Nearly half the world's adults will experience lower urinary tract symptoms by 2018

Other issues like incontinence will also increase, with South America, Asia and the developing regions of Africa particularly affected by the conditions, which are more common as people get older.

"Our study suggests that urinary and bladder symptoms are already highly prevalent worldwide and that these rates will increase significantly as the population ages" says lead author Dr Debra E Irwin from the Department of Epidemiology at the University of North Carolina, USA.

"These findings raise a number of important worldwide issues that will need to be tackled, as a matter of urgency, by clinicians and public health experts if we are to prevent, and manage, these conditions."

The research team calculated the numbers and prevalence of individuals aged 20 years plus affected by each condition in 2008, using data on gender and age from two key sources:

• Worldwide and regional population estimates from the US Census Bureau International Data Base
• The EPIC study, a large population-based, cross-sectional telephone survey of more than 19,000 men and women in five countries, led by Dr Irwin.

The data was then extrapolated to provide 2013 and 2018 estimates for lower urinary tract symptoms (LUTS), overactive bladder (OAB), urinary incontinence (UI) and LUTS suggestive of bladder outlet obstruction (LUTS/BOO), using the current symptom definitions from the International Continence Society.

"It is well known that people do not always seek medical attention for urinary problems, so basing our figures on studies using self-reported symptoms is an effective way of measuring worldwide prevalence" explains Dr Irwin.

Key findings of the analysis include:

• The worldwide prevalence of LUTS will increase to just under 46% by 2018, affecting 47% of women and 45% of men.
• Between 2008 and 2018 the number of people experiencing at least one LUTS will have grown by 18%, affecting an estimated 2.3 billion people, with the biggest increase in Africa (30%), followed by South America (20.5%), Asia (20%), North America (16%) and Europe (2.5%).
• OAB will have increased by 20% between 2008 and 2018, affecting an estimated 546 million people, with the biggest increase in Africa (31%), followed by South America (22%), Asia (22%), North America (18%) and Europe (4%).
• UI will have increased by 22% between 2008 and 2018, affecting an estimated 423 million people, with the biggest increase in Africa (31%), followed by South America (25%), Asia (24%), North America (18%) and Europe (5%).
• LUTS/BOO will have increased by 18.5% between 2008 and 2018, affecting an estimated 1.1 billion people, with the biggest increase in Africa (30%), followed by South America (21%), Asia (20%) North America (16%) and Europe (3%).

"We believe that our study underlines the clear and urgent need to improve the awareness, prevention, diagnosis and management of these conditions" says Dr Irwin, who worked with co-authors from the USA, UK and Sweden.

"International and national programmes that increase public awareness, educate clinicians and implement public health campaigns that tackle the social stigma of LUTS, will be a significant step towards reaching this objective.

"These public health programmes would need to be adapted by region, because countries often differ in their healthcare resources, treatment guidelines and social perceptions."

More information: Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary. Irwin et al. BJUI. 108, pp1132. (October 2011) doi:10.1111/j.1464-410X.2010.09993,10498.x

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