DEFINITION OF OVERACTIVE BLADDER AND EPIDEMIOLOGY OF URINARY-INCONTINENCE

Objectives. To review the definition of the overactive bladder and to summarize the results of epidemiologic studies on this specific disord er as well as urinary incontinence (UI) in general. Methods, From a li terature search covering the time period from 1954 through 1995, 48 ep idemiologic studies and several other publications dealing with the pr evalence and natural history of UI were reviewed. A metaanalysis of re ported data was performed with respect to incontinence definitions, in vestigation methods, home country of survey, sex, and age groups. Resu lts. Differences in definitions of incontinence, target populations, a nd study design in different investigations resulted in inhomogeneity and difficulties of comparing the available data, By grouping the stud ies with respect to similarities in the above-mentioned criteria and a nalyzing the results for each group of studies, an attempt was made to understand the great variation of reported results. Differences in pr evalence of incontinence were identified for all examined groups of st udies and for distinct ethnic populations. Scarce information about in cidence, spontaneous remission rates, and risk factors was used to elu cidate the natural history of UI in women and men. Conclusions, Althou gh generally accepted definitions of the overactive bladder specifical ly and UI in general are highly desirable, they have not yet been esta blished. Such definitions should comprise aspects of severity and demo nstrability of the condition, bother factor, and impact on quality of life. Moreover, basic requirements for epidemiologic surveys of incont inence, such as validation of questionnaire results, need to be define d and standardized to create a sensible basis for useful epidemiologic studies in the future. (C) 1997, Elsevier Science Inc. All rights res erved.