Prevalence of urinary incontinence in Chinese adult women: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YU Kun ¹ ,  XIE Zhenguo ² , YU Zhihai ¹ , LIU Sheng ¹ , LIU Meiping ¹

1. Department of Urology, Chongqing Three Gorges Central Hospital & Affiliated Three Gorges Hospital of Chongqing Medical University, Chongqing, 404000, P.R.China;
2. Department of Pharmacy, Chongqing Three Gorges Central Hospital & Affiliated Three Gorges Hospital of Chongqing Medical University, Chongqing, 404000, P.R.China;

Corresponding?author：

XIE Zhenguo, Email: xiezhenguo@foxmail.com

Keywords：

Urinary incontinence; Adult women; Prevalence; Meta-analysis; Cross-sectional study; Health equity; Special population

DOI：

10.7507/1672-2531.201806057

Video：

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Objectives To provide reference for decision-making on prevention and treatment of urinary incontinence by assessing the prevalence of urinary incontinence in Chinese adult women. Methods We searched CNKI, VIP, WanFang Data, CBM, PubMed, EMbase, The Cochrane Library to collect cross-sectional studies on urinary incontinence in adult women in mainland China from inception to June 2018. Two reviewers independently screened literature, extracted data, and evaluated the risk of bias of the included studies. Meta-analysis was performed using Stata 12.0 software. Results A total of 20 studies were involved, including 90 126 patients. Meta-analysis showed that the prevalence of urinary incontinence in adult women was 31.1% (95%CI: 28.3% to 34.0%). The subgroup analysis showed that stress urinary incontinence was the main subtype, of which was mainly with mild incontinence, with an average prevalence rate of 27.5% (95%CI: 22.6% to 32.4%) in urban areas and 32.5% (95%CI: 23.3% to 41.7%) in rural areas; 30.9% (95%CI: 26.8% to 35.1%) in the south and 31.4% (95%CI: 26.0% to 36.7%) in the north. The prevalence rate was rising from 2005 to 2008, and it remained at a high level in the following years, and the prevalence increased with age. Conclusions The prevalence of urinary incontinence in adult women in China has been at a high level since 2005. There has been no significant improvement in the past 10 years. Therefore, we should attach great importance to it and take appropriate interventions to prevent the occurrence of urinary incontinence.

Citation： YU Kun, XIE Zhenguo, YU Zhihai, LIU Sheng, LIU Meiping. Prevalence of urinary incontinence in Chinese adult women: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(1): 36-43. doi: 10.7507/1672-2531.201806057 Copy

