Epidemiological Investigation And Follow - Up Study Of Lower Urinary Tract Symptoms In Chinese Adult Women

BackgroundLower urinary tract symptoms (LUTS) have attracted substantial attention in recent years because of the heightened awareness of their detrimental impact on health-related quality of life. Studies reports that tens of thousands people have been reported to complain about moderate to severe LUTS, and women are more prone to it. Many large-scale epidemiological studies of LUTS have been conducted to better understand this situation, with the reported prevalence estimates of LUTS subsets varying widely. This is possibly due to differences in study populations, symptoms assessment, data collection, or definitions used. Epidemiological studies of lower urinary tract symptoms (LUTS) are few in China, and none has been conducted nationwide.Objective1. To estimate the prevalence of LUTS of adult women in different areas with different ages in China.2. To investigate the potential risk factors of LUTS in China.3. To evaluate the bother LUTS impose on adult women in China.MethodsThis is the second analysis of a population-based cross-sectional survey on urinary incontinence conducted between February and July 2006 in six regions of China. Cluster samples were randomly selected for interviews. The previous survey included 2 phase:a pilot study conducted in Beijing, China followed by a nationwide study. Detailed study procedures and results of stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI) were described in previous studies.Phase 1 (a pilot survey in Beijing) assessed a representative sample of approximately 5221 respondents (one urban and one rural districts) who were interviewed face to face by trained interviewers using a standardized questionnaire.Phase 2 was a nationwide survey which was conducted between February and July of 2006 in six regions in China. The sampling process was multistage and stratified according to geographic region (northwest, southwest, north, east, northeast, and central-south China) and degree of urbanization (large cities and undeveloped economic status were assessed on the basis of the gross domestic product for each province).A modified Chinese Bristol Female Lower Urinary Tract Symptoms questionnaire was administered. The participants were asked about the presence of individual LUTS and rated their symptom bother. Descriptive statistics, x2 tests, receiver operating characteristic curves, and multivariate logistic regressions were used for data analysis.ResultsA total of 18 992 respondents (94.96%) were included. The prevalence of any LUTS, storage symptoms, or voiding symptoms was 55.5%,53.9%, and 12.9%, respectively, and increased with age. Nocturia was the most common symptom (23.4%), followed by urgency (23.3%) and stress urinary incontinence (SUI; 18.9%). Nocturia was most frequently rated as bothersome (93.0%) but was generally minor (80.5%). Urgency and urgency urinary incontinence (UUI) were most frequently reported as severe (11.5% and 10.8%) or moderate (18.5% and 16.8%) bothers. Any LUTS were more prevalent in urban women (57.1% vs 53.9%). Multiple factors increased the odds of bother and individual LUTS, and older age and coexisting pelvic organ prolapse were strong predictors (p< 0.05). This survey was conducted 8 yr ago and did not assess all LUTS. Conclusions:Half of adult women suffered with LUTS; nocturia, urgency, and SUI were more prevalent. Urgency and UUI were most frequently reported as severe or moderate bothers. Multiple factors influenced bother and individual LUTS.Conclusion1. The prevalence of lower urinary tract symptoms is high and increases with age in adult women in China.2. Urgency and urgency urinary incontinence were most frequently regarded as severe or moderate bothers and should be targeted for medical intervention.3. Multiple factors influenced bother and individual LUTS,Older age and coexisting pelvic organ prolapse were strong predictors...