Wennberg Anna-Lena, Molander Ulla, Fall Magnus, Edlund Christer, Peeker Ralph, Milsom Ian
Department of Obstetrics and Gynaecology, Sahlgrenska Academy at Gothenburg University and Sahlgrenska University Hospital, Gothenburg, Sweden.
Eur Urol. 2009 Apr;55(4):783-91. doi: 10.1016/j.eururo.2009.01.007. Epub 2009 Jan 13.
Female urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) are highly prevalent conditions with a profound influence on well-being and quality of life. There are a few studies describing progression as well as remission, in the short term, of UI in the general population as well as in selected groups; at present, there are very few population-based studies describing the natural course of other LUTS in the same women, and there are no long-term longitudinal studies.
To describe the prevalence of UI, OAB, and other LUTS in the same women studied prospectively over time and, thus, to assess possible progression or regression.
DESIGN, SETTING, AND PARTICIPANTS: A longitudinal population-based study was performed in one primary health care district in the city of Gothenburg, Sweden. The participants were a sample of women aged > or = 20 yr who were randomly selected from the Swedish National Population Register, assessed in 1991 (n=2911), and available for reassessment in 2007 (n=1408).
A self-administered postal questionnaire regarding UI, OAB, and other LUTS was returned by 77% of the contacted women in 1991. The same women who responded in 1991 and who were still alive and available in the Swedish National Population Register 16 yr later were reassessed using a similar self-administered postal questionnaire.
In 2007, 1081 of the available 1408 women responded to the questionnaire (77%). The overall prevalence of UI, OAB, nocturia, and daytime micturition frequency of eight or more times per day increased by 13%, 9%, 20% (p<0.001), and 3% (p<0.05), respectively, from 1991 to 2007. The incidence of UI and OAB were 21% and 20%, respectively, and the corresponding remission rates were 34% and 43%, respectively. Women with OAB symptoms were classified as OAB dry or OAB wet, depending on the presence or absence of concomitant UI. The prevalence of OAB dry did not differ between the two assessment occasions (11% and 10%, respectively), but the prevalence of OAB wet increased from 6% to 16% (p<0.001).
UI and other LUTS constitute dynamic conditions. In this study, there was a marked overall increase in the prevalence of UI, OAB, and nocturia in the same women from 1991 to 2007. Both incidence and remission of most symptoms were considerable.
女性尿失禁(UI)、膀胱过度活动症(OAB)及其他下尿路症状(LUTS)极为常见,对幸福感和生活质量有深远影响。有一些研究描述了普通人群以及特定群体中UI在短期内的进展和缓解情况;目前,基于人群的研究极少描述同一女性中其他LUTS的自然病程,且尚无长期纵向研究。
描述同一批女性中UI、OAB及其他LUTS随时间的前瞻性研究患病率,从而评估可能的进展或消退情况。
设计、地点和参与者:在瑞典哥德堡市的一个初级卫生保健区进行了一项基于人群的纵向研究。参与者是年龄≥20岁的女性样本,她们从瑞典国家人口登记册中随机选取,于1991年进行评估(n = 2911),并于2007年可供重新评估(n = 1408)。
1991年,77%的受访女性通过邮寄方式自行填写了关于UI、OAB及其他LUTS的问卷。对1991年做出回应且1年后仍在世并可在瑞典国家人口登记册中查到的同一批女性,使用类似的邮寄问卷进行重新评估。
2007年,1408名可用女性中有1081名回复了问卷(77%)。从1991年到2007年,UI、OAB、夜尿症以及白天排尿频率每天8次或更多次的总体患病率分别增加了13%、9%、20%(p<0.001)和3%(p<0.05)。UI和OAB的发病率分别为21%和20%,相应的缓解率分别为34%和43%。有OAB症状的女性根据是否伴有UI被分类为OAB干性或OAB湿性。两次评估时OAB干性的患病率无差异(分别为11%和10%),但OAB湿性的患病率从6%增加到16%(p<0.001)。
UI和其他LUTS是动态变化的情况。在本研究中,从1991年到2007年同一批女性中UI、OAB和夜尿症的患病率总体显著增加。大多数症状的发病率和缓解率都相当可观。