1.	Abrams P, Cardozo L, Fall M, et al. The standardization of terminology in lower urinary tract function: report from the Standardization Sub-committee of the International Continence Society. Urology, 2003, 61(1): 37-49.
2.	Milsom I, Coyne KS, Nicholson S, et al. Global prevalence and economic burden of urgency urinary incontinence: a systematic review. Eur Urol, 2014, 65(1): 79-95.
3.	周全, 宋巖峰, 羅龍華, 等. 兩種閉孔路徑尿道中段懸吊術治療女性壓力性尿失禁的 Meta 分析. 中華全科醫師雜志, 2013, 12(2): 127-129.
4.	Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet, 2003, 82(3): 327-338.
5.	朱蘭, 郎景和, 王宏, 等. 北京地區成年女性尿失禁的流行病學研究. 中華醫學雜志, 2006, (11): 728-731.
6.	曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四:觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
7.	鄧麗, 韋業平, 張麗瀅, 等. 南寧市成年女性尿失禁流行病學調查. 廣西醫科大學學報, 2013, 30(6): 963-966.
8.	何本鴻, 龔艷麗. 利川市成年女性尿失禁流行病學調查. 醫學新知雜志, 2006, 16(6): 358-359.
9.	劉曉旭. 河北省部分地區女性尿失禁流行病學調查. 石家莊: 河北醫科大學, 2011.
10.	衛中慶, 周文俊, 喻榮彬, 等. 南京地區成年女性尿失禁的流行病學調查. 臨床泌尿外科雜志, 2009, 24(1): 49-52.
11.	丁峰. 廈門社區女性盆底功能障礙性疾病流行病學研究. 福州: 福建醫科大學, 2011.
12.	來光華, 赫小龍, 張驍, 等. 杭州市成年女性尿失禁患病情況及對生活質量的影響. 浙江預防醫學, 2016, 28(4): 328-331.
13.	李亞欽, 宋巖峰, 何曉宇, 等. 福州市某社區女性居民尿失禁患病率調查. 中華流行病學雜志, 2004, 25(4): 363.
14.	張素英. 杭州地區成年女性尿失禁的流行病學調查. 杭州: 浙江大學, 2009.
15.	曹曉靜. 粵東地區女性盆底功能障礙性疾病流行病學調查. 北京: 首都醫科大學, 2016.
16.	Liu B, Wang L, Huang SS, et al. Prevalence and risk factors of urinary incontinence among Chinese women in Shanghai. Int J Clin Exp Med, 2014, 7(3): 686-696.
17.	初磊, 王建軍, 樊伯珍, 等. 上海市成年女性尿失禁的流行病學研究. 現代婦產科進展, 2015, 24(6): 421-424.
18.	陳旭. 遼寧地區成年女性尿失禁流行病學調查研究. 沈陽: 中國醫科大學, 2009.
19.	葛靜, 魯永鮮, 張弈, 等. 北京地區成年女性尿失禁患病率及就診率調查. 中國婦產科臨床雜志, 2010, 11(1): 15-17.
20.	黃亮, 張淞文, 王濤, 等. 北京地區女性下尿路癥狀流行病學研究. 中國婦幼保健, 2011, 26(26): 4014-4018.
21.	蔣妍, 閆璐, 杜飛達, 等. 河北省女性尿失禁患病率調查及其影響因素分析. 中華婦產科雜志, 2016, 51(12): 914-920.
22.	李易霞, 馬蘭, 何春妮, 等. 新疆馬蘭地區成年女性尿失禁的流行病學調查. 中國醫藥導報, 2012, 9(13): 128-131.
23.	劉青, 仇杰, 龍麗霞, 等. 甘肅省女性尿失禁的流行病學調查及影響因素的多因素 Logistic 分析. 實用婦產科雜志, 2012, 28(10): 830-833.
24.	宋迎春, 張培蓮, 謝麗, 等. 西安市區成年女性尿失禁的流行病學及對生活質量影響的研究. 陜西醫學雜志, 2014, 43(2): 225-228.
25.	張蕾. 中國成年女性下尿路癥狀流行病學調查及隨訪研究-多中心橫斷面及前瞻性隊列研究. 北京: 北京協和醫學院, 2015.
26.	Ma SS. The prevalence of adult female urinary incontinence in Hong Kong Chinese. Int Urogynecol J Pelvic Floor Dysfunct, 1997, 8(6): 327-331.
27.	Azuma R, Murakami K, Iwamoto M, et al. Prevalence and risk factors of urinary incontinence and its influence on the quality of life of Japanese women. Nurs Health Sci, 2008, 10(2): 151-158.
28.	Choo MS, Ku JH, Oh SJ, et al. Prevalence of urinary incontinence in Korean women: an epidemiologic survey. Int Urogynecol J Pelvic Floor Dysfunct, 2007, 18(11): 1309-1315.
29.	Reynolds WS, Dmochowski RR, Penson DF. Epidemiology of stress urinary incontinence in women. Curr Urol Rep, 2011, 12(5): 370-376.
30.	Wu JM, Vaughan CP, Goode PS, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol, 2014, 123(1): 141-148.
31.	Hunskaar S, Lose G, Sykes D, et al. The prevalence of urinary incontinence in women in four European countries. BJU Int, 2004, 93(3): 324-330.
32.	何春妮, 張淑萍, 藺玉紅, 等. 新疆烏魯木齊周邊不同民族女性尿失禁調查分析. 中國醫師雜志, 2009, 11(10): 1435-1436.
33.	Tennstedt SL, Link CL, Steers WD, et al. Prevalence of and risk factors for urine leakage in a racially and ethnically diverse population of adults: the Boston area community health (BACH) survey. Am J Epidemiol, 2008, 167(4): 390-399.
34.	Fenner DE, Trowbridge ER, Patel DA, et al. Establishing the prevalence of incontinence study: racial differences in women’s patterns of urinary incontinence. J Urol, 2008, 179(4): 1455-1460.
35.	Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA, 2008, 300(11): 1311-1316.
36.	Goode PS, Burgio KL, Redden DT, et al. Population based study of incidence and predictors of urinary incontinence in black and white older adults. J Urol, 2008, 179(4): 1449-1454.
37.	Kupelian V, Wei JT, O’Leary M P, et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) survey. Arch Intern Med, 2006, 166(21): 2381-2387.
38.	Anger JT, Saigal CS, Litwin MS. The prevalence of urinary incontinence among community dwelling adult women: results from the national health and nutrition examination survey. J Urol, 2006, 175(2): 601-604.
39.	Al-Mukhtar OJ, Akervall S, Milsom I, et al. Urinary incontinence in nulliparous women aged 25-64 years: a national survey. Am J Obstet Gynecol, 2017, 216(2): 141-149.
40.	賀媛, 趙小蘭, 曾強. 城市成人超重、肥胖、中心性肥胖的流行特征和相關危險因素分析. 實用預防醫學, 2015, 22(4): 390-394.
41.	Subak LL, Richter HE, Hunskaar S. Obesity and urinary incontinence: epidemiology and clinical research update. J Urol, 2009, 182(Suppl 6): S2-S7.
42.	Lawrence JM, Lukacz ES, Liu IL, et al. Pelvic floor disorders, diabetes, and obesity in women: findings from the Kaiser permanente continence associated risk epidemiology study. Diabetes Care, 2007, 30(10): 2536-2541.
43.	Maclennan AH, Taylor AW, Wilson DH, et al. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG, 2000, 107(12): 1460-1470.
44.	Romero-Talamas H, Unger CA, Aminian A, et al. Comprehensive evaluation of the effect of bariatric surgery on pelvic floor disorders. Surg Obes Relat Dis, 2016, 12(1): 138-143.
45.	Subak LL, King WC, Belle SH, et al. Urinary incontinence before and after bariatric surgery. JAMA Intern Med, 2015, 175(8): 1378-1387.
46.	艾聰, 李光校, 周波, 等. 中國 2000 年后急性心肌梗死患者抑郁患病率的 Meta 分析. 中國循證醫學雜志, 2017, 17(1): 47-51.

