SUMMARY One thousand and sixty women aged 18 or over, randomly selected from a defined geographical area in South Wales, were interviewed at home about their urinary symptoms. Ninety-five per cent co-operated, of whom 45% admitted to some degree of incontinence. 'Stress' incontinence was reported by 22% of women, 'urge' incontinence by 10%, and both types combined-'complex'-by 14%. In most women urinary loss was both small and infrequent but 5% of all women experienced a loss sufficient to necessitate a change of clothes; in 2-6% such loss occurred daily. Over 3% of all women reported that incontinence interfered with their social or domestic life but only half of these had sought medical advice.Urinary incontinence is a troublesome and probably underreported1 disorder in women. Its prevalence in the general community is unknown. The purpose of the present report is to measure the prevalence and severity of incontinence, and to estimate its social consequences among women from a South Wales community. MethodA random sample of 1140 women was drawn from the electoral register for a defined geographical area in South Wales centred on a light industrial town (population 38 000). Each of the selected women was sent a letter explaining the study and then visited by one of five female interviewers who had been trained by the first author in interviews in a cervical cytology clinic. A standard questionnaire,* which had been developed for an earlier survey,2 was used throughout. In order to minimise embarrassment, questions were asked first on general medical history and then on urinary symptoms and incontinence.These latter questions referred to a period of 12 'Copies of the appropriate sections of the questionnaire can be obtained from the authors. months before each interview and unless otherwise stated the results refer to the prevalence of incontinence during a period of 12 months.A symptomatic classification of the type of incontinence was derived from a section of the questionnaire. This is similar to that used in a study in
SUMMARY Possible aetiological factors for urinary incontinence were examined in a prevalence study among a random sample of 1000 women aged 18 and over. Infective factors were not markedly associated with incontinence but mechanical factors such as parity and obesity were. No association was found, however, between a history of perineal damage at childbirth and incontinence. Women with incontinence had on average a higher score for a 'neuroticism' trait elicited by questionnaire than women without the disorder.Little is known with certainty about the causes of urinary incontinence in women but many associated and predisposing factors have been described.' Simple stress incontinence is said to be associated commonly with vaginal prolapse2 but factors related to urgency-associated incontinence are numerous.3 In the present study a questionnaire was administered by trained interviewers to a random sample of women from, the community. The prevalence and severity of the disorder has been reported previously' and in the present paper we report the findings relating to the aetiological hypotheses which were tested by the study. Mechanical factors Those likely to be associated with raised intra-abdominal pressure and lower-than-average perineal tone were examined Methods
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