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abstract

219 - A COMMUNITY-BASED EPIDEMIOLOGICAL SURVEY OF LOWER URINARY TRACT SYMPTOMS IN TAIWANESE RESIDENTS AGED 40 YEARS AND ABOVE

219

A COMMUNITY-BASED EPIDEMIOLOGICAL SURVEY OF LOWER URINARY TRACT SYMPTOMS IN TAIWANESE RESIDENTS AGED 40 YEARS AND ABOVE

NG, G. CHEN;
Department of Obstetrics and Gynecology, Chung Shan Med. Univ. Hosp., Taichung, Taiwan.

Introduction: Lower urinary tract symptoms (LUTS) which consists of storage and voiding symptoms were quite common among general population. In a population-based study conducted in five European countries; 64.3% adults reported at least one LUTS [1]. The occurrence of LUTS increased with age and caused decrease in health-related quality of life [2]. Population survey has revealed that LUTS has become a large economic burden on health services currently and will continue to be in the future due to the growing aging population [3].
Objective: This is part of the three years study designed to evaluate the natural history of LUTS in local community residents aged ≧ 40 years in central Taiwan. We evaluated the prevalence of OAB and voiding dysfunction in different gender using validated questionnaires. We try to identify the potential risk factors that were associated with the occurrence of LUTS in these community residents. We will summarize the data of female residents in this abstract.
Methods: This study was carried out in few district communities located in the west and south area of central Taiwan. Community residents aged 40 years and above were invited to participate in this three years study. The residents who agree to participate in this study were asked to fill in a structured questionnaire. The structured questionnaire contained groups of different questionnaires that were translated into Chinese and each was validated separately. A trained research assistant was sent to interview the participants and assisted the residents who did not have an educational background to fill in the questionnaires. Subjective perception of LUTS and impact of QoL were measured by the OABSS (Homma’s version), UDI-6, and IIQ-7questionnaires. Residents were recorded as having overactive bladder (OAB) if the total score of OABSS was≧4. Urge urinary incontinence (UUI) was defined as urine leakage preceded by the feeling of urgency which is slightly or more distressful (UDI-6 scoring; ≧1). Voiding difficulty (VD) was defined as feeling of difficulty in emptying the bladder which is slightly or more distressful (UDI-6 scoring; ≧1). Descriptive statistics were performed to evaluate the prevalence of LUTS in these community residents. Multivariable logistic regression analysis was performed to consider the effect of all potential risk factors associated with LUTS.
Results: A total of 2,411 community residents aged 40 years and above who completed all questionnaires of the initial survey were recruited, of which 1469(60.9%) were women. The prevalence of OAB and urge urinary incontinence was 33.1% and 26.8% respectively in female community residents. The prevalence of voiding difficulty was 28.3%. The potential risk factors that might predispose the community residents to the occurrence of overactive bladder and voiding difficulty were analyzed. For the female residents, age≧60 (OR, 1.5; 95%CI, 1.1- 2.0), menopause (OR1.4; 95% CI, 1.0- 1.9) and a history of diabetes mellitus (OR, 1.8; 95% CI, 1.2- 2.8) are the risk factors of overactive bladder. Age≧60 (OR, 1.4; 95%CI, 1.0- 1.9), BMI ≧25 (OR, 1.3; 95% CI, 1.0- 1.7) and instrument delivery (OR, 1.5; 95% CI, 1.0- 2.1) are the risk factors of voiding difficulty (Table 1).
Table 1 factors associated with overactive bladder and voiding difficulty

 

Overactive bladder

Voiding difficulty

 

OR 95%CI

OR 95%CI

Age>=60

1.51 (1.12- 2.04)*

1.41 (1.03- 1.93)*

BMI >=25

1.27 (0.99- 1.63)

1.34 (1.04- 1.73)*

Employment status

  

Unemployed

0.92 (0.69- 1.21)

1.03 (0.78- 1.37)

Low education level

1.32 (0.99- 1.74)

1.19 (0.89- 1.59)

Low income

1.15 (0.87- 1.51)

1.04 (0.78- 1.38)

Parities>2

0.97 (0.75- 1.25)

0.94 (0.72- 1.22)

Cesarean section

0.77 (0.52- 1.14)

1.18 (0.79- 1.75)

Instrument delivery

1.36 (0.94- 1.96)

1.47 (1.01- 2.13)*

menopause

1.39 (1.02- 1.90)*

1.33 (0.97- 1.83)

Diabetes mellitus

1.81 (1.18- 2.78)*

1.30 (0.82- 2.05)

Previous gynecology surgery

1.23 (0.92- 1.66)

1.08 (0.79- 1.47)


Overactive bladder was defined as OABSS≧4 Voiding difficulty was defined as UDI6-5≧1 *P<0.05
Conclusions: Our result imply that the prevalence of OAB and voiding difficulty were high among community female residents. Age≧60 is the common risk factor. The senior population is growing in Taiwan, senior citizens (aged 65 or older) are expected to account for 20 percent of the country's total population by 2025. It is important to understand the epidemiology of LUTS in the community residents to guide the health care policy and intervention strategies in the future.
References: 1 European urology 2006;50: 1306-1315 2 BJU Int 2001;87:760-766 3 urology 2006;50: 1050-1057