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Epidemiological Survey of Adult Female Stress Urinary Incontinence

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Epidemiological Survey of Adult Female Stress Urinary Incontinence Zhang et al. BMC Women’s Health (2021) 21:172 https://doi.org/10.1186/s12905-021-01319-z RESEARCH Open Access Epidemiological survey of adult female stress urinary incontinence Rui Qin Zhang1, Man Cheng Xia1, Fan Cui1, Jia Wei Chen1, Xiao Dong Bian1, Hong Jie Xie1 and Wei Bing Shuang1,2* Abstract Background: The prevalence of stress urinary incontinence (SUI) in adult female in Taiyuan and what are the related risk factors are not clear. The aim of this study was to provide a basis for exploring the prevention and treatment of SUI in adult female in Taiyuan. Methods: A voluntary online questionnaire was used to investigate adult female in the community and surround- ing townships of Taiyuan. Most of the questionnaires refer to the International Consultation on Incontinence Ques- tionnaire-Female Lower Urinary Tract Symptoms, and adapt to the specifc circumstances of the region. Data were analyzed using SPSS software (version 22.0). Results: A total of 4004 eligible questionnaires were obtained. The prevalence of SUI in adult female in Taiyuan was 33.5%. Univariate analysis and multivariate logistic regression analysis showed that place of residence, smoking, body mass index, diet, number of deliveries, mode of delivery, dystocia, menopause, oral contraceptives, urinary tract infec- tion, making the bladder empty faster by pushing down and holding urine were risk factors for adult female stress urinary incontinence in Taiyuan. Conclusion: The prevalence of SUI in adult female in Taiyuan was high, and based on risk factors identifed in this sur- vey, population-level intervention strategies should be developed for the prevention and treatment of adult female SUI in Taiyuan. Keywords: Stress urinary incontinence, Epidemiology, Risk factor Background in many regions in China [5–7], while there is still a lack Stress urinary incontinence (SUI) is defned as “the com- of relevant epidemiological data in Taiyuan. Terefore, plaint of involuntary loss of urine on efort or physi- in this work, the epidemiology of adult female SUI in cal exertion (e.g., sporting activities), or on sneezing or Taiyuan was investigated and analyzed. It can not only coughing” [1], and it is the most common type of uri- understand the prevalence of SUI and related infuenc- nary incontinence. Although SUI does not threaten the ing factors in Taiyuan area, but also enrich the epide- patient’s life, it seriously afects the patient’s quality of miological data of SUI in Taiyuan area, lay a foundation life [2–4]. In recent years, the prevalence of female SUI for epidemiological investigation in China, and is more has gradually attracted public attention. Epidemiologi- conductive to establishing our own prevention standards cal surveys of regional populations have been conducted with reference to international standards combined with China’s national conditions, so that they can achieve the *Correspondence: [email protected] ultimate purpose of early understanding, early detec- 1 Department of First Clinical Medical College, Shanxi Medical University, tion, early diagnosis and treatment and reducing the Taiyuan 030001, Shanxi, China prevalence. Full list of author information is available at the end of the article © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The Creative Commons Public Domain Dedication waiver (http:// creat iveco mmons. org/ publi cdoma in/ zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Zhang et al. BMC Women’s Health (2021) 21:172 Page 2 of 10 Materials and methods The content of the questionnaire Study participants and criteria Te questionnaire (Additional fle: 1) was designed Adult female aged 18 years and older were ran- mainly based on the ICIQ-FLUTS Questionnaire and domly selected in the Taiyuan area. Inclusion crite- it also took into account demographic and socioeco- ria: (1) Respondents with complete information on nomic characteristics of female in Taiyuan, and the the questionnaire; (2) female aged 18 years and older; survey on the willingness to seek medical treatment (3) Household registration in Taiyuan or permanent for SUI and the way to obtain SUI-related knowledge residence in the local area for more than 2 years; (4) was also added. Te questionnaire contained relevant