FEMALE UROLOGY

URINARY INCONTINENCE

WHY do we need to learn something about incontinence?

When is a condition “IMPORTANT”?

“IMPORTANT” Diseases

• Life - threateningCommon, afflicts manyDebilitating, affects quality of lifeFinancially straining, costlyPotential for improvement in the

management and care

There remains a paucity of information regarding urinary incontinence in non-caucasian women worldwide.

- Hunskaar, et al. Epidemiology and Natural History of Urinary Incontinence.

Incontinence. Ed. Abrams, Khoury and Wein. 1999

Prevalence Study on Urinary Incontinence in

Asia

Asia Pacific Continence Advisory Board

Objectives

• Determine the prevalence of urinary incontinence in Asia

• Determine the status of urinary incontinence as a problem

• Determine the demographic factors related to the occurrence of urinary incontinence

Methodology

• Questionnaire survey• Created by an expert panel• Translated into the local dialect, validated• Multiple-choice type of queries• Self-administered under supervision of a

medically-trained personnel

URINARY INCONTINENCE

Have you ever leaked urine inappropriately before reaching the toilet in the past 6 months?

YES

Types of Incontinence

STRESS Leakage of urine with coughing, sneezing, etc.

URGE Leakage of urine associated with

a strong sensation to void

MIXEDcombination

Survey Population

• TOTAL : 7875• Males : 2369

• Females : 5506

• Participating countries :• Philippines

• Indonesia

• Malaysia

• Singapore

• Thailand

• China• Hong Kong• Taiwan• Korea• India• Pakistan

India12%

Pakistan11%

Taiwan12%

Korea8%

HK8%

China4%

Thailand17%

Philippines13%

Malaysia6%

Indonesia5%Singapore

4%

Survey Population

TOTAL : 5506

Prevalence of Urinary Incontinence Among Females in

Asia

20.3

13.9 13.15.8 11.8

6.2

24

7.4

22.6

1211.6

14.6

0

5

10

15

20

25

30

14.6%14.6%(5.8-24.0)

Prevalence of Urinary Incontinence among Females

14.6

3237

26

0

5

10

15

20

25

30

35

40

45

50

Asia (APCAB) Japan United States Europe

**

**

*

* Fukui, 1986** Hampel, et al. 1997

Type of Incontinence

Mixed63.8%

Stress13.1%

Urge23.1%

Type of IncontinenceAsia vs. World

Urge23.1%

Stress13.1%

Mixed63.8%

Urge22%

Mixed29%

Stress50%

ASIA WORLDHampel 1997

Incontinence as a Problem

• Degree of Bother• Scoring from 0 to 5

0 – no bother, 5 – severe

• Need for Leakage Protection

• Seeking Help

Incontinence as a Problem

Degree of Bother

1- very mild24.3%

0 - none36.1%

4 - severe3.6%

3 - moderate7.6%

2 - mild16.5%

5 - very severe5.2% not indicated

7%

YES : 53.7%

Incontinence as a Problem

Need for Leakage Protection

38.6%

(328/801)

Incontinence as a Problem

Rate of Seeking Help

No54.4%

Yes41%

Not

indicated

4.6%

Incontinence as a Problem

Rate of Seeking Help

41

50

25

0

10

20

30

40

50

60

70

Rate of Seeking

Help

Asia USA Europe* **

* NIH Consensus Statement on Urinary Incontinence,1988** Holts et al, 1988

Traditional Medicine

15.9%

General Practitioner

30.8%

Not indicated

2.7%Others17.1%

Nurse1.2%

Specialist24.7%

Primary Care7.6%

Seeking Help : Who?

Demographic Factors Associated with a Higher Prevalence of Urinary Incontinence

• Older age

• Multiparity

• Manual labor

• Positive family history for voiding dysfunction

• Use of a sitting toilet

• Higher income

Urinary Incontinence is an “IMPORTANT” disease

Common, afflicts many • 14.6% of the female population suffer from it

Debilitating, affects quality of lifemajority (53%) are bothered to a certain degree16% are bothered significantly55% will need to seek help

Financially straining, costly38% need protection = need for pads / diapers

Thank you