• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 223
  • 103
  • 49
  • 34
  • 22
  • 6
  • 6
  • 5
  • 5
  • 3
  • 3
  • 2
  • 2
  • 1
  • 1
  • Tagged with
  • 515
  • 406
  • 209
  • 195
  • 111
  • 101
  • 98
  • 92
  • 83
  • 74
  • 60
  • 59
  • 54
  • 53
  • 50
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
81

Prevalência das incontinências urinária e anal na população urbana de Pouso Alegre - MG / Prevalence of urinary and fecal incontinence in Pouso Alegre Minas Gerais

Santos, Claudia Regina de Souza 18 December 2008 (has links)
Este estudo objetivou conhecer as prevalências das incontinências urinária (IU), anal (IA) e combinada (IC) em adultos da zona urbana da cidade de Pouso Alegre, Minas Gerais e verificar os fatores demográficos e clínicos associados às perdas urinárias e anais nessa população. Estudo epidemiológico e de corte transversal, foi realizado na cidade de Pouso Alegre, após aprovação pelo Comitê de Ética da Escola de Enfermagem da Universidade de São Paulo. Quinhentos e dezenove indivíduos, com idade igual ou superior a 18 anos, condições físicas e mentais adequadas e que aceitaram participar da investigação, compuseram a amostra do estudo, estabelecida a partir de amostragem estratificada por conglomerado que definiu 341 domicílios, sorteados aleatoriamente. Todos os residentes desses domicílios, que se enquadraram nos critérios descritos, foram entrevistados utilizando-se três instrumentos: Dados Demográficos e Clínicos, Características da IU (desenvolvido por Menezes, Hashimoto e Santos 2008) e Presença de Incontinência Anal (domínio do The Bowel Function in the Community Tool, adaptado e validado para o português por Domansky e Santos 2007). Os dados foram submetidos aos testes de Qui-Quadrado, de Hosmer Lemeshow e à regressão logística multivariada (stepwise). As prevalências foram padronizadas por sexo e idade. Os resultados mostraram prevalências de 20,1% para IU, sendo de 6,2% entre os homens e de 32,9% para as mulheres; de 7,0% para IA tanto geral, como para homens e mulheres; e de 3,0% para a IC, sendo de 1,0% para os homens e de 5,0% para as mulheres. No modelo final de regressão logística, maior tempo de perdas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), acidente vascular encefálico (OR=15,9; p<0,001) e cistocele (OR=12,5; p<0,001) foram os fatores mais fortemente associados à IU; número de filhos (OR=5,1; p<0,001), doença hemorroidária (OR=4,4; p<0,001) e cistocele (OR=3,0; p<0,001), para a IA; e modificações nos hábitos de vida -sair de casa (OR=62,2; p<0,001)), maior tempo de perdas (OR=39,2; p<0,001), sexo feminino (OR=21,6; p<0,001) e viuvez (OR=19,4; p<0,001), para a IC. O estudo permitiu conhecer a epidemiologia das incontinências em uma cidade do sul de Minas Gerais, contribuindo não só para o estabelecimento metodológico desse tipo de estudo como para o desenvolvimento de políticas públicas para a sua prevenção, primária e secundária, bem como seu tratamento ainda que, inicialmente, em nível municipal / This study aimed to analyze the urinary (UI) and fecal incontinence (FI), isolated and combined (CI), in adults from the urban area of Pouso Alegre city (Minas Gerais state/ Brazil) and the demographic and clinical variables associated to urinary and fecal losses. This epidemiological study was carried out in Pouso Alegre city, after the approval from the Ethics Committee of Nursing School of University of São Paulo. Five hundred and nineteen individuals, residents in 341 homes sorted at random, aging 18 years old, with adequate mental and physical conditions and who accepted to participate in this investigation were interviewed. Three instruments were used for data collection: demographical clinical data, UI data (developed and validated by Menezes, Hashimoto and Santos 2008) and Presence of anal incontinence (on of the domains of the Bowel Function in the Community Tool, adapted and validated to the Portuguese by Domansky and Santos 2007). Data were submitted to Qui-Square, Hasmer Lemeshow tests and to logistical regression (stepwise). The prevalence was established by gender and age. The results showed 20.1% for UI prevalence, being 6.2% for male and 32.9% for female; 7.0% for FI, in general and for both male and female; and 3.0% for CI, being 1.0% for male and 5.0% for female. In the final model of logistical regression, UI time (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), stroke (OR=15,9; p<0,001) and bladder prolapse (OR=12,5; p<0,001) were the most important factors associated to UI; number of children (OR=5,1; p<0,001), hemorrhoidals (OR=4,4; p<0,001) and bladder prolapse (OR=3,0; p<0,001), for FI; change in daily life habits (OR=62,2; p<0,001)), CI time (OR=39,2; p<0,001), female gender (OR=21,6; p<0,001) and be widow (OR=19,4; p<0,001), for CI. This study allowed to obtain the epidemiology of urinary and fecal incontinence in a small town in Brazil contributing not only for new studies using the same methodology but also for the establishment of public polices and programs for UI, FI and CI primary and secondary prevention as well as their management at least in a local level
82

