Urinary symptoms and incontinence in an urban community: prevalence and associated factors in older men and women

Background: There is increasing recognition of the importance of a wide range of urinary symptoms in both men and women and that these symptoms are undertreated. Aims: To determine the prevalence of and factors associated with urinary symptoms, including nocturia, urgency, urge and stress incontinence and, in men, urinary stream difficulties; and the prevalence of being bothered by the symptoms and ever seeking treatment for them. Method: Household survey by computer-assisted telephone interviews of people aged 41 years and over and living in inner metropolitan Sydney. Results: Fifty-three per cent (95% confidence interval (CI) 46-60) of men and 61% (95% CI 55-67) of women reported one or more symptoms in the previous month. In men, the most frequently reported symptoms were urgency (30%, 95% CI 24-36) and nocturia (25%, 95% CI 19-31). In women, stress incontinence (35%, 95% CI 29-41) and urgency (33%, 95% CI 27-39) were the most common symptoms reported. In men, the significant factors associated with reporting one or more symptoms, after adjustment for other variables, were age 60 years or more, no private medical insurance, obesity and fair or poor self-rated health. For women, the significant associations were age 50-59 years, age 70 years or more, no private health insurance, high psychological distress and fair or poor self-rated health. Conclusions: Urinary symptoms are experienced by more than half of men and women aged over 40 in the central Sydney community, but many do not seek treatment. Such symptoms should be considered more broadly than the traditional focus on male 'prostatism' and female incontinence.