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Smith AL, Berry A, Brubaker L, Cunningham SD, Gahagan S, Low LK, Mueller M, Sutcliffe S, Williams BR, Brady SS. The brain, gut, and bladder health nexus: A conceptual model linking stress and mental health disorders to overactive bladder in women. Neurourol Urodyn 2024; 43:424-436. [PMID: 38078701 PMCID: PMC10872494 DOI: 10.1002/nau.25356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/28/2023] [Accepted: 11/25/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVE A small, but growing literature links stressors and mental health disorders (MHDs) across the life course to overactive bladder (OAB) and urinary incontinence symptoms. Mechanisms by which stressors and MHDs may impact bladder health are not fully understood, limiting novel prevention and treatment efforts. Moreover, potential biopsychosocial mechanisms involving the brain and gut have not been considered in an integrated, comprehensive fashion. METHODS Members of the prevention of lower urinary tract symptoms Research Consortium developed conceptual models to inform research on biopsychosocial mechanisms through which stress and MDHs may impact bladder health among girls and women, focusing on brain and gut physiology. RESULTS Two conceptual models were developed-one to explain central (brain-based) and peripheral (gut-based) mechanisms linking stressors and MHDs to OAB and bladder health, and one to highlight bidirectional communication between the brain, gut, and bladder. Traumatic events, chronic stressors, and MHDs may lead to a maladaptive stress response, including dysregulated communication and signaling between the brain, gut, and bladder. Gut bacteria produce molecules and metabolites that alter production of neurotransmitters, amino acids, short-chain fatty acids, and inflammatory immune response molecules that mediate communication between the gut and brain. Microbiota signal neurogenesis, microglia maturation, and synaptic pruning; they also calibrate brain-gut-bladder axis communication through neurotransmission and synaptogenesis, potentially influencing bladder symptom development. Life course trajectories of risk may be prevented or interrupted by central and peripheral resources for neuropsychological resilience. CONCLUSIONS Depicted pathways, including brain-gut-bladder communication, have implications for research and development of novel prevention and treatment approaches.
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Affiliation(s)
- Ariana L. Smith
- Division of Urology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Amanda Berry
- Division of Urology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Linda Brubaker
- Department of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego School of Medicine, University of California San Diego, La Jolla, California
| | - Shayna D. Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT
| | - Sheila Gahagan
- Department of Pediatrics, UC San Diego School of Medicine, University of California, San Diego CA
| | - Lisa Kane Low
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan
| | - Margaret Mueller
- Department of Ob/Gyn, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, MO
| | - Beverly R. Williams
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham (UAB) and Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs
| | - Sonya S. Brady
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN
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Cunningham SD, Carandang RR, Boyd LM, Lewis JB, Ickovics JR, Rickey LM. Psychosocial Factors Associated with Lower Urinary Tract Symptoms One Year Postpartum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:40. [PMID: 38248505 PMCID: PMC10815698 DOI: 10.3390/ijerph21010040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
Pregnancy carries substantial risk for developing lower urinary tract symptoms (LUTSs), with potential lifelong impacts on bladder health. Little is known about modifiable psychosocial factors that may influence the risk of postpartum LUTSs. We examined associations between depressive symptoms, perceived stress, and postpartum LUTSs, and the moderating effects of perceived social support, using data from a cohort study of Expect With Me group prenatal care (n = 462). One year postpartum, 40.3% participants reported one or more LUTS. The most frequent LUTS was daytime frequency (22.3%), followed by urinary incontinence (19.5%), urgency (18.0%), nocturia (15.6%), and bladder pain (6.9%). Higher odds of any LUTS were associated with greater depressive symptoms (adjusted odds ratio (AOR) 1.08, 95% confidence interval (CI) 1.04-1.11) and perceived stress (AOR 1.12, 95% CI 1.04-1.19). Higher perceived social support was associated with lower odds of any LUTS (AOR 0.94, 95% CI 0.88-0.99). Perceived social support mitigated the adverse effects of depressive symptoms (interaction AOR 0.99, 95% CI 0.98-0.99) and perceived stress (interaction AOR 0.97, 95% CI 0.95-0.99) on experiencing any LUTS. Greater depressive symptoms and perceived stress may increase the likelihood of experiencing LUTSs after childbirth. Efforts to promote bladder health among postpartum patients should consider psychological factors and social support.
