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- Wennberg, Anna Lena, 1968, et al.
(författare)
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A longitudinal population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in women
- 2009
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Ingår i: Eur Urol. ; 55:4, s. 783-91
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: 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. OBJECTIVE: 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). METHODS: 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. RESULTS AND LIMITATIONS: 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). CONCLUSIONS: 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.
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| 2. |
- Wennberg, Anna Lena, 1968
(författare)
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Lower Urinary Tract symptoms in women – Aspects on epidemiology and treatment
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Lower urinary tract symptoms in women – aspects on epidemiology and treatment Lower urinary tract symptoms (LUTS) are common conditions that compromise a person’s quality of life and result in increased health care costs for society. The aims of this thesis were to describe the prevalence and natural course of different LUTS in women (Paper I), to assess prevalence changes over time (Paper II), and to evaluate the importance of genetic factors on LUTS (Paper III). The long-term results of the Stamey needle colposuspension for female stress urinary incontinence were also assessed (Paper IV). Paper I: In this population-based, longitudinal study the very same women (n=1081) were assessed regarding the prevalence, progression and remission of various LUTS in 1991 and 2007, using a postal questionnaire. The proportion of women reporting urinary incontinence (UI), overactive bladder (OAB), nocturia and daytime voiding frequency of ≥8 times/day increased markedly over time. Both incidence and remission for most symptoms were considerable. Paper II: The prevalence of LUTS, help-seeking behaviour, treatment and quality of life were compared in two population-based surveys of women performed in 1991 (n=2911) and 2007 (n=3158) using a similar questionnaire. The reported prevalence of UI and OAB was unchanged over time as was help-seeking due to UI. In 2007, more women stated that the presence of UI limited their daily life. Paper III: Questionnaire-based national cohort survey evaluating the prevalence of LUTS in Swedish twins born 1959-1985 (n=25 364). Heritability was assessed in female twins. LUTS were more common in women than in men. The strongest genetic effects were observed for UI and nocturia and the lowest for OAB without incontinence where environmental effects dominated. Shared environment accounted for nearly one third of the total variation for OAB without incontinence and for one fifth of the variation for stress UI. Non-shared environmental effects were in the range of 45-65% for the various LUTS. Paper IV: Twenty-four women, treated by the Stamey method for stress UI, were followed up by means of a questionnaire, urodynamic assessment and a standardised quantification test. Time to follow-up was 63 months. Approximately half of the women considered themselves continent at follow-up. The mean postoperative leakage was significantly reduced as compared to preoperatively. Most women were satisfied with the result of the operation. Conclusions: These studies showed that the prevalence of UI and OAB in women has been largely unchanged in the last 16 years. UI, OAB and other LUTS constitute dynamic conditions. The prevalence of symptoms increases with increasing age, but both progression and remission over time are common. The strongest genetic effects were observed for conditions involving UI and for nocturia while the lowest genetic effects were observed for OAB, where environmental factors were more important. The Stamey procedure may be used in a selected group of women with genuine stress UI and stable detrusor with acceptable long-term results and patient satisfaction.
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| 3. |
- Wennberg, Anna Lena, 1968, et al.
(författare)
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Lower urinary tract symptoms: lack of change in prevalence and help-seeking behaviour in two population-based surveys of women in 1991 and 2007
- 2009
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Ingår i: BJU International. - 1464-410X. ; 104:7, s. 954-959
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES To test the hypothesis that the overt prevalence and help-seeking pattern for lower urinary tract symptoms (LUTS) might have changed over time, by comparing the prevalence of urinary incontinence (UI), overactive bladder (OAB) and other LUTS (principally storage symptoms) and help-seeking pattern in two equivalent groups of women 16 years apart. SUBJECTS AND METHODS We compared two cross-sectional studies; population-based random samples of women aged >/=20 years in the central district of Gothenburg in 1991 (2911) and 2007 (3158) were asked to complete similar self-administered postal questionnaires regarding UI and other LUTS. RESULTS The mean (sd, range) age of the two groups was 48.1 (20.4, 20-98 ) years in 1991 and 46.2 (20.0, 20-101) years in 2007, respectively. When comparing the two study populations there were no significant differences in the reported prevalence of UI, OAB or nocturia (defined as two or more voids per night) over time. Nocturia according to the International Continence Society definition was significantly more prevalent in 2007 than 1991, as was daytime voiding frequency of eight or more times a day. OAB dry (i.e. with no incontinence) was more common in 1991, while OAB wet (i.e. with incontinence) was more prevalent in 2007. Of the women in 1991 and 2007, 6% and 7%, respectively, had sought help from the healthcare system due to UI. Significantly more women in 2007 than in 1991 stated that the presence of UI limited their social life (29% vs 13%, P < 0.001). CONCLUSION LUTS are common in women and the prevalence rates of UI and OAB have not changed during the last 16 years. Many women still do not seek help from the healthcare system, and the help-seeking pattern has remained unchanged, despite effective treatment currently being offered.
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