Prevalence of Female Urinary Incontinence in the General Population According to Different Definitions and Study Designs

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).

Design, setting, and participants: 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).

Outcome measurements and statistical analysis: 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.

Results and limitations: 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.

Patient summary: 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.