1. Abrams P, Cardozo L, Fall M, et al. The standardization of terminology in lower urinary tract function: report from the Standardization Sub-committee of the International Continence Society. Urology, 2003, 61(1): 37-49.
2. Milsom I, Coyne KS, Nicholson S, et al. Global prevalence and economic burden of urgency urinary incontinence: a systematic review. Eur Urol, 2014, 65(1): 79-95.
3. 周全, 宋巖峰, 羅龍華, 等. 兩種閉孔路徑尿道中段懸吊術治療女性壓力性尿失禁的 Meta 分析. 中華全科醫師雜志, 2013, 12(2): 127-129.
4. Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet, 2003, 82(3): 327-338.
5. 朱蘭, 郎景和, 王宏, 等. 北京地區成年女性尿失禁的流行病學研究. 中華醫學雜志, 2006, (11): 728-731.
6. 曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四:觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
7. 鄧麗, 韋業平, 張麗瀅, 等. 南寧市成年女性尿失禁流行病學調查. 廣西醫科大學學報, 2013, 30(6): 963-966.
8. 何本鴻, 龔艷麗. 利川市成年女性尿失禁流行病學調查. 醫學新知雜志, 2006, 16(6): 358-359.
9. 劉曉旭. 河北省部分地區女性尿失禁流行病學調查. 石家莊: 河北醫科大學, 2011.
10. 衛中慶, 周文俊, 喻榮彬, 等. 南京地區成年女性尿失禁的流行病學調查. 臨床泌尿外科雜志, 2009, 24(1): 49-52.
11. 丁峰. 廈門社區女性盆底功能障礙性疾病流行病學研究. 福州: 福建醫科大學, 2011.
12. 來光華, 赫小龍, 張驍, 等. 杭州市成年女性尿失禁患病情況及對生活質量的影響. 浙江預防醫學, 2016, 28(4): 328-331.
13. 李亞欽, 宋巖峰, 何曉宇, 等. 福州市某社區女性居民尿失禁患病率調查. 中華流行病學雜志, 2004, 25(4): 363.
14. 張素英. 杭州地區成年女性尿失禁的流行病學調查. 杭州: 浙江大學, 2009.
15. 曹曉靜. 粵東地區女性盆底功能障礙性疾病流行病學調查. 北京: 首都醫科大學, 2016.
16. Liu B, Wang L, Huang SS, et al. Prevalence and risk factors of urinary incontinence among Chinese women in Shanghai. Int J Clin Exp Med, 2014, 7(3): 686-696.
17. 初磊, 王建軍, 樊伯珍, 等. 上海市成年女性尿失禁的流行病學研究. 現代婦產科進展, 2015, 24(6): 421-424.
18. 陳旭. 遼寧地區成年女性尿失禁流行病學調查研究. 沈陽: 中國醫科大學, 2009.
19. 葛靜, 魯永鮮, 張弈, 等. 北京地區成年女性尿失禁患病率及就診率調查. 中國婦產科臨床雜志, 2010, 11(1): 15-17.
20. 黃亮, 張淞文, 王濤, 等. 北京地區女性下尿路癥狀流行病學研究. 中國婦幼保健, 2011, 26(26): 4014-4018.
21. 蔣妍, 閆璐, 杜飛達, 等. 河北省女性尿失禁患病率調查及其影響因素分析. 中華婦產科雜志, 2016, 51(12): 914-920.
22. 李易霞, 馬蘭, 何春妮, 等. 新疆馬蘭地區成年女性尿失禁的流行病學調查. 中國醫藥導報, 2012, 9(13): 128-131.
23. 劉青, 仇杰, 龍麗霞, 等. 甘肅省女性尿失禁的流行病學調查及影響因素的多因素 Logistic 分析. 實用婦產科雜志, 2012, 28(10): 830-833.
24. 宋迎春, 張培蓮, 謝麗, 等. 西安市區成年女性尿失禁的流行病學及對生活質量影響的研究. 陜西醫學雜志, 2014, 43(2): 225-228.
25. 張蕾. 中國成年女性下尿路癥狀流行病學調查及隨訪研究-多中心橫斷面及前瞻性隊列研究. 北京: 北京協和醫學院, 2015.
26. Ma SS. The prevalence of adult female urinary incontinence in Hong Kong Chinese. Int Urogynecol J Pelvic Floor Dysfunct, 1997, 8(6): 327-331.
27. Azuma R, Murakami K, Iwamoto M, et al. Prevalence and risk factors of urinary incontinence and its influence on the quality of life of Japanese women. Nurs Health Sci, 2008, 10(2): 151-158.
28. Choo MS, Ku JH, Oh SJ, et al. Prevalence of urinary incontinence in Korean women: an epidemiologic survey. Int Urogynecol J Pelvic Floor Dysfunct, 2007, 18(11): 1309-1315.
29. Reynolds WS, Dmochowski RR, Penson DF. Epidemiology of stress urinary incontinence in women. Curr Urol Rep, 2011, 12(5): 370-376.
