Prevalence and associated factors of urinary incontinence in women living in China: a literature review

Abstract

Background: This review of studies on urinary incontinence (UI) was focused primarily on UI prevalence rates and associated factors across the adult lifecourse of Chinese women. UI is a urologic symptom that can have a significant impact on women's physical and mental health and quality of life. In addition, women with UI may experience socioeconomic burdens due to UI's effect on their ability to work and function in society. Although researchers from many countries have reported prevalence rates and associated factors for UI, little is known about the prevalence of UI in China's large female population. Language may act as a barrier to the inclusion of published studies in English-language journals. To overcome this barrier and to add to the global knowledge base about UI in women, the authors reviewed and discussed findings from epidemiological studies published in China and in Chinese language.

Methods: The authors retrieved research studies from the Wanfang database using the following search terms: "Subject: (Female) × Subject: (Urinary incontinence) × Subject: (Prevalence) × Date: 2013 to 2019". Searches employed the China National Knowledge Infrastructure Database, VIP Database for Chinese Technical Periodicals and China Biology Medicine Database. The authors also used PubMed to search English-language studies published in Chinese journals on UI in Chinese women.

Results: This literature review includes 48 articles published between January 2013 and December 2019. The overall UI prevalence rates reported in adult Chinese women ranged from 8.7 to 69.8%, representing 43-349 million women, respectively. For women aged 17-40 years, 41-59 years, and 60 years and older, prevalence rates ranged from 2.6-30.0, 8.7-47.7, to 16.9-61.6%, respectively. Significant associated factors for overall UI included age, body mass index, constipation, parity, and menopause. Despite the 17-40 age range being peak reproductive years, the literature revealed little focus on UI prevalence rates. For women aged 41-59 years, the main associated factors included those related to pregnancy and gynecologic diseases. For women 60 years and older, chronic diseases represented most of the associated factors.

Conclusions: About 43-349 million Chinese women may experience UI. Many of the identified associated factors could be mitigated to reduce UI incidence and prevalence rates. Little is known about the prevalence rates and associated factors for UI among young (aged 17-40) Chinese women. Future research should investigate UI in young women to improve bladder health across their lifecourse.

Keywords: Bladder; China; Prevalence; Urinary incontinence; Women.

Fig. 1

PRISMA flow diagram for the review process

Fig. 2

Prevalence rates of female urinary incontinence by location in China (This figure is created by authors with Word of Microsoft Office Home and Student 2019 (https://www.microsoftstore.com.cn/office/office-home-student-2019). It does not represent all the territory of China (China Sea Islands etc.).). UI (UI: Urinary incontinence, type not specified) of adult women (≥ 18 or 20 years old). SUI (SUI: Stress urinary incontinence) of adult women (≥ 18 years old). UI of older women (≥ 60 or older). No prevalence of UI reported. Two studies including women with 17 years old: *[20]. **[40]