Informed consent to participate in the survey voluntar- questions on demographic characteristics (such as ily. Exclusion criteria: (1) respondents with mental and place of residence (urban and rural), age, occupation, neurological diseases (Patients with associated diseases body mass index (BMI), physical exercise, sedentary, were excluded by viewing the population health records smoking, drinking, daily water intake, diet), obstetrics of the communities surveyed); (2) respondents who do and gynecology (such as age at menarche, sexual his- not sign the informed consent; (3) respondents with tory, oral contraceptives, number of miscarriages, age incomplete questionnaire data. at frst birth, number of deliveries, number of pregnan- cies, mode of delivery, birth weight, episiotomy, dysto- Survey period and method cia, menopause), and other factors (such as a history of Te survey was conducted from February 2019 to pelvic surgery, urinary tract infection, defecation, hold- January 2020. Te questionnaire was flled in online ing urine, making the bladder empty faster by pushing by on-site scanning code, and a questionnaire survey down). Among them, mode of delivery and birth weight was conducted using a random multilevel cluster sam- refer to the frst delivery. pling. Six districts in Taiyuan City were selected: Yingze Statistical analysis District, Xinghualing District, Wanbailin District, Jiancaoping District, Jinyuan District, and Xiaodian Statistical software SPSS 22.0 was used for data entry District. According to the data of the National Bureau and statistical analysis. Expression of enumeration of Statistics in the past two years, under the condition data by rate, univariate analysis of risk factors for SUI 2 of ensuring the balance of economic level, living envi- was performed using the Chi-square (χ ). Multivariate ronment, and occupational distribution of the sampled logistic regression analysis was performed on data that survey sites, each part was then randomly selected from were statistically signifcant after univariate analysis, a sub-district and township, and then a community and categorical variables with the frst group as dummy var- a village were selected from each sub-district and town- iables. P < 0.05 was considered statistically signifcant. ship according to the random cluster sampling, with a total of 12 areas. Estimation of sample size: Te num- Results ber of investigators is calculated according to the epide- A total of 4352 questionnaires were sent out in this sur- vey, and 4004 valid questionnaires were returned, with miological formula n = 400 (1 − P)/P (P is the estimated prevalence). It has been reported [8] that the average a recovery rate of 92%. Of the 4004 adult female, 1341 prevalence of SUI is 27.5% in urban areas and 32.5% in were diagnosed with SUI. Te prevalence of SUI was rural areas in China, based on which it is estimated that 33.5%. the sample size should be greater than 1055 in urban areas and greater than 831 in rural areas. Te preva- Univariate analysis of risk factors for SUI lence was measured as a percentage of the total number Relationship between demographic data and SUI of patients with a symptom. Tis survey is an anony- Tis survey showed that there were statistically sig- mous survey. A specially-assigned person explains the nifcant diference (P < 0.05) between the SUI and non- signifcance of this survey to the investigators and pro- SUI groups in the comparison of the place of residence vides free consultation service. Te survey is voluntarily (urban and rural), age, occupation, body mass index flled in to ensure the quality of the survey. All female (BMI), sedentary, smoking, drinking, daily water intake included in the study gave informed consent and signed and diet, while there was no statistically signifcant an informed consent form. Tis study was approved by (P > 0.05) diference in the comparison of whether phys- the Ethics Committee of First Hospital of Shanxi Medi- ical exercise was performed (Table 1). cal University. Zhang et al. BMC Women’s Health (2021) 21:172 Page 3 of 10 Table 1 Relationship between demographic characteristics and SUI Demographic characteristics N SUI χ2 P N % Place of residence Urban 1869 564 30.2 17 < 0.001 Rural 2135 777 36.4 Age (years) 20–29 1455 333 22.9 128 < 0.001 30–39 820 293 35.7 40–49 882 384 43.5 50–59 532 201 37.8 60 315 130 41.3 ≥ Occupation Manual work 637 279 43.8 55 <
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