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Affiliation(s)
- Shayna D Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Rogie Royce Carandang
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Lisa M Boyd
- Virginia Polytechnic Institute, State University, Blacksburg, VA 24061, USA
| | - Jessica B Lewis
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06510, USA
| | - Jeannette R Ickovics
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - Leslie M Rickey
- Departments of Urology and Obstetrics, Gynecology & Reproductive Services, Yale School of Medicine, New Haven, CT 06510, USA
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Li Q, Cheng Y, Shi H, Xue K, Zhou F. Advances in the natural history of urinary incontinence in adult females. J OBSTET GYNAECOL 2023; 43:2171774. [PMID: 36772931 DOI: 10.1080/01443615.2023.2171774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
The aim of this review is to summarise the related characteristics of the natural history of female urinary incontinence (UI) using a narrative descriptive approach. PubMed, EMBASE and Web of Science were searched for articles published from 1 January 2010 to 1 January 2020 on the natural history of female UI, which including incidence, persistence, progression, remission, and regression of a single subtype of UI and the mutual influence of different UI subtypes. This literature review includes 15 articles published, indicates that UI is highly dynamic, with symptoms varying according to disease severity and subtype and influenced by multiple factors at different disease stages. Recent studies have increased our understanding of the natural history of UI. Future research should systematically analyse the progression of each subtype of UI and interactions between subtypes to prevent the progression of UI across females life course.
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Affiliation(s)
- Qianqian Li
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Yun Cheng
- Xuzhou Maternity and Child Health Care Hospital, Xuzhou, China
| | - Hongli Shi
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Kaikai Xue
- Jiangsu College of Nursing, Huai'an, China
| | - Fang Zhou
- Dean of School of Nursing, Xuzhou Medical University, Xuzhou, China
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Brady SS, Shan L, Markland AD, Huling JD, Arguedas A, Fok CS, Van Den Eeden SK, Lewis CE. Trajectories of depressive symptoms over 20 years and subsequent lower urinary tract symptoms and impact among women. Menopause 2023; 30:723-731. [PMID: 37159879 PMCID: PMC10313766 DOI: 10.1097/gme.0000000000002193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The aim of the study is to examine the association between depressive symptoms and subsequent lower urinary tract symptoms (LUTS) and impact (a composite outcome) among women (N = 1,119) from the Coronary Artery Risk Development in Young Adults study. METHODS The Center for Epidemiologic Studies-Depression Scale (CES-D) was administered in 1990-1991 and every 5 years through 2010-2011. In 2012-2013, LUTS and impact data were collected for the first time. Accumulation of risk was examined in the following three ways: (1) mean CES-D score across 20 years (5 observations); (2) depressive symptom trajectory group, determined by group-based trajectory modeling; and (3) intercepts and slopes obtained from women's individual CES-D score trajectories through two-stage mixed effects modeling. For each approach, ordinal logistic regression analyses examined odds of having "greater LUTS/impact" for each unit change in a depressive symptom variable. RESULTS (1) With each one-unit increase in mean CES-D score over the 20-year period, women were 9% more likely to report greater LUTS/impact (odds ratio [OR] = 1.09, 95% CI = 1.07-1.11). (2) In comparison with women with consistently low depressive symptoms, women with consistently threshold depression or consistently high depressive symptoms were twice (OR = 2.07, 95% CI = 1.59-2.69) and over five times (OR = 5.55, 95% CI = 3.07-10.06) as likely, respectively, to report greater LUTS/impact. (3) Women's individual symptom intercept and slope interacted. Increases in depressive symptoms across 20 years (greater slopes) were associated with greater LUTS/impact when women's initial CES-D score (intercept) was in the moderate-to-high range relative to the sample. CONCLUSIONS Depressive symptoms over 20 years, examined with different degrees of nuance, were consistently associated with subsequently measured LUTS and impact.
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Affiliation(s)
- Sonya S. Brady
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health
| | - Liang Shan
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL
| | - Alayne D. Markland
- Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham School of Medicine and Birmingham VA Medical Center, Birmingham, AL
| | - Jared D. Huling
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN
| | - Andrés Arguedas
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN
| | - Cynthia S. Fok
- Department of Urology, University of Minnesota Medical School, Minneapolis, MN
| | - Stephen K. Van Den Eeden
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
- Department of Urology, University of California, San Francisco, San Francisco, CA
| | - Cora E. Lewis
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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Norton JM, Dowling-Castronovo A, Conroy B, Hijaz A, Kim M, Loizou C, Meyer DE, Constantine ML. The Inflection Point Model: a Model to Explore the Hidden Burdens of Non-Cancerous Genitourinary Conditions. Urology 2021; 166:56-65. [PMID: 34390729 DOI: 10.1016/j.urology.2021.07.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/19/2021] [Accepted: 07/29/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To propose a conceptual model to identify points along the condition course where actions or inaction affect downstream burdens of non-cancerous genitourinary conditions (NCGUC). MATERIALS AND METHODS The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) convened an interdisciplinary meeting to comprehensively consider the burdens of NCGUCs. Subsequently, the authors met monthly to conceptualize the model. RESULTS Inflection points (IP) describe time points during a condition course that are sensitive to change. Our proposed Inflection Point Model (IPM) helps conceptualize burden/benefit trade-offs in any related decision and provides a platform to identify the downstream aggregate burden of a NCGUC across multiple socio-ecological levels at a single time point, which may be summed across the condition course to measure cumulative burden. Two personae demonstrate the utility of this model to better understand impacts of two common NCGUCs. CONCLUSIONS The IPM may be applied in multiple contexts: narrowly to explore burden of a single NCGUC at a single IP; or more broadly, to address multiple conditions, multiple IPs, or multiple domains/levels of social ecology. Applying the IPM may entail combining population data describing prevalence of NCGUCs, associated behaviors, and resulting outcome patterns that can be combined with suitable mathematical models to quantify aggregate and cumulative burden. The IPM challenges stakeholders to expand from the individual to include broader levels of social ecology. Application of the IPM will undoubtedly identify data gaps and research needs that must be fulfilled to delineate and address the burden of NCGUCs.
