健康女性における尿失禁発症の実態とリスク要因について  [in Japanese] Current status and risk factors of urinary incontinence in healthy women  [in Japanese]

女性の健康問題の中で尿失禁は深刻な課題である。今回, 分娩後1〜43年の女性を対象として, 尿失禁の発症の実態を分娩後年数との関連性から検討すると共に, 尿失禁発症に関するリスク要因について検討した。その結果, 以下のことが明らかになった。1. 尿失禁を経験している女性は全体で40%に達していた。2. 分娩後10年以上を経た女性では尿失禁の発症頻度が有意に高くなった。尿失禁タイプをみると, 分娩後10年未満では腹圧性尿失禁タイプが多く, 分娩後年数の増加に伴い, 切迫性や溢流性尿失禁タイプが多くなった。3. 尿失禁発症のリスク要因として, 年齢, 出産経験, BMI, 閉経, 母親の尿失禁の経験に加えて, 経膣分娩, 圧出分娩および会陰切開があげられた。4. 尿失禁に対する対応をみると, 他者に相談したと回答した者はわずか4.3%であり, 実際尿失禁のために医療機関を受診した者は4人(0.5%)であった。以上, 女性尿失禁の発症を予防するための啓発活動を今後さらに積極的に推進する必要のあることが示唆された。

Purpose and methods : This survey was designed to assess the relationship between the years after delivery and urinary incontinence and to clarify the risk factors of developing urinary incontinence. Subjects were 1,926 women who had experience giving birth from 1 year to 43 years before. The subjects filled out a list of symptoms and other related factors of the urinary incontinence (self report). The differences between the groups were assessed using Kruskal-Wallis test, Bonferroni/Dunn test and logistic regression analysis (p<0.05). Results : 40 % of women had urinary incontinence. In this study, after 10 years following delivery, the urinary incontinence incidence rate is significantly higher. In addition, with regards to the type of urinary incontinence, stress urinary incontinence was higher in women with less than 10 years following delivery, and urge or overflow incontinence was increased with each passing year after delivery. The risk factors associated with developing urinary incontinences were vaginal deliveries, induced deliveries, and episiotomy ; in addition to age, birth frequency, Body Mass Index (BMI), menopause, and in women whose mother's also had experiences of urinary incontinence. From the responses, 4.3% of those who reported having urinary incontinence answered that they talked about their problems and only 4 people consulted a medical doctor because of urinary incontinence. Conclusions : These results suggest that there is a need for education and raising the awareness of urinary incontinence which 40 % of parous women have experienced.