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Mariani A, Gambazza S, Carta F, Ambrogi F, Brivio A, Bulfamante AM, Daccò V, Bassotti G, Colombo C. Prevalence and factors associated with urinary incontinence in females with cystic fibrosis: An Italian single-center cross-sectional analysis. Pediatr Pulmonol 2022; 57:132-141. [PMID: 34636479 DOI: 10.1002/ppul.25723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/29/2021] [Accepted: 10/10/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Individuals with cystic fibrosis (CF) are deemed to have a higher risk of developing urinary incontinence (UI), likely due to repeated increasing pressure on the pelvic floor. We aimed to determine the prevalence of female UI in a large CF referral center, and to assess the association between UI and severity of CF disease. METHODS We consecutively recruited female patients regularly attending our CF center, aged ≥6 years and with a confirmed diagnosis of CF. Prevalence, severity, and impact of UI were assessed by administering two validated questionnaires. Relationship between variables was evaluated by means of multiple correspondence analysis, whereas a logistic model was fitted to capture the statistical association between UI and independent variables. RESULTS UI was present in 51/153 (33%, 95% confidence interval [CI]: 26%-41%) females. Among children and adolescents, the prevalence was 12/82 (15%, 95% CI: 8%-25%) whereas among adults was 39/71 (55%, 95% CI: 43%-67%). The only explanatory variable associated with UI was age, with children presenting the lowest risk (odds ratio, 0.32; 95% CI: 0.05-0.93). Females presenting low or high nutritional status show higher profile risk of having UI. CONCLUSIONS Stress UI is a common complication in females with CF since childhood. Although it frequently occurs in older patients with a more severe phenotype, much attention should be paid to adults and to their nutritional status.
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Affiliation(s)
- Alessandra Mariani
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Simone Gambazza
- Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Federica Carta
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Federico Ambrogi
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Anna Brivio
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Anna M Bulfamante
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Valeria Daccò
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giacomo Bassotti
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Carla Colombo
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
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2
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Sexual and Reproductive Health in Cystic Fibrosis. Respir Med 2020. [DOI: 10.1007/978-3-030-42382-7_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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3
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Arbuckle JL, Parden AM, Hoover K, Griffin RL, Richter HE. Prevalence and Awareness of Pelvic Floor Disorders in Female Adolescents Seeking Gynecologic Care. J Pediatr Adolesc Gynecol 2019; 32:288-292. [PMID: 30529498 DOI: 10.1016/j.jpag.2018.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/04/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
STUDY OBJECTIVE To determine the prevalence and awareness of pelvic floor disorder symptoms among female adolescents. DESIGN Cross-sectional study via a written, anonymous survey of adolescents. The survey was composed of validated measures for determination of symptom prevalence. SETTING Pediatric and adolescent gynecology clinic in the southeast United States. PARTICIPANTS Female adolescents ages 14-21 years. INTERVENTIONS None. MAIN OUTCOME MEASURES We used χ2 analyses for categorical variables and t test for continuous variables. RESULTS Two hundred sixteen questionnaires were completed. The mean age of respondents was 17.1 (±2.1) years and most respondents had at least heard about urinary (UI) and fecal incontinence (FI; 62.9%). The prevalence of any UI was 31.5%. Urgency UI (UUI) was reported by 15.7% and stress UI was reported by 6.9% of adolescents; 8.8% of participants experienced UUI and stress UI symptoms. FI and pelvic organ prolapse symptoms were reported by 0.9%. There were no differences in reported prevalence rates of UI (31.7% vs 27.9%), FI (1.4% vs 0%), or pelvic organ prolapse (1.4% vs 0%) between younger (14-17 years) and older (18-21 years) adolescent participants, respectively (all P > .05). Although UI was fairly prevalent among respondents, most stated that it had a minimal effect on daily living. CONCLUSION UI symptoms were common among female adolescents, with UUI being the most reported. Early education regarding pelvic floor disorder symptoms might lead to prevention or empowerment to seek treatment as adolescents age.
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Affiliation(s)
- Janeen L Arbuckle
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - Alison M Parden
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kimberly Hoover
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Russell L Griffin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Holly E Richter
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama
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Neemuchwala F, Ahmed F, Nasr SZ. Prevalence of Pelvic Incontinence in Patients With Cystic Fibrosis. Glob Pediatr Health 2017; 4:2333794X17743424. [PMID: 29226186 PMCID: PMC5714092 DOI: 10.1177/2333794x17743424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/20/2017] [Indexed: 11/17/2022] Open
Abstract
Cystic fibrosis (CF) patients are at risk for developing pelvic (urinary and/or fecal) incontinence due to progressive weakness of pelvic floor muscles secondary to recurrent episodes of coughing and respiratory infections. Many patients do not bring these symptoms to the attention of their health care providers because of social embarrassment and lack of knowledge of available effective treatment. Several studies have identified the prevalence of incontinence in CF adults and adolescents. However, few studies identified the problem in children with CF. Our study aims are to identify the prevalence of pelvic incontinence in CF patients aged 6 to 21 years, to identify the correlation between incontinence and severity of lung disease, and to help develop treatment strategy in collaboration with physical therapy to address these issues.