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Affiliation(s)
- Jenna M Norton
- Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
| | | | - Britt Conroy
- Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Adonis Hijaz
- Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Michelle Kim
- Department of Urology, Massachusetts General Hospital, Harvard Medical School Boston, Boston, MA
| | | | - David E Meyer
- United States Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Cincinnati, OH
| | - Melissa L Constantine
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
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Habitus and Pelvic Floor Symptoms and Support 1 Year Postpartum. Obstet Gynecol 2021; 137:821-830. [PMID: 33831903 DOI: 10.1097/aog.0000000000004349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/28/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the association between habitus measures and pelvic floor support and symptoms in primiparous women 1 year after term vaginal delivery. METHODS In this cross-sectional study including women enrolled at seven academic and community sites, we assessed pelvic floor support, weight, height, waist circumference, and percent fat using air displacement plethysmography and participants completed questionnaires, all at one year postpartum. We tested the association of quintiles of habitus measure, including body mass index (BMI), waist circumference, percent body fat, and waist/height ratio, with the primary outcomes: anatomic support, dichotomized as maximal vaginal descent less than 0 cm (better support) compared with 0 cm or more (worse support) per the pelvic organ prolapse quantification examination and symptom burden (positive with bothersome symptoms in two or more of six symptom domains), and on five secondary outcomes. The sample size provides 90% power to detect odds ratios (ORs) of 1.78 or greater between women at mean compared with mean+1 SD of habitus measure. RESULTS Of 592 participants, 55 (9.3%) demonstrated worse support and 321 (54.2%) symptom burden. In multivariable analyses, habitus measures were not significantly associated with anatomic support or, except for the highest waist/height ratio quintile, with symptom burden. Compared with women in the first quintile of each habitus measure, those in most higher quintiles demonstrated elevated odds of moderate to severe urinary incontinence (UI); increased odds for stress urinary incontinence (SUI) were mainly limited to the highest quintile. After adjusting for percent body fat, the increased odds for BMI on SUI (OR 2.47, 95% CI 1.43-4.28) were no longer significant (OR 1.38, 95% CI 0.54, 3.51). CONCLUSION Habitus in primiparous patients at 1 year postpartum was not associated with anatomic support or symptom burden. Habitus was more associated with moderate to severe UI than mild UI. The association of higher BMI with SUI was attenuated by fitness, reflected by fat percentage.
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7
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Carvalhais A, Araújo F, Ferreira M. Incontinence Quiz: Translation, validation, and reproducibility in Portuguese women. Neurourol Urodyn 2020; 39:2490-2497. [PMID: 32960996 DOI: 10.1002/nau.24521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/08/2020] [Accepted: 09/09/2020] [Indexed: 11/09/2022]
Abstract
AIM The purpose of the present study was to translate and validate the Incontinence Quiz (IQ) questionnaire into a Portuguese version. METHODS The Portuguese version of the 14-item Incontinence Quiz was prepared following translation and back-translation procedures and was tested on a pilot group of 10 women. Internal consistency (Cronbach's α), test-retest reliability (intraclass correlation coefficient [ICC]), and construct validity (using two indicators: education level and being a qualified health professional) were assessed in 141 women from the staff of two higher education institutions. Participant's socio-demographic characteristics were collected by questionnaire. RESULTS The translation and back-translation process was performed without constraints. Cronbach's α ranged from 0.696 (Item 13) to 0.748 (Item 6), and global Chronbach's α was .740. ICC values for the IQ total score were .78, .57, and .79 for correct, wrong, and do not know answers, respectively. Both economic indicators were positively associated with the percentage of correct answers. CONCLUSIONS Validity and reliability of the translated Portuguese IQ were achieved which will allow the comparison of results with studies in other cultures.
