Epidemiology and classification of urinary incontinence.

Urinary incontinence is a common symptom affecting the physical, psychological, social and economic well-being of individuals and their families. It also poses a considerable economic burden on health and social services. The literature reports widely varying prevalence rates for incontinence that are partially explained by methodological differences between studies. However, community-based studies indicate that approximately 6% of the population, particularly women and older people, will have urinary incontinence of sufficient severity to interfere with their quality of life. This represents a significant demand for health care. Although further research on prevalence is unlikely to add anything new to current knowledge on the size of the problem, more information is needed on the onset, progression and risk factors of urinary incontinence to inform methods of effective treatment and preventive strategies. In addition, there has been little investigation of the triggers to seeking professional help or of the response of health professionals to patients' demands for treatment, either for incontinence or other lower urinary tract symptoms. The aetiology of incontinence is multifactorial; incontinence is caused by pathophysiological impairments to the lower urinary tract and neurological system, as well as a range of external factors. The key to effective management, therefore, is a comprehensive assessment of the patient, including other lower urinary tract symptoms, so that appropriate intervention is tailored on a diagnosis and not on symptoms.