Utveckling av inkontinensprodukt

Andersson, Andréas, Sundeborn, Mattias January 2009 (has links)
Together with Attends in Aneby a thesis of 15 ECTS (credits) have been undertaken. The assignment was to develop a new incontinence product for single use. Users of the product value comfort, flexibility, softness, comfort and a discreet product. Users are for individuals with incontinence problems that usually receive the products via prescription. The product must also have an attractive price and good quality from the purchase / originator's perspective. Currently there are two models that Attends supplies, which the project intends to develop, (Slips / Briefs and Pull On's). The first has a low price but also lower usability than the other. The products have a well-developed absorptive function and with respect to this, only a new design of the chassis will be developed. Project issue were: How should a concept look like when combining Pull On's and Slips / Briefs? Is it possible to develop a better product? Production methods, costs and customer satisfaction will not be taken into account given that incontinence is a sensitive topic and that it would make the task too extensive. Consideration of patents, industrial designs and design protection are not taken into account when over two hundred applications per month are registered.   The mission was carried out as a development project where the product is broken down into parts which are then developed and combined to form a new developed product. Tools that were used are brainstorming and morphological matrix. This project resulted in a concept that can be described as a hybrid of today's two products. With two parts of elastic material in the waist, the product will gain a better fit for the user. It also creates a wider span between the maximum and minimum waistline each size will cover. The final product also has an adjustment function to increase the user friendliness and comfort. With the help of adjustment so you can change the pressure against the body, making the user able to customize the product. A continuation of the project is to examine whether new materials can be inserted into the device instead of the elastic composite. It is important that further development of the product is made together with a test group to gain answers about ease of use and other problems that can arise in everyday use. A continuation should also involve interviewing healthcare professionals who come into contact with the product.
83

The effectiveness of four translation strategies on nurses' adoption of an evidence-based bladder protocol

Frasure, Jamey S. January 1900 (has links)
Thesis (Ph. D.)--West Virginia University, 2009. / Title from document title page. Document formatted into pages; contains ix, 174 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 140-150).
84

Résultats cliniques et fonctionnels du traitement de l'incontinence urinaire à l'effort par la voie rétro-pubienne (TVT) et trans-obturatrice (TOT et TVT-O) en cas d'insuffisance sphinctérienne (PCUM<30cmH2O) étude comparative chez 162 patientes /

Guillo, Éric. Démaria, Fabien Arnaud Stéphane January 2008 (has links) (PDF)
Thèse d'exercice : Médecine. Gynécologie-obstétrique : Paris 12 : 2007. / Titre provenant de l'écran-titre. 65 f. : ill. Bibliogr. f. 57-64.
85

Pelvic floor dysfunction : a clinical and epidemiological study /

Uustal Fornell, Eva January 2003 (has links) (PDF)
Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 4 uppsatser.
86

Clinical and epidemiological aspects of pelvic floor dysfunction /

Tegerstedt, Gunilla, January 2004 (has links)
Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.
87

Efektivita používání pomůcek pro inkontinentní nemocné v následné péči / The effectiveness of aids for incontinence patients in aftercare

MUSILOVÁ, Jana January 2014 (has links)
This thesis deals with the effectiveness of use of aids intended for incontinent ill people in subsequent care. The thesis is divided into a theoretical part and experience part. The experience part of the thesis has been implemented by means of qualitative research. The data have been obtained on the basis of two different half pen and paper interviews with patients/clients who are using incontinence aids prescribed by a doctor on a coupon or by a matron or a ward sister from the subsequent care department in hospitals with the state-funded organization and in hospitals with the joint-stock company organization. The result of the qualitative research showed, that both groups of respondents use mostly only plastic pants or nappies out of the whole assortment of aids. For patients/clients living at home the reason is that on the basis of anamnesis the general doctors prescribe the incontinence aids only in the most serious incontinence cases. At the subsequent care department the situation is caused by a big number of immobile fully incontinent patients/clients. The results show, that the quantity of absorb aids prescribed by general doctors is insufficient. It does not reach the quantity limits given in the documents by VZP (Public Health Insurance Company). Taking into consideration the low income of seniors, the respondents have to pay considerable amounts of money for incontinence aids which are necessary for them. There is an absolute lack of absorption aids in the hospital with the state funded organization. The incontinence aids are financed by three different ways. Patients/clients themselves have to get and pay the absorption aids at the Geriatrics department I and subsequent care department 2. The hospital provides them only with one-off mats and hygienic aids free of charge. The reason for this is a low limit of material. The respondents regard this system of financing negatively. It burdens patients/clients and nurses too. If patients/clients do not have the aids, the hospital has to lend the aids, make a list of debts and collects them back. On this account conflict situations often arise in families. At these departments there are reserved five social beds which enable patients/clients the prescription of aids by a doctor on a coupon likewise the patients who are ill and cure at home. At the stopgap department patients/clients pay a monthly fee; this includes the costs on incontinence aids too. At the subsequent care department 2A, B of the hospital with the join-stock company organization the aids are fully paid by the hospital. There is available a sufficient assortment and quantity of absorb and hygienic aids, which enable an individual attitude.
88

Prevalência das incontinências urinária e anal na população urbana de Pouso Alegre - MG / Prevalence of urinary and fecal incontinence in Pouso Alegre Minas Gerais

Claudia Regina de Souza Santos 18 December 2008 (has links)
Este estudo objetivou conhecer as prevalências das incontinências urinária (IU), anal (IA) e combinada (IC) em adultos da zona urbana da cidade de Pouso Alegre, Minas Gerais e verificar os fatores demográficos e clínicos associados às perdas urinárias e anais nessa população. Estudo epidemiológico e de corte transversal, foi realizado na cidade de Pouso Alegre, após aprovação pelo Comitê de Ética da Escola de Enfermagem da Universidade de São Paulo. Quinhentos e dezenove indivíduos, com idade igual ou superior a 18 anos, condições físicas e mentais adequadas e que aceitaram participar da investigação, compuseram a amostra do estudo, estabelecida a partir de amostragem estratificada por conglomerado que definiu 341 domicílios, sorteados aleatoriamente. Todos os residentes desses domicílios, que se enquadraram nos critérios descritos, foram entrevistados utilizando-se três instrumentos: Dados Demográficos e Clínicos, Características da IU (desenvolvido por Menezes, Hashimoto e Santos 2008) e Presença de Incontinência Anal (domínio do The Bowel Function in the Community Tool, adaptado e validado para o português por Domansky e Santos 2007). Os dados foram submetidos aos testes de Qui-Quadrado, de Hosmer Lemeshow e à regressão logística multivariada (stepwise). As prevalências foram padronizadas por sexo e idade. Os resultados mostraram prevalências de 20,1% para IU, sendo de 6,2% entre os homens e de 32,9% para as mulheres; de 7,0% para IA tanto geral, como para homens e mulheres; e de 3,0% para a IC, sendo de 1,0% para os homens e de 5,0% para as mulheres. No modelo final de regressão logística, maior tempo de perdas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), acidente vascular encefálico (OR=15,9; p<0,001) e cistocele (OR=12,5; p<0,001) foram os fatores mais fortemente associados à IU; número de filhos (OR=5,1; p<0,001), doença hemorroidária (OR=4,4; p<0,001) e cistocele (OR=3,0; p<0,001), para a IA; e modificações nos hábitos de vida -sair de casa (OR=62,2; p<0,001)), maior tempo de perdas (OR=39,2; p<0,001), sexo feminino (OR=21,6; p<0,001) e viuvez (OR=19,4; p<0,001), para a IC. O estudo permitiu conhecer a epidemiologia das incontinências em uma cidade do sul de Minas Gerais, contribuindo não só para o estabelecimento metodológico desse tipo de estudo como para o desenvolvimento de políticas públicas para a sua prevenção, primária e secundária, bem como seu tratamento ainda que, inicialmente, em nível municipal / This study aimed to analyze the urinary (UI) and fecal incontinence (FI), isolated and combined (CI), in adults from the urban area of Pouso Alegre city (Minas Gerais state/ Brazil) and the demographic and clinical variables associated to urinary and fecal losses. This epidemiological study was carried out in Pouso Alegre city, after the approval from the Ethics Committee of Nursing School of University of São Paulo. Five hundred and nineteen individuals, residents in 341 homes sorted at random, aging 18 years old, with adequate mental and physical conditions and who accepted to participate in this investigation were interviewed. Three instruments were used for data collection: demographical clinical data, UI data (developed and validated by Menezes, Hashimoto and Santos 2008) and Presence of anal incontinence (on of the domains of the Bowel Function in the Community Tool, adapted and validated to the Portuguese by Domansky and Santos 2007). Data were submitted to Qui-Square, Hasmer Lemeshow tests and to logistical regression (stepwise). The prevalence was established by gender and age. The results showed 20.1% for UI prevalence, being 6.2% for male and 32.9% for female; 7.0% for FI, in general and for both male and female; and 3.0% for CI, being 1.0% for male and 5.0% for female. In the final model of logistical regression, UI time (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), stroke (OR=15,9; p<0,001) and bladder prolapse (OR=12,5; p<0,001) were the most important factors associated to UI; number of children (OR=5,1; p<0,001), hemorrhoidals (OR=4,4; p<0,001) and bladder prolapse (OR=3,0; p<0,001), for FI; change in daily life habits (OR=62,2; p<0,001)), CI time (OR=39,2; p<0,001), female gender (OR=21,6; p<0,001) and be widow (OR=19,4; p<0,001), for CI. This study allowed to obtain the epidemiology of urinary and fecal incontinence in a small town in Brazil contributing not only for new studies using the same methodology but also for the establishment of public polices and programs for UI, FI and CI primary and secondary prevention as well as their management at least in a local level
89

Incidence et rémission de l’incontinence urinaire des femmes entre 45 et 60 ans. / Incidence and Remission of Female Urinary Incontinence at Midlife

Legendre, Guillaume 08 December 2016 (has links)
Objectif : L’objectif principal de ce travail était d’évaluer les facteurs de risque d’incidence et de rémission de l’incontinence urinaire (IU) au sein d’une cohorte de femmes de la cinquantaine en prenant en compte le type d’IU (Incontinence urinaire d’effort - IUE -, Incontinence par argenture - IUU- et Incontinence urinaire mixte – IUM) et la gravité des symptômes.Matériel et Méthodes : Les données sont issues des questionnaires de l’enquête « les femmes et leur santé », des questionnaires annuels de la cohorte GAZEL et du questionnaire spécifique « les troubles urinaires » posé en 2000 et 2008. Un modèle de Cox a été utilisé entre 1990 et 2008 à partir des données de la question « Avez-vous des difficultés à retenir vos urines ? ». Des modèles de régression logistiques ont été utilisés entre 2000 et 2008 à partir de la question validée de l’IU « Au cours des 12 derniers mois, vous est-il arrivé d’avoir des fuites involontaires d’urine ? ».Résultats : Au sein de notre population, le taux annuel d’incidence de l’IU est de 5,5 % et le taux annuel de rémission est de 6,2 %, confirmant que l’IU est un phénomène dynamique avec des périodes possibles d’aggravation et d’amélioration partielle ou totale. Ces taux sont variables avec le type d’IU : entre 2000 et 2008, les taux d’incidence étaient respectivement de 14,9 % pour l’IUE, de 3,2 % pour l’IUU et de 3.1% pour l’IUM. L’IUE est le type le plus enclin à connaître une rémission de l’IU en comparaison à l’IUU et l’IUM. Les facteurs associés à l’apparition d’une IU sont des facteurs sociaux (le niveau d’études élevé), obstétricaux (la parité), hormonaux (la ménopause), et en rapport avec l’état de santé, physique ou mentale (la prise de poids, l’apparition de symptômes dépressifs, la dégradation de la qualité de vie - dans les dimensions tonus et isolement social du score NHP). La rémission complète est d’autant moins fréquente que les femmes vieillissent et qu’elles prennent du poids. Pour chaque type d’IU, l’influence des facteurs de risque semble différente. Ainsi, le niveau d’étude (être titulaire du baccalauréat), l’IMC (à l’inclusion, et au cours du suivi) et un syndrome dépressif à l’inclusion sont associés à l’apparition d’une IUE. Un antécédent de prise en charge chirurgicale de l’IU est associé à l’apparition d’une IUU et d’une IUM. La correction chirurgicale de l’IU pendant le suivi est, comme attendu, associée à une rémission des symptômes d’IUE, mais en revanche la rééducation périnéale et un antécédent d’accouchement par voie vaginale, sont associés à une persistance des symptômes d’IUE. L’accouchement par voie vaginale était également associé à la persistance de l’IUM. L’IUU et l’IUM sont les types d’IU les plus graves à l’inclusion. De plus, l’aggravation est plus marquée en cas d’IUU ou d’IUM que d’IUE. Hormis le type, les facteurs associés à une aggravation des symptômes sont une operation pour une IU (à l’inclusion) et l’apparition d’un syndrome dépressif. L’aggravation des symptômes est négativement associée à la consommation d’alcool à l’inclusion et une chirurgie de l’incontinence pendant la période d’étude. Le rôle des facteurs sociaux, comme l’obtention du baccalauréat par exemple, est associé à l’apparition d’un IU légère, alors que des facteurs obstétricaux comme un antécédent d’accouchement par voie basse est associé à une apparition de l’IU grave.Conclusion : L’IU est un phénomène dynamique avec des périodes possibles d’aggravation et d’amélioration partielle ou totale. L’analyse des facteurs de risque associés à l’IU doit intégrer une différentiation du type et de la gravité. Les données concernant l’épidémiologie de l’IU chez les femmes entre 45 et 60 ans sont encore trop peu nombreuses. D'autres enquêtes longitudinales incluant un nombre plus important de femmes sont essentielles afin de confirmer nos résultats et mieux conseiller les femmes en présentant les symptômes. / Objective: The main objective of this work was to evaluate the risk factors of incidence and remission of urinary incontinence (UI) in a cohort of women at midlife, taking into account the type of UI (Stress urinary incontinence - SUI – Urge urinary incontinence – IUU - and mixed urinary incontinence - IUM) and the severity of symptoms.Material and Methods: Data were obtained from the survey questionnaires "women and their health," the annual questionnaires cohort GAZEL and specific questionnaire "urinary problems" posed in 2000 and 2008. A Cox model was used between 1990 and 2008 from the data of the question "Have you trouble holding your urine? ". Logistic regression models were used between 2000 and 2008 from the issue validated UI "Over the last 12 months, did you have any involuntary loss of urine ? ".Results: In our population, the annual rate of incidence of UI was 5.5% and the annual rate of remission was 6.2%, confirming that the UI is a dynamic condition with possible periods of worsening and of improvement. These rates vary with the type of UI: between 2000 and 2008, incidence rates were 14.9% for SUI, 3.2% for UUI and 3.1% for the MUI. SUI is the most likely type to experience a possible remission of the UI compared to UUI and MUI. Factors associated with the occurrence of UI are social factors (high educational level), obstetrical (parity), hormonal (menopause), and factors in relation with physical or mental health status (weight gain, onset of depressive symptoms, impairment in health-related quality of life - energy dimension and social isolation dimension of NHP score). Complete remission is even less common as women gain in age and in weight. For each type of UI, the influence of risk factors seems different. Thus, educational level (baccalaureate), BMI (at baseline and during follow-up) and a depressive syndrome at baseline are associated with the onset of SUI. An antecedent of surgical procedure for UI is associated with the occurrence of UUI and MUI. Surgical correction of the UI during follow-up is, as expected, associated with remission of symptoms of SUI. By contrast, pelvic floor muscle training exercises and vaginal childbirth, are associated with persistence of symptoms of SUI. The vaginal delivery was also associated with the persistence of MUI. MUI and UUI are the more severe types of UI at baseline. Furthermore, the aggravation is more pronounced in case of UUI or MUI that for SUI. Aside from the type, the factors associated with worsening symptoms are a prior surgery for a UI (at baseline) and the onset of a depressive syndrome. A worsening of UI is negatively associated with alcohol consumption at baseline and incontinence surgery during the study period. The role of social factors, such as the baccalaureate for example, is associated with the appearance of a slight UI, while obstetric factors such as a vaginal childbirth is associated with the appearance of a severe UI.Conclusion: The UI is a dynamic condition with possible periods of worsening and of partial or total improvement. The analysis of risk factors associated with the UI must incorporate a differentiation of the type and severity. Data on the epidemiology of UI in women between 45 and 60 years are still too few. Other longitudinal studies including a larger number of women are essential to confirm our results and to better counselling women with UI symptoms.
90

