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
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