History should include discussion about the patient’s typical voiding pattern, onset, and duration of incontinence symptoms, whether or not the patient is bothered by symptoms and any associated factors that can affect incontinence, i.e., amount and type of daily fluid intake and bladder irritants (caffeine, carbonated beverages, artificial sweeteners, alcohol, etc.). Therefore, a thorough and empathetic history taking should be conducted by the primary clinician. The presentation of incontinence symptoms can often be late due to the unwillingness of the patient population to report it. The care for any urinary incontinence almost always begins at a primary clinician’s office. Interestingly, urge incontinence is often the predominant subtype among 40% to 80% of those within the male population. The prevalence of "any sub-type" of urinary incontinence" (3% to 11%) in all ages of men is considered much lower than that for women. Even then, it is this second type of incontinence that is often extraordinarily bothersome and is more likely to require treatment. Studies have shown that stress incontinence is of high prevalence among postmenopausal women, whereas urge incontinence may have a somewhat lower prevalence. When considering the prevalence of urge incontinence specifically among women and men, a slightly different picture is depicted. The association of age with incontinence also prevails in men, but severe incontinence in elderly males is often half the number of that in women. Unlike stress incontinence, which reaches a peak mostly around the fifth decade of a patient's life and then shows a decline, both urge, and mixed incontinence continues to increase in prevalence with increasing age. Observational data from four European countries, as well as median prevalence data from a review of epidemiological studies from around the world, have revealed similar trends. When the whole population is considered as one, most studies pick either mixed or urge incontinence as less prevalent than stress incontinence. Overall, the association of age and urinary incontinence is well established. Even then, the reported prevalence for any sub-type of urinary incontinence in adult women is of a broad range (5% to 72%), with an approximate convergence of 30% according to different studies). This is probably the reason why, in many epidemiological studies from earlier dates, there had been no differentiation between urge and stress urinary incontinence.Īccurate prevalence measurement for urinary incontinence via robust epidemiological studies and validated measures tend to exist more in the United States and some developed European /Asian countries rather than the developing world. The data regarding the true prevalence of different types of urinary incontinences vary widely depending on the population studied, the social stigma and lack of interest to self-report (respondent bias in observational studies), and also on the case definitions in the questionnaires used. Other factors found to be associated with urinary incontinence of different subtypes include previous hysterectomy or pelvic surgery, parity, pulmonary disease, diabetes mellitus, dementia, or residing in a nursing home. The prevalence of urinary incontinence of any kind varies mainly with age and obesity.
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