Epidemiology and etiology

The true prevalence of UI has been difficult to determine because of methodologic issues such as varying definitions of UI and reporting bias. Although the condition occurs across the lifespan, the peak prevalence, at least in women, is around the age of menopause (approximately 50 years), which is followed by a slight decrease in the 55- to 60-year-old age group, and then a steadily increasing prevalence after age 65. In general, the median prevalences of UI are as follows :

• 30% to 50% in elderly females (50-75% in female SNF residents)

• 10% in adult males (in excess of 50% in elderly male SNF residents)

UI can result from abnormalities within (intrinsic to) and outside of (extrinsic to) the urinary tract. Within the urinary tract, abnormalities may occur in the urethra (including the bladder outlet and urinary sphincters), the bladder, or a combination of both structures. Focusing on abnormalities in these two structures, a simple classification scheme emerges for all but the rarest intrinsic causes of UI. Accurate diagnosis and classification of UI type is critical to the selection of appropriate drug therapy.



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