30. Wu JM, Vaughan CP, Goode PS, et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women. Obstet Gynecol, 2014, 123(1): 141-148.
31. Hunskaar S, Lose G, Sykes D, et al. The prevalence of urinary incontinence in women in four European countries. BJU Int, 2004, 93(3): 324-330.
32. 何春妮, 張淑萍, 藺玉紅, 等. 新疆烏魯木齊周邊不同民族女性尿失禁調查分析. 中國醫師雜志, 2009, 11(10): 1435-1436.
33. Tennstedt SL, Link CL, Steers WD, et al. Prevalence of and risk factors for urine leakage in a racially and ethnically diverse population of adults: the Boston area community health (BACH) survey. Am J Epidemiol, 2008, 167(4): 390-399.
34. Fenner DE, Trowbridge ER, Patel DA, et al. Establishing the prevalence of incontinence study: racial differences in women’s patterns of urinary incontinence. J Urol, 2008, 179(4): 1455-1460.
35. Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA, 2008, 300(11): 1311-1316.
36. Goode PS, Burgio KL, Redden DT, et al. Population based study of incidence and predictors of urinary incontinence in black and white older adults. J Urol, 2008, 179(4): 1449-1454.
37. Kupelian V, Wei JT, O’Leary M P, et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) survey. Arch Intern Med, 2006, 166(21): 2381-2387.
38. Anger JT, Saigal CS, Litwin MS. The prevalence of urinary incontinence among community dwelling adult women: results from the national health and nutrition examination survey. J Urol, 2006, 175(2): 601-604.
39. Al-Mukhtar OJ, Akervall S, Milsom I, et al. Urinary incontinence in nulliparous women aged 25-64 years: a national survey. Am J Obstet Gynecol, 2017, 216(2): 141-149.
40. 賀媛, 趙小蘭, 曾強. 城市成人超重、肥胖、中心性肥胖的流行特征和相關危險因素分析. 實用預防醫學, 2015, 22(4): 390-394.
41. Subak LL, Richter HE, Hunskaar S. Obesity and urinary incontinence: epidemiology and clinical research update. J Urol, 2009, 182(Suppl 6): S2-S7.
42. Lawrence JM, Lukacz ES, Liu IL, et al. Pelvic floor disorders, diabetes, and obesity in women: findings from the Kaiser permanente continence associated risk epidemiology study. Diabetes Care, 2007, 30(10): 2536-2541.
43. Maclennan AH, Taylor AW, Wilson DH, et al. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG, 2000, 107(12): 1460-1470.
44. Romero-Talamas H, Unger CA, Aminian A, et al. Comprehensive evaluation of the effect of bariatric surgery on pelvic floor disorders. Surg Obes Relat Dis, 2016, 12(1): 138-143.
45. Subak LL, King WC, Belle SH, et al. Urinary incontinence before and after bariatric surgery. JAMA Intern Med, 2015, 175(8): 1378-1387.
46. 艾聰, 李光校, 周波, 等. 中國 2000 年后急性心肌梗死患者抑郁患病率的 Meta 分析. 中國循證醫學雜志, 2017, 17(1): 47-51.

Chinese Journal of Evidence-Based Medicine

Prevalence of urinary incontinence in Chinese adult women: a meta-analysis

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