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Affiliation(s)
- Alice Carvalhais
- Departamento de Tecnologias de Diagnóstico e Terapêutica, Escola Superior de Saúde do Vale do Sousa, INEGI, LAETA, Porto, Portugal.,INEGI, LAETA, Porto, Portugal
| | - Fábio Araújo
- Departamento de Tecnologias de Diagnóstico e Terapêutica, Escola Superior de Saúde do Vale do Sousa, INEGI, LAETA, Porto, Portugal.,ISPUP-EPI Unit, Universidade do Porto, INEGI, LAETA, Porto, Portugal
| | - Margarida Ferreira
- Departamento de Tecnologias de Diagnóstico e Terapêutica, Escola Superior de Saúde do Vale do Sousa, INEGI, LAETA, Porto, Portugal.,Physical and Rehabilitation Medicine Department, Hospital Senhora da Oliveira, Guimarães, Portugal
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8
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Malde S, Marcelissen T, Vrijens D, Apostilidis A, Rahnama'I S, Cardozo L, Lovick T. Sacral nerve stimulation for refractory OAB and idiopathic urinary retention: Can phenotyping improve the outcome for patients: ICI-RS 2019? Neurourol Urodyn 2020; 39 Suppl 3:S96-S103. [PMID: 32662561 DOI: 10.1002/nau.24204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 10/20/2019] [Indexed: 11/09/2022]
Abstract
AIMS Sacral nerve stimulation (SNS) is widely used to treat refractory idiopathic overactive bladder (OAB) and idiopathic urinary retention. However, clinical outcomes are variable and understanding predictive factors for success or side-effects would enable personalization of therapy and optimization of outcomes. At the International Consultation on Incontinence-Research Society meeting 2019, a Think Tank was convened to discuss how advances in the basic science study of SNS may be translatable into clinical practice to improve outcomes of patients undergoing SNS treatment. METHODS We conducted a literature review and expert consensus meeting focusing on current methods of phenotyping patients and specifically, how advances in basic science research of the mechanism of action of SNS can be translated into clinical practice to improve patient selection for therapy. RESULTS The terms "Idiopathic OAB" and "idiopathic urinary retention" encompass several underlying pathophysiological phenotypes. Commonly, phenotyping is based on clinical and urodynamic factors. Animal studies have demonstrated that high-frequency stimulation can produce rapid onset, reversible conduction block in peripheral nerves. Altering stimulation parameters may potentially enable personalization of therapy depending upon the clinical indication in the future. Similarly, advances in conditional and closed-loop stimulation may offer greater efficacy for certain patients. Phenotyping based on psychological comorbidity requires further study to potentially optimize patient selection for therapy. CONCLUSIONS Idiopathic OAB and idiopathic urinary retention are heterogenous conditions with multiple potential underlying phenotypes. Tailoring stimulation parameters to the needs of each individual according to phenotype could optimize outcomes. Assessing psychological comorbidity may improve patient selection. Areas for further research are proposed.
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Affiliation(s)
- Sachin Malde
- Department of Urology, Guy's Hospital, London, UK
| | - Tom Marcelissen
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Desiree Vrijens
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Sajjad Rahnama'I
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Urology, Uniklinik Aachen RWTH, Aachen, Germany
| | - Linda Cardozo
- Department of Urogynaecology, King's College Hospital, London, UK
| | - Thelma Lovick
- School of Physiology, Pharmacology, and Neuroscience, University of Bristol, Bristol, UK
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Scarabelot KS, da Silva Pereira F, Pelegrini A, Tuon T, Virtuoso JF. Anthropometric indicators as predictors of pelvic floor muscle distress in young women. Neurourol Urodyn 2020; 39:1949-1957. [PMID: 32628314 DOI: 10.1002/nau.24406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/14/2020] [Indexed: 11/06/2022]
Abstract
AIM To identify anthropometric indicators that could predict pelvic floor muscle distress (PFMD) in young women. METHOD A cross-sectional study was conducted, whose sample consisted of 54 women aged between 18 and 35 years. The Pelvic Floor Distress Inventory was used to assess the PFMD. The anthropometric indicators evaluated were body mass index (BMI) being measured the weight and height, body fat percentage (skinfolds), waist circumference (WC), waist-to-hip ratio (WHR), and relative fat mass (RFM), which is calculated from height and WC. Descriptive and inferential statistics (Spearman correlation, simple linear regression, and receiver operating characteristic curve) were used, with a significance level of 5%. RESULTS The PFMD and the anthropometric indicators BMI (r = .43), body fat percentage (r = .42), WC (r = .46), WHR (r = .49), and RFM (r = .48) showed a positive and moderate correlation (P < .01). In all, 24%, 23%, 20%, and 18% of the PFMD can be credited to RFM, WC, WHR, and body fat percentage, respectively. The cut-off point for RFM was 38.44 for the symptom of pressure in the lower abdomen and 36.24 for symptom of stress urinary incontinence and incomplete emptying of the bladder. CONCLUSION Anthropometric indicators of body fat percentage, WC, WHR, and RFM can be predictors of PFMD in young women minimally symptomatic.
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Affiliation(s)
- Karoline S Scarabelot
- Programa de Pós-Graduação em Ciências do Movimento Humano, UDESC, CEFID, Florianópolis, Santa Catarina, Brazil
| | - Franciele da Silva Pereira
- Programa de Pós-Graduação em Ciências do Movimento Humano, UDESC, CEFID, Florianópolis, Santa Catarina, Brazil
| | - Andreia Pelegrini
- Programa de Pós-Graduação em Ciências do Movimento Humano, UDESC, CEFID, Florianópolis, Santa Catarina, Brazil
| | - Talita Tuon
- Programa de Pós-Graduação em Ciências da Reabilitação, UFSC, Centro Araranguá, Santa Catarina, Brazil
| | - Janeisa F Virtuoso
- Programa de Pós-Graduação em Ciências da Reabilitação, UFSC, Centro Araranguá, Santa Catarina, Brazil
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Guidelines for the evaluation and treatment of perimenopausal depression: summary and recommendations. Menopause 2019; 25:1069-1085. [PMID: 30179986 DOI: 10.1097/gme.0000000000001174] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
There is a new appreciation of the perimenopause - defined as the early and late menopause transition stages as well as the early postmenopause - as a window of vulnerability for the development of both depressive symptoms and major depressive episodes. However, clinical recommendations on how to identify, characterize and treat clinical depression are lacking. To address this gap, an expert panel was convened to systematically review the published literature and develop guidelines on the evaluation and management of perimenopausal depression. The areas addressed included: 1) epidemiology; 2) clinical presentation; 3) therapeutic effects of antidepressants; 4) effects of hormone therapy; and 5) efficacy of other therapies (eg, psychotherapy, exercise, and natural health products). Overall, evidence generally suggests that most midlife women who experience a major depressive episode during the perimenopause have experienced a prior episode of depression. Midlife depression presents with classic depressive symptoms commonly in combination with menopause symptoms (ie, vasomotor symptoms, sleep disturbance), and psychosocial challenges. Menopause symptoms complicate, co-occur, and overlap with the presentation of depression. Diagnosis involves identification of menopausal stage, assessment of co-occurring psychiatric and menopause symptoms, appreciation of the psychosocial factors common in midlife, differential diagnoses, and the use of validated screening instruments. Proven therapeutic options for depression (ie, antidepressants, psychotherapy) are the front-line treatments for perimenopausal depression. Although estrogen therapy is not approved to treat perimenopausal depression, there is evidence that it has antidepressant effects in perimenopausal women, particularly those with concomitant vasomotor symptoms. Data on estrogen plus progestin are sparse and inconclusive.
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Aune D, Mahamat‐Saleh Y, Norat T, Riboli E. Body mass index, abdominal fatness, weight gain and the risk of urinary incontinence: a systematic review and dose–response meta‐analysis of prospective studies. BJOG 2019; 126:1424-1433. [DOI: 10.1111/1471-0528.15897] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 11/27/2022]
Affiliation(s)
- D Aune
- Department of Epidemiology and Biostatistics School of Public Health Imperial College London London UK
- Department of Nutrition Bjørknes University College Oslo Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine Oslo University Hospital Oslo Norway
| | - Y Mahamat‐Saleh
- CESP, Fac. de médecine ‐ Univ. Paris‐Sud Fac. demédecine ‐ UVSQ INSERM Université Paris‐Saclay Villejuif France
- Gustave Roussy Villejuif France
| | - T Norat
- Department of Epidemiology and Biostatistics School of Public Health Imperial College London London UK
| | - E Riboli
- Department of Epidemiology and Biostatistics School of Public Health Imperial College London London UK
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12
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John G. Urinary incontinence and cardiovascular disease: a narrative review. Int Urogynecol J 2019; 31:857-863. [DOI: 10.1007/s00192-019-04058-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 07/16/2019] [Indexed: 11/29/2022]
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13
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Maki PM, Kornstein SG, Joffe H, Bromberger JT, Freeman EW, Athappilly G, Bobo WV, Rubin LH, Koleva HK, Cohen LS, Soares CN. Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations. J Womens Health (Larchmt) 2019; 28:117-134. [DOI: 10.1089/jwh.2018.27099.mensocrec] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Pauline M. Maki
- Department of Psychiatry and Department of Psychology, University of Illinois at Chicago, Chicago Illinois
| | - Susan G. Kornstein
- Department of Psychiatry and Institute of Women's Health, Virginia Commonwealth University, Richmond, Virginia
| | - Hadine Joffe
- Connors Center for Women's Health and Department of Psychiatry, Brigham and Women's Hospital and Dana Farber Cancer Institute/Harvard Medical School, Boston, Massachusetts
| | - Joyce T. Bromberger
- Department of Epidemiology, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ellen W. Freeman
- Department of Obstetrics and Gynecology and Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Geena Athappilly
- Edith Nourse Rogers Memorial Veterans Hospital, Bedford Massachusetts; Harvard Medical School, Boston Massachusetts
| | - William V. Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Leah H. Rubin
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Lee S. Cohen
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Claudio N. Soares
- Department of Psychiatry, Queen's University School of Medicine, Ontario Canada
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Lamerton TJ, Torquati L, Brown WJ. Overweight and obesity as major, modifiable risk factors for urinary incontinence in young to mid-aged women: a systematic review and meta-analysis. Obes Rev 2018; 19:1735-1745. [PMID: 30230164 DOI: 10.1111/obr.12756] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/15/2018] [Accepted: 07/16/2018] [Indexed: 12/18/2022]
Abstract
The purpose of this review and meta-analysis was to evaluate overweight and obesity as risk factors for urinary incontinence in young to mid-aged women. Understanding these relationships during this life stage is important as early onset increases the risk for developing severe and persistent incontinence. A systematic search resulted in 497 citations, 14 of which were retained for review. Data were analysed by overweight and obesity and by subtype of urinary incontinence - stress, urge, mixed and severe. When compared with 'normal' body mass index, overweight was associated with a one-third increase in risk of urinary incontinence (relative risk = 1.35, 95% confidence interval = 1.20-1.53), while the risk was doubled in women with obesity (relative risk = 1.95, 95% confidence interval = 1.58-2.42). When estimates were pooled according to urinary incontinence subtype, there was no statistical difference in risk. Overweight and obesity are strong predictors of urinary incontinence, with a significantly greater risk observed for obesity. Clinical advice to young women at risk of, or presenting with, obesity should not be limited to metabolic health only but should emphasize the role of excess weight on pelvic floor weakening and subsequent risk of incontinence.
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Affiliation(s)
- T J Lamerton
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - L Torquati
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - W J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
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15
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Markland AD, Vaughan CP, Okosun IS, Goode PS, Burgio KL, Johnson TM. Cluster analysis of multiple chronic conditions associated with urinary incontinence among women in the USA. BJU Int 2018; 122:1041-1048. [PMID: 29745041 DOI: 10.1111/bju.14246] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To identify patterns of prevalent chronic medical conditions among women with urinary incontinence (UI). MATERIALS AND METHODS We combined cross-sectional data from the 2005-2006 to 2011-2012 US National Health and Nutrition Examination Surveys, and identified 3 800 women with UI and data on 12 chronic conditions. Types of UI included stress UI (SUI), urgency UI (UUI), and mixed stress and urgency UI (MUI). We categorized UI as mild, moderate or severe using validated measures. We performed a two-step cluster analysis to identify patterns between clusters for UI type and severity. We explored associations between clusters by UI subtype and severity, controlling for age, education, race/ethnicity, parity, hysterectomy status and adiposity in weighted regression analyses. RESULTS Eleven percent of women with UI had no chronic conditions. Among women with UI who had at least one additional condition, four distinct clusters were identified: (i) cardiovascular disease (CVD) risk-younger; (ii) asthma-predominant; (iii) CVD risk-older; and (iv) multiple chronic conditions (MCC). In comparison to women with UI and no chronic diseases, women in the CVD risk-younger (age 46.7 ± 15.8 years) cluster reported the highest rate of SUI and mild UI severity. In the asthma-predominant cluster (age 51.5 ± 10.2 years), women had more SUI and MUI and more moderate UI severity. Women in the CVD risk-older cluster (age 57.9 ± 13.4 years) had the highest rate of UUI, along with more severe UI. Women in the MCC cluster (age 61.0 ± 14.8 years) had the highest rates of MUI and the highest rate of moderate/severe UI. CONCLUSIONS Women with UI rarely have no additional chronic conditions. Four patterns of chronic conditions emerged with differences by UI type and severity. Identification of women with mild UI and modifiable conditions may inform future prevention efforts.
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Affiliation(s)
- Alayne D Markland
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama-Birmingham UAB School of Medicine, Birmingham, AL, USA.,Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA
| | - Camille P Vaughan
- Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, Atlanta VA Medical Center, Decatur, GA, USA.,Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Ike S Okosun
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Patricia S Goode
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama-Birmingham UAB School of Medicine, Birmingham, AL, USA.,Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA
| | - Kathryn L Burgio
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama-Birmingham UAB School of Medicine, Birmingham, AL, USA.,Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA
| | - Theodore M Johnson
- Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, Atlanta VA Medical Center, Decatur, GA, USA.,Department of Medicine, Division of General Medicine and Geriatrics, Emory University School of Medicine, Atlanta, GA, USA
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16
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Luo R, Dai W, Tay LH, Ng FC, Koh LT. Urinary incontinence in female outpatients in Singapore. Int Urogynecol J 2017; 29:579-584. [PMID: 28971219 DOI: 10.1007/s00192-017-3488-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/12/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aims of this study were to determine the prevalence, symptom characteristics, risk factors and impact on quality of life (QoL) of urinary incontinence (UI) in female outpatients in Singapore, to describe the attitudes of these women towards UI, and to investigate the barriers to healthcare-seeking behaviour in symptomatic women. METHODS This was a cross-sectional study in a convenience sample and 249 women enrolled from outpatient clinics. A modified self-administered questionnaire which included two validated instruments (the International Consultation on Incontinence Questionnaire-Urinary Incontinence short form and the Incontinence Impact Questionnaire-7) was used. RESULTS Questionnaires from 230 women were included in the analysis. The overall prevalence of UI was 41.74% (95% CI 35.49-48.26%). Most of the symptomatic women suffered from mild UI and the most common subtype was stress UI. Age (OR 1.03, 95% CI 1.00-1.05), vaginal delivery (OR 2.67, 95% CI 1.43-4.97) and being sexually active (OR 2.41, 95% CI 1.31-4.43) were associated with UI. Among symptomatic women, only 41.25% (95% CI 30.82-52.53%) had sought medical attention before. The most common barrier to healthcare-seeking behaviour was embarrassment. The median QoL score was 33.33, indicating a mild impact of UI on QoL. QoL score was associated with UI severity (p < 0.001). CONCLUSIONS Despite the high prevalence of UI, only about 41% of UI sufferers had sought medical attention before. Common barriers included embarrassment, fear of surgery and misconceptions. This study emphasizes the need for policy development for UI prevention and management in Singapore.
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Affiliation(s)
- Rui Luo
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Wei Dai
- Saw Swee Hock School of Public health, National University of Singapore, Singapore, Singapore
| | - Lee Hua Tay
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Foo Cheong Ng
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Li-Tsa Koh
- Department of Urology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
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17
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Abstract
: Overactive bladder is a term used to describe a group of lower urinary tract symptoms that are prevalent in women, particularly as they age. Those with overactive bladder often experience related physical and psychological symptoms or conditions and report a poorer quality of life than other women. Many factors that increase the risk of developing overactive bladder are modifiable; therefore, lifestyle and behavioral interventions are first-line treatments. More treatment options are becoming available to women as research provides new information about the underlying pathophysiology of overactive bladder. Nurses play a major role in its screening, assessment, and management in women, many of whom do not seek help and try to self-manage symptoms, leading to a continuing cycle of unpredictable urgency and incontinence.
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18
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Chai TC, Asfaw TS, Baker JE, Clarkson B, Coleman P, Hoffstetter S, Konkel K, Lavender M, Nair S, Norton J, Subak L, Visco A, Star RA, Bavendam T. Future Directions of Research and Care for Urinary Incontinence: Findings from the National Institute of Diabetes and Digestive and Kidney Diseases Summit on Urinary Incontinence Clinical Research in Women. J Urol 2017; 198:22-29. [PMID: 28286067 DOI: 10.1016/j.juro.2016.10.133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Female urinary incontinence is prevalent, costly and morbid. Participants in a NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases) sponsored summit reviewed findings from NIH (National Institutes of Health) funded clinical research on urinary incontinence in women and discussed the future of urinary incontinence research. MATERIALS AND METHODS The NIDDK convened the Summit on Urinary Incontinence Clinical Research in Women on March 14, 2014. Participants representing a broad range of clinical expertise reviewed completed NIH sponsored urinary incontinence related studies, including results from community based epidemiological studies such as the BACH (Boston Area Community Health) Survey and from randomized clinical trials such as PRIDE (Program to Reduce Incontinence by Diet and Exercise), and studies conducted by the Pelvic Floor Disorders Network and the Urinary Incontinence Treatment Network. RESULTS BACH Survey results improved our understanding of precursors, incidence, prevalence and natural history of urinary incontinence in a diverse group of women. The Pelvic Floor Disorders Network study found that anticholinergic medications and onabotulinumtoxinA are efficacious for treating urge urinary incontinence, and Burch colposuspension and retropubic mid urethral polypropylene slings are efficacious for decreasing stress urinary incontinence following pelvic organ prolapse surgery in women with potential stress urinary incontinence. The Urinary Incontinence Treatment Network study found that fascial slings were better than colposuspension, and that retropubic and transobturator mid urethral polypropylene slings were equivalent for stress urinary incontinence. In patients with stress urinary incontinence a preoperative urodynamic study was noninferior to basic office examinations for surgical outcome. The addition of behavioral intervention did not allow female patients to discontinue antimuscarinics for urge urinary incontinence. PRIDE showed that modest weight reductions significantly decreased urinary incontinence. CONCLUSIONS Strategies for future research on urinary incontinence should include a focus on early disease, risk factor identification, better phenotyping, incorporation of new technologies, patient centered research and prevention.
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Affiliation(s)
- Toby C Chai
- Department of Urology, Yale School of Medicine, New Haven, Connecticut.
| | - Tirsit S Asfaw
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York
| | - Jan E Baker
- Department of Obstetrics and Gynecology, University of Utah Health Care, Salt Lake City, Utah
| | - Becky Clarkson
- Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Susan Hoffstetter
- Department of Obstetrics, Gynecology and Women's Health, St. Louis University School of Medicine, St. Louis, Missouri
| | - Kimberly Konkel
- Center for Faith-Based and Neighborhood Partnerships, U.S. Department of Health and Human Services, Washington, D.C
| | | | - Shailaja Nair
- Drexel Center for Women's Health, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Jenna Norton
- Division of Kidney, Urologic and Hematologic Disease, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Leslee Subak
- Department of Obstetrics, Gynecology and Reproductive Science, University of California, San Francisco, San Francisco, California
| | - Anthony Visco
- Division of Urogynecology, Duke University School of Medicine, Durham, North Carolina
| | - Robert A Star
- Division of Kidney, Urologic and Hematologic Disease, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Tamara Bavendam
- Division of Kidney, Urologic and Hematologic Disease, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
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19
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Vrijens D, Berghmans B, Nieman F, van Os J, van Koeveringe G, Leue C. Prevalence of anxiety and depressive symptoms and their association with pelvic floor dysfunctions-A cross sectional cohort study at a Pelvic Care Centre. Neurourol Urodyn 2017; 36:1816-1823. [DOI: 10.1002/nau.23186] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/12/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Desiree Vrijens
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
- Department of Urology; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Bary Berghmans
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Fred Nieman
- Department of Clinical Epidemiology and Medical Technology Assessment; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON; Maastricht University Medical Centre; Maastricht The Netherlands
- King's Health Partners, Institute of Psychiatry; King's College London; London United Kingdom
- MeHNS, Research School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
| | - Gommert van Koeveringe
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
- Department of Urology; Maastricht University Medical Centre; Maastricht The Netherlands
- MeHNS, Research School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
| | - Carsten Leue
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON; Maastricht University Medical Centre; Maastricht The Netherlands
- MeHNS, Research School for Mental Health and Neuroscience; Maastricht University; Maastricht The Netherlands
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20
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Abstract
PURPOSE OF REVIEW We sought to provide a review of the recent literature regarding the prevalence and epidemiological trends in pelvic floor disorders (PFDs) including pelvic organ prolapse (POP), urinary incontinence and fecal incontinence. We also examined the current trends in surgical treatment for these disorders and discuss future care needs. RECENT FINDINGS Approximately, one quarter of all women suffer from at least one or more PFDs. Urinary incontinence represents the most common PFD with an estimated prevalence of 15-17%, whereas fecal incontinence affects, approximately, 9% of adult women. POP is more difficult to assess with prevalence estimates ranging from 3 to 8%. Surgery for PFDs is common as 20% of women undergo stress urinary incontinence or POP surgery over their lifetime. As the aging population grows, the number of women with PFDs will increase substantially and the demand for care for these disorders will continue to grow through the year 2050. SUMMARY PFDs are a significant public health issue and they negatively impact the lives of millions of adult women. The projected increase in the number of women affected by PFDs over the next 40 years will create increased demand for providers properly trained in Female Pelvic Medicine and Reconstructive Surgery.
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21
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Bavendam TG, Norton JM, Kirkali Z, Mullins C, Kusek JW, Star RA, Rodgers GP. Advancing a Comprehensive Approach to the Study of Lower Urinary Tract Symptoms. J Urol 2016; 196:1342-1349. [PMID: 27341750 DOI: 10.1016/j.juro.2016.05.117] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE Lower urinary tract symptoms are common in the United States population, leading to significant economic, quality of life and public health issues. The burden will increase as the population ages, and risk factors for lower urinary tract symptoms, including diabetes and obesity, remain highly prevalent. Improving clinical management and establishing the knowledge base to prevent lower urinary tract symptoms will require a comprehensive research approach that examines factