title: Prevalence of Female Urinary Incontinence in the General Population According to Different Definitions and Study Designs.
abstract: BACKGROUND
  Estimates of the prevalence of female urinary incontinence (UI) vary widely.
  
  
  OBJECTIVE
  To estimate UI prevalence among women in France using data from five national surveys and analyse prevalence differences among the surveys according to their design (representative sample or not, survey focused on UI or not) and UI definition (based on symptoms or disease perception).
  
  
  METHODS
  Data came from two representative telephone surveys, Fecond (5017 women aged 15-49 yr) and Barometer (3089 women aged 40-85 yr), general and urinary postal surveys of the GAZEL cohort (3098 women aged 54-69 yr), and the web-based NutriNet survey (85,037 women aged 18-87 yr).
  
  
  METHODS
  Definitions of UI based on the International Conference on Incontinence Questionnaire UI short form (ICIQ-UI-SF) and on a list of health problems were considered. We compared age-adjusted prevalence rates among studies via logistic regression and generalised linear models.
  
  
  CONCLUSIONS
  Overall, 13% of the women in Fecond, 24% in Barometer, 15% in the GAZEL general survey, 39% in the GAZEL urinary survey, and 1.5% in the NutriNet survey reported any UI. Prevalence rates in representative samples with the same UI definition (ICIQ-UI-SF) were concordant. UI prevalence in the representative samples was 17%. The estimated number of women in France with UI was 5.35 million (95% confidence interval [CI] 5.34-5.36 million) for any UI and 1.54 million (95% CI 1.53-1.55 million) for daily UI. For the GAZEL sample, UI prevalence was lower but UI severity was greater for responses to a questionnaire with the list-based UI definition rather than to a questionnaire with the ICIQ-UI-SF-based definition. In all surveys, information about UI was self-reported and was not validated by objective measurements.
  
  
  CONCLUSIONS
  UI definitions and sampling strategies influence estimates of UI prevalence among women. Precise estimates of UI prevalence should be based on non-UI-focused surveys among representative samples and using a validated standardised symptom-based questionnaire.
  
  
  RESULTS
  We looked at estimates of urinary incontinence (UI) prevalence in studies with different designs and different UI definitions in a large population of French women. We found that estimates varied with the definition and the design. We conclude that the most precise estimates of UI prevalence are obtained in studies of representative populations that are not focused on UI and use a validated international standard questionnaire with sufficient details to allow grading of UI severity. Most women reported rare urine leakages involving small amounts of urine with little impact on their quality of life.
authors.affiliation: INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Gender, Sexuality and Health Team, F-94276, Le Kremlin-Bicêtre, France; Université Paris-Sud, UMRS 1018, F-94276, le Kremlin Bicêtre, France; Doctoral School of Public Health, UMRS 1018, F-94276, Le Kremlin-Bicêtre, France; French School of Public Health, Rennes, France; Institut National d'Études Démographiques (INED), F-75012, Paris, France. Electronic address: dina.dinova@gmail.com.
authors.forename: Dina
authors.initials: D
authors.lastname: Bedretdinova
authors.affiliation: INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Gender, Sexuality and Health Team, F-94276, Le Kremlin-Bicêtre, France; Université Paris-Sud, UMRS 1018, F-94276, le Kremlin Bicêtre, France; Institut National d'Études Démographiques (INED), F-75012, Paris, France; Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Université de Poitiers, CHU de Poitiers, Poitiers, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Fritel
authors.affiliation: INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Gender, Sexuality and Health Team, F-94276, Le Kremlin-Bicêtre, France; Université Paris-Sud, UMRS 1018, F-94276, le Kremlin Bicêtre, France; Institut National d'Études Démographiques (INED), F-75012, Paris, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Panjo
authors.affiliation: INSERM, Centre for Research in Epidemiology and Population Health (CESP), U1018, Gender, Sexuality and Health Team, F-94276, Le Kremlin-Bicêtre, France; Université Paris-Sud, UMRS 1018, F-94276, le Kremlin Bicêtre, France; Institut National d'Études Démographiques (INED), F-75012, Paris, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Ringa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D063189:Symptom Assessment; D009626:Terminology as Topic; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
keywords: Cross-sectional study; Epidemiology; Prevalence; Questionnaire; Symptoms; Telephone-based study; Urinary incontinence; Web-based study; Women