Epidemiology and classification of urinary incontinence

Urinary incontinence is a common symptom affecting the physical, psychologi cal, social and economic well-being of individuals and their families. It a lso poses a considerable economic burden on health and social services. The literature reports widely varying prevalence rates for incontinence that a re partially explained by methodological differences between studies. Howev er, community-based studies indicate that approximately 6% of the populatio n, particularly women and older people, will have urinary incontinence of s ufficient severity to interfere with their quality of life. This represents a significant demand for health care. Although further research on prevale nce is unlikely to add anything new to current knowledge on the size of the problem, more information is needed on the onset, progression and risk fac tors of urinary incontinence to inform methods of effective treatment and p reventive strategies. In addition, there has been little investigation of t he triggers to seeking professional help or of the response of health profe ssionals to patients' demands for treatment, either for incontinence or oth er lower urinary tract symptoms. The aetiology of incontinence is multifactorial; incontinence is caused by pathophysiological impairments to the lower urinary tract and neurological system, as well as a range of external factors. The key to effective manage ment, therefore, is a comprehensive assessment of the patient, including ot her lower urinary tract symptoms, so that appropriate intervention is tailo red on a diagnosis and not on symptoms.