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Frayman KB, Kazmerski TM, Sawyer SM. A systematic review of the prevalence and impact of urinary incontinence in cystic fibrosis. Respirology 2017; 23:46-54. [DOI: 10.1111/resp.13125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/04/2017] [Accepted: 06/04/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Katherine B. Frayman
- Department of Respiratory and Sleep Medicine; Royal Children's Hospital; Parkville VIC Australia
- Department of Paediatrics; The University of Melbourne; Parkville VIC Australia
- Murdoch Childrens Research Institute; Parkville VIC Australia
| | - Traci M. Kazmerski
- Division of Pulmonary and Respiratory Diseases, Department of Medicine; Boston Children's Hospital; Boston MA USA
- Institute for Healthcare Improvement; Cambridge MA USA
| | - Susan M. Sawyer
- Department of Paediatrics; The University of Melbourne; Parkville VIC Australia
- Murdoch Childrens Research Institute; Parkville VIC Australia
- Royal Children's Hospital Centre for Adolescent Health; Parkville VIC Australia
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Ashbrook JE, Shacklady C, Johnson S, Yeowell G, Goodwin PC. Is there an association between back pain and stress incontinence in adults with cystic fibrosis? A retrospective cross-sectional study. J Cyst Fibros 2017; 17:78-82. [PMID: 28476560 DOI: 10.1016/j.jcf.2017.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 02/26/2017] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Back pain and stress urinary incontinence (SUI) are common in adults with cystic fibrosis (CF). This study aimed to establish whether there is an association between back pain, lung function and stress urinary incontinence and its relative risk. METHOD This was a cross-sectional, retrospective analysis of the Manchester Musculoskeletal Screening Tool (MMST) data. It includes pain, (Short Form McGill Pain Questionnaire (SF-MPQ and VAS)) and International Consultation on Incontinence Short Form (ICIQ-UI-SF) measures. Associations were tested using Spearman's rank correlation coefficient. Relative risk of developing symptoms was calculated the sig level was p=0.05. RESULTS ICIQ-UI-SF was associated with back pain (SF-MPQ) (Rho=0.32, p<0.001) and pain (VAS) (Rho=0.23, p<0.01). RR of developing SUI with back pain was 2; RR of developing back pain with SUI was 1.3. CONCLUSIONS An association is indicated between back pain (SF-MPQ and VAS), and SUI in adults with CF. This information is important when developing management strategies in the CF population.
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Affiliation(s)
- Jane E Ashbrook
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Southmoor Rd, Manchester M23 9LT, United Kingdom
| | - Carol Shacklady
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom
| | - Sue Johnson
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Southmoor Rd, Manchester M23 9LT, United Kingdom
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom
| | - Peter Charles Goodwin
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom.
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Conway S, Balfour-Lynn IM, De Rijcke K, Drevinek P, Foweraker J, Havermans T, Heijerman H, Lannefors L, Lindblad A, Macek M, Madge S, Moran M, Morrison L, Morton A, Noordhoek J, Sands D, Vertommen A, Peckham D. European Cystic Fibrosis Society Standards of Care: Framework for the Cystic Fibrosis Centre. J Cyst Fibros 2015; 13 Suppl 1:S3-22. [PMID: 24856776 PMCID: PMC7105239 DOI: 10.1016/j.jcf.2014.03.009] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A significant increase in life expectancy in successive birth cohorts of people with cystic fibrosis (CF) is a result of more effective treatment for the disease. It is also now widely recognized that outcomes for patients cared for in specialist CF Centres are better than for those who are not. Key to the effectiveness of the specialist CF Centre is the multidisciplinary team (MDT), which should include consultants, clinical nurse specialist, microbiologist, physiotherapist, dietitian, pharmacist, clinical psychologist, social worker, clinical geneticist and allied healthcare professionals, all of whom should be experienced in CF care. Members of the MDT are also expected to keep up to date with developments in CF through continued professional development, attendance at conferences, auditing and involvement in research. Specialists CF Centres should also network with other Centres both nationally and internationally, and feed Centre data to registries in order to further the understanding of the disease. This paper provides a framework for the specialist CF Centre, including the organisation of the Centre and the individual roles of MDT members, as well as highlighting the value of CF organisations and disease registries.