Vers une modélisation de l'incontinence urinaire des femmes / Modeling Urinary Incontinence in Women

Bedretdinova, Dina 30 November 2015 (has links)
VERS UNE MODELISATION DE L’INCONTINENCE URINAIRE DES FEMMES Introduction : L’objectif principal était de mieux comprendre l’histoire naturelle de l’incontinence urinaire (IU) féminine grâce à une modélisation de sa prévalence sur ses facteurs de risque, en tenant compte de sa gravité et de ses types. Un objectif secondaire était de travailler sur la classification des circonstances des fuites urinaires.Matériel et méthodes : Nous avons utilisé les données de deux sondages téléphoniques sur une population représentative, Le Baromètre Santé 2010 (3089) et Fecond (5017) ; de deux enquêtes postales au sein de la cohorte GAZEL (3098), l’une générale et l’autre centrée sur les problèmes urinaires ; et enfin d’un sondage internet de volontaires adultes, NutriNet-Santé (85037). L’IU a été définie à partir d'un questionnaire validé, l’ICIQ-UI-SF et à partir d’une liste de problèmes de santé. Nous avons utilisé des modèles binomiaux et multinomiaux de régression logistique, des analyses de correspondances multiples et de classification ascendante hiérarchique.Résultats : La prévalence de l’IU tout venant (quel que soit son type ou sa gravité) variait de 1,5 % à 38,8 % selon les enquêtes et était égale à 17,3 % dans les 2 échantillons représentatifs. La conception de l’enquête, c’est-à-dire la nature de l’échantillon (représentatif ou non), son objectif (centré sur la santé générale ou l’IU), le mode de recueil des données et la mode de définition de l’IU (à partir d’un questionnaire spécifique validé ou basée sur une liste de maladies) étaient susceptibles de modifier à la hausse ou à la baisse les estimations de la prévalence de l’IU.Les fuites les plus fréquentes étaient les fuites à la toux, les fuites avant d’arriver aux toilettes et les fuites lors de l’exercice physique. Les femmes décrivant des circonstances attribuées aux principaux types d’IU, effort, par urgenturie et mixte, formaient un groupe distinct de celles déclarant des circonstances attribuées au type IU autre. De même, les femmes déclarant des circonstances attribuables à une IU d’effort se démarquaient de celles déclarant des circonstances attribuables à une IU par urgenturie. Les circonstances les plus discriminantes pour classer les femmes incontinentes étaient : fuites tout le temps, à la toux, pendant le sommeil et après la miction. Dans toutes les enquêtes nous avons identifié des associations significatives entre presque tous les facteurs de risque disponibles et l’incontinence ; mais certains facteurs étaient liés avec toutes les formes d’IU et d’autres seulement avec certaines formes. De plus nombreuses associations ont été observées avec l’IU grave, c’est-à-dire quotidienne, qu’avec l’IU hebdomadaire. Nous avons observé plus d’associations significatives avec l’IU mixte et l’IU autre qu’avec l’IU d’effort et l’IU par urgenturie. Les plus fortes associations ont été observées pour la dépression et l’obésité, liées avec presque toutes les formes d’IU. Les variables obstétricales étaient souvent liées à l’IU mixte. Conclusion : Le questionnaire ICIQ-UI-SF est approprié pour estimer la prévalence de l’incontinence urinaire dans des échantillons représentatifs mais il apparaît insuffisant pour définir tous les types d’IU. Nos résultats ont objectivé qu’il est possible d’utiliser les circonstances des fuites d’urine pour identifier des groupes spécifiques de femmes incontinentes, et que certaines circonstances peu utilisées en cliniques sont pourtant très discriminantes. Il y a probablement des travaux à faire et à poursuivre pour explorer dans quelle mesure les circonstances des fuites ont une valeur pronostique ou prédictive de réponse au traitement. Grâce à la modélisation, où nous avons pris en compte le type et la gravité de l’IU, nous avons pu constater quelles modalités de l’IU sont liées à certains facteurs de risque et quelles modalités ne le sont pas. / TOWARDS A MODELLING OF FEMALE URINARY INCONTINENCE Introduction: The main objective was to better understand the natural history of the female urinary incontinence (UI) through modelling of its prevalence by risk factors, while taking into account its severity and its type. A secondary objective was to work on the classification of the circumstances of urinary leakage.Methods: Data came from two telephone surveys of a representative population, The Health Barometer 2010 and Fecond; two mail surveys within the cohort GAZEL, one general and the other centred on urinary problems; and an Internet survey of adult volunteers, NutriNet-Health. We defined UI from a validated questionnaire, the ICIQ-UI-SF, and from a list of diseases. We used binomial and multinomial logistic regression models, multiple correspondence analysis and hierarchical clustering.Results: The prevalence of any UI ranged from 1.5% to 38.8%. In both representative samples it was 17.3%. The design of the survey, i.e. the sampling (representative or not), its objective (centred on general health or UI-centred), the data collection mode and UI definition (symptom-based or perception-based) were likely to change either upwards or downwards the estimates of the prevalence of UI.The most frequent circumstances were leaks during coughing, leakage before getting to the toilet and leaks during physical exercise. Women describing circumstances attributable to stress, urge or mixed types of incontinence formed a separate group from those reporting leakage circumstances attributable to other UI. Similarly, women declaring circumstances attributable to stress UI stood out from those declaring circumstances attributable to urge UI. The most discriminating circumstances to classify incontinent women were: leaks all the time, leaks during coughing, leaks during sleep and leaks after urination.In all the surveys included in our work we have identified significant associations between almost all available risk factors and incontinence, but some factors were associated with all forms of incontinence and others only with few forms. In addition, more associations were observed with severe UI (i.e. daily UI), than with weekly UI. Among UI types, we observed more significant associations with mixed UI and other UI than with stress and urge UI. The strongest associations were found for depression and obesity with almost all forms of UI. Obstetric variables were often associated with mixed UI.Conclusion: Precise estimates of UI prevalence should be based on non–UI-focused surveys among representative samples and using a validated standardised symptom-based questionnaire, as ICIQ-UI-SF, but it appears to be insufficient to define all types of UI. We found that it is possible to use the circumstances of urine leaks for identifying specific groups of incontinent women. But we need to explore to what extent the circumstances of urinary leakage have prognostic or predictive value for response to treatment. With modelling, as we took into account UI type and severity, we identified which UI modalities are related to certain risk factors and which are not.

Page generated in 0.076 seconds