A population-based survey of the prevalence, potential risk factors, and symptom-specific bother of lower urinary tract symptoms in adult Chinese women: a cross-sectional study

Abstract

BackgroundFew epidemiological studies of lower urinary tract symptoms have been done in China, and none has been done nationwide. Our study aimed to estimate the prevalence and potential risk factors of these symptoms, and the bother they cause in adult women (older than 20 years) in China. MethodsThis is the second analysis of a population-based cross-sectional survey on urinary incontinence done between February and July, 2006, in six regions of China. Cluster samples were randomly selected for interviews. A modified Chinese Bristol Female Lower Urinary Tract Symptoms questionnaire was administered. Participants were asked about the presence of individual symptoms and rated their symptom bother. Descriptive statistics, chi-squared test, receiver operating characteristic curve, and multivariate logistic regressions were used for data analysis. The study was approved by the institutional ethics committee of Peking Union Medical College Hospital, Beijing, China. Findings18 992 (95·0%) of 20 000 respondents were included in this study. 976 (4·9%) of the questionnaires could not be assessed and were excluded in the previous urinary incontinence study; 32 participants were further excluded because of missing information regarding reproductive factors or lower urinary tract symptoms. 10 540 (55·5%) reported at least one lower urinary tract symptom, 10 245 (53·9%) recalled storage symptoms, and 2444 (12·9%) reported voiding symptoms; the prevalence of all these symptoms increased with age. Nocturia was the most common symptom (4450 [23·4%] patients), followed by urgency (4430 [23·3%]) and stress urinary incontinence (3592 [18·9%]). Nocturia was most frequently rated as bothersome (4138 [93·0%]) but was generally minor (3331 [80·5%]). Urgency and urgency urinary incontinence were most frequently reported as severe (315 [11·5%] and 189 [10·8%], respectively) or moderate (508 [18·5%] and 294 [16·8%], respectively) bothers. Lower urinary tract symptoms were more prevalent in women in urban areas than those in rural areas (5420 [57·1%] vs 5210 [53·9%]). Several factors increased the odds of bother and individual lower urinary tract symptoms, and older age and coexisting pelvic organ prolapse were strong predictors (appendix). This survey was done in 2006 and did not assess all lower urinary tract symptoms. InterpretationHalf of adult women have lower urinary tract symptoms, with nocturia, urgency, and stress urinary incontinence being the most prevalent. Urgency and urgency urinary incontinence were most frequently regarded as severe or moderate bothers and should be targeted for medical intervention. FundingThe Chinese Government (5-year national project, number 3053750)