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Affiliation(s)
- Steven Conway
- Paediatric and Adult CF Units, Leeds Teaching Hospitals Trust, UK.
| | | | | | - Pavel Drevinek
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Paediatrics, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic; University Hospital Motol, Prague, Czech Republic
| | - Juliet Foweraker
- Department of Microbiology, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | | | - Harry Heijerman
- HagaZiekenhuis, Department of Pulmonology & Cystic Fibrosis, The Hague, The Netherlands
| | - Louise Lannefors
- Copenhagen CF Centre, Rigshospitalet, University Hospital, Copenhagen, Denmark
| | - Anders Lindblad
- Gothenburg CF Centre, Queen Silvia Children's Hospital, Göteborg, Sweden
| | - Milan Macek
- Department of Biology and Medical Genetics, University Hospital Motol, Prague, Czech Republic; Second School of Medicine, Charles University Prague, Prague, Czech Republic
| | - Sue Madge
- Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, UK
| | - Maeve Moran
- National Referral Centre for Adult Cystic Fibrosis, Pharmacy Department, St. Vincent's University Hospital, Ireland
| | - Lisa Morrison
- Gartnavel General Hospital, West of Scotland Adult CF Unit, Glasgow, UK
| | - Alison Morton
- Adult Cystic Fibrosis Unit, St James's Hospital, Leeds, UK
| | | | - Dorota Sands
- Department of Pediatrics, Institute of Mother and Child, Warsaw, Poland
| | | | - Daniel Peckham
- Adult Cystic Fibrosis Unit, St James's Hospital, Leeds, UK
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Sexual and reproductive health in cystic fibrosis: a life-course perspective. THE LANCET RESPIRATORY MEDICINE 2015; 3:70-86. [DOI: 10.1016/s2213-2600(14)70231-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Abstract
Abstract
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10
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Yu CJ, Hsu CC, Lee WC, Chiang PH, Chuang YC. Medical diseases affecting lower urinary tract function. UROLOGICAL SCIENCE 2013. [DOI: 10.1016/j.urols.2013.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Factors Influencing Quality of Life in Children With Urinary Incontinence. J Urol 2011; 186:1048-52. [DOI: 10.1016/j.juro.2011.04.104] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Indexed: 11/23/2022]
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Abstract
Urinary incontinence has been found to be common in girls and women with cystic fibrosis (CF). This often can have a marked impact on daily activities and quality of life. It may also lead to potential deterioration of respiratory status due to reduced adherence to forced expiratory manoeuvres (cough, lung function tests and exercise) by the girls trying to avoid occurrence of urinary incontinence (UI). Analysis of the literature is limited by the fact that different definitions and a variety of questionnaires have been used. There is little literature regarding UI in men and boys which is thought to be less common than in females. National guideline recommendations in the management of CF in Australia and the United Kingdom have in recent years changed to incorporate screening and management of UI. No studies to date have looked at outcomes of interventions in children and adolescents with CF or other respiratory conditions; however those working with this population need to be aware of the problem of UI as it is a treatable condition and could potentially be prevented.
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HIRAYAMA F, LEE AH, BINNS CW, NISHIMURA K, TANIGUCHI H. Association of impaired respiratory function with urinary incontinence. Respirology 2009; 14:753-6. [DOI: 10.1111/j.1440-1843.2009.01538.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Vella M, Cartwright R, Cardozo L, Parsons M, Madge S, Burns Y. Prevalence of incontinence and incontinence-specific quality of life impairment in women with cystic fibrosis. Neurourol Urodyn 2009; 28:986-9. [DOI: 10.1002/nau.20732] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Browne WJ, Wood CJ, Desai M, Weller PH. Urinary incontinence in 9-16 year olds with cystic fibrosis compared to other respiratory conditions and a normal group. J Cyst Fibros 2008; 8:50-7. [PMID: 18930699 DOI: 10.1016/j.jcf.2008.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Revised: 08/29/2008] [Accepted: 09/09/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Individuals with cystic fibrosis (CF) are deemed at risk of developing urinary incontinence (UI) due to repeated coughing and other factors causing increased pressure on the pelvic floor. Increased incidence of UI is recognised in women and increasingly in men and children. However, there is little comparison with normal controls and other respiratory conditions with chronic cough. Our aim was to report the incidence, degree and impact of UI in 9-16 year olds related to clinical status in CF, compared to these. METHODS 9-16 year olds were invited to fill in a self-administered anonymous/confidential questionnaire at clinic. Data recorded were sex, age, height, weight, spirometry expressed as percentage predicted. Normal controls - age and sex only recorded. RESULTS No significant differences were found between incidence of UI (21% CF; 22% respiratory; and 17% normal controls, P=0.43). No relationship found between respiratory or nutritional status and UI. Laughing, exercise and cough were the most common causes of UI. No difference between groups for age range, physiotherapy, breathlessness, antibiotics, urinary tract infections and menarche. Only 6% reported more than a few drops of UI. CONCLUSION Incidence of urinary incontinence is no different between 9-16 year old girls and boys with CF, and controls.
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Affiliation(s)
- W J Browne
- Physiotherapy Department, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK.
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Bibliography. Current world literature. Cardiovascular medicine. Curr Opin Pediatr 2007; 19:601-6. [PMID: 17885483 DOI: 10.1097/mop.0b013e3282f12851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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