Prevalence and natural history of female incontinence.

OBJECTIVE: Urinary incontinence is a common and highly embarrassing condition among females of all age groups and has been the subject of several epidemiological studies in the past.
METHODS: From an extensive literature search covering the time period from 1954 to 1995, 48 epidemiological studies and several other publications dealing with prevalence and natural history of female incontinence were reviewed. Meta-analysis of reported data was performed in respect of incontinence definitions, investigation methods, home country of survey and age groups.
RESULTS: Available data are nonhomogenous and difficult to compare because of differences in definitions of incontinence, target populations and study design in different investigations. By grouping the studies by similarities in the above criteria and analysing the results for each group of studies, an attempt was made to understand the great variation of reported results. Differences in prevalence of incontinence were identified for all examined aspects and for distinct ethnic populations. The little information that exists on the incidence, spontaneous remission rates and risk factors were used to elucidate the natural history of female incontinence.
CONCLUSION: A generally accepted definition of incontinence is highly desirable and should comprise aspects of severity and demonstrability of the condition, bother factor and impact on quality of life. Furthermore, basic requirements for epidemiological surveys of incontinence such as validation of questionnaire results need to be defined and standardised to establish a sensible basis for useful epidemiological studies in the future.