度及相关危险因素进行了评估。严重尿失禁定义为每周失禁几次或更多次。中度尿失禁定义为每月仅失禁几次，轻度尿失禁定义为每年仅失禁几次。在逻辑回归模型中检验潜在危险因素关联的比值比。
压力性、急迫性、混合性及任何类型尿失禁的总体患病率分别为23.7%、9.9%、14.5%和49.2%。压力性尿失禁患病率在第五个十年达到峰值。急迫性和混合性尿失禁的患病率随年龄增加。在严重尿失禁中发现的危险因素数量最多且关联最强。年龄、种族背景和体重是所有尿失禁严重程度水平共有的重要危险因素。尽管产次和子宫切除术是中度和重度尿失禁的危险因素，但不是轻度尿失禁的危险因素。
尿失禁的患病率因类型和病例定义而异。已知危险因素与严重尿失禁的关联更强，而与较轻尿失禁严重程度类型缺乏危险因素，这表明严重尿失禁主要包括临床上有意义的病例，而轻度尿失禁代表可能在临床上无意义的短暂或非病理性状态。
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