4Examples of prevalence of any UI in studies of women living in the community
5URINARY INCONTINENCESeveral European and Americans epidemiologic studies a range of prevalence between 10 and 40%Among older women a range of prevalence between 10 and 50% or even wider remains a reasonable estimate
6Examples of prevalence of any UI in studies of older women living in the community
7URINARY INCONTINENCEHigher prevalence estimates in older ages.Some studies noted an early prevalence peak in midlife and then a steady increase among the aged (from EPINCONT study gradual increase of prevalences across adulthood until age 50 when prevalence reaches 30%, a stabilization or even slight decline until age 70 when prevalence start rising again).
8Prevalence of UI (any leakage) in women of 20 years+ Data from the EPINCONT study
9URINARY INCONTINENCE A prevalence range from 6 to 72%. Prevalence has always been higher in institutions because residents in nursing homes or in residential care facilities tend to be older and more impaired than community residing women.A prevalence range from 6 to 72%.Several recent studies suggest prevalences of 50% or higher.
10Relative proportion of different types of UI among women living in the community
11URINARY INCONTINENCEApproximately half of all incontinent women are classified as stress incontinent, the highest proportion among urge, stress, and mixed types of incontinenceA smaller proportion is classified as mixed incontinent, the smallest one as urge incontinent.Several recent studies suggest prevalences of 50% or higher.
12URINARY INCONTINENCE A prevalence range from 6 to 72%. Prevalence has always been higher in institutions because residents in nursing homes or in residential care facilities tend to be older and more impaired than community residing women.A prevalence range from 6 to 72%.Several recent studies suggest prevalences of 50% or higher.
13Distribution of different type of UI in age groups Distribution of different type of UI in age groups. Data from the EPINCONT study
14URINARY INCONTINENCE Proportion of types of UI differ by age. Mixed UI predominates in older women.Genuine stress incontinence (GSI) predominates in young and middle-aged group.In regard to this a recent study (Hannestd et al, 2000), demonstrated a fairly regular increase in prevalence of mixed incontinence across the age range, and a regular decrease in prevalence GSI.
15The prevalence of “any” and “severe” UI among older women living in the community
16Prevalence of UI by age group and severity Data from the EPINCONT study
17Prevalence of UI by age group and impact Data from the EPINCONT study
18Severity of the different types of UI Data from the EPINCONT study
19Established and suggested risk factors for UI in women AgePregnancyChildbirthMenopauseHisterectomyObesityLUTSFunctional impairmentCognitive impairmentOccupational risksFamily history and geneticsOther factors
20URINARY INCONTINENCE in athletes women Nygaard et al (1994)158 athletes, mean age 19.9 yearsall nulliparous28% urinary incontinence during sportactivities (2/3 IU more often that rarely)67% gymnastics66% basketball50% tennis10% swimming0% golf
21URINARY INCONTINENCE in athletes women Warren and Shanthahigh impact sports activities may produce urinary incontinenceGreydanus and Pateladolescent gynecology:stress urinary incontinence is common in female athetes
22URINARY INCONTINENCE in athletes women Bø and Borgenhigh prevalence of stress and urge incontinence in female elite athletes,mainly in eating disordered athletes compared with healthy athletes
23URINARY INCONTINENCE in athletes women Thyssen et alelite women athletes and dancers291 women, mean age 22.8 years51,9% urinary loss (43% during sport/dancing; 42% during daily life)the activity most likely correlated withurinary incontinence was jumping
24Incontinenza urinaria: fattori di rischio EtàGravidanzaParitàFattori legati al parto ed al fetoMenopausa e livelli ormonaliIsterectomiaObesitàInfezioni urinarie ricorrentiRiduzione delle capacità motorieRiduzione delle capacità cognitiveFumoStoria familiare
25Incontinenza urinaria maschile Nel sesso maschile la prevalenza di incontinenza urinaria è decisamente diversa, variando tra l’11 ed il 34%.Vi è una predominanza di incontinenza da urgenza (40-80%) seguita da forme miste (10-30%) e da incontinenza da sforzo (<10%).
26Incontinenza urinaria maschile L’aumento della prevalenza di incontinenza urinaria con l’età nel maschio è dovuto principalmente alle forme da urgenza.Fattori di rischio sono rappresentati, oltre che dall’età, da riduzione delle capacità motorie e/io cognitive, da malattie neurologiche e, soprattutto, dall’intervento di prostatectomia (sia transuretrale che radicale).La prostatectomia radicale sembra legata ad una prevalenza più elevata di incontinenza urinaria rispetto alla TURP .
27Incontinenza fecaleNell’adulto, la IF sembra avere una prevalenza addirittura tra l’11 ed il 15% adottando un questionario validato ma anonimo.Si stima che il 30% dei residenti in istituti geriatrici abbia avuto almeno un episodio di IF.
28Incontinenza fecale: fattori di rischio SessoPartoResidenza in casa di riposoDiarreaInterventi chirurgici perinealiMalattie neurologiche
30PREVALENCE (18-86 yrs)2,6347,7243,316,4%DegreeSwift SE, 2000
31PROLAPSE 50% of parous women have some degree of genital prolapse 10 to 20% of these are symptomatic20% of gynaecological waiting lists59% of major gynaecological surgery in the elderlyMore common amongst caucasiansOnly 2% amongst nulliparous women
32GENITAL PROLAPSE In women there is 11,1% likelihood of surgery for genital prolapse(Olsen, 1997)
33CPP EPIDEMIOLOGY CPP has a prevalence of about 12% in the USA It accounts for 10% of gynaecological consultations, and up to 33% of laparoscopiesIt also accounts for 12-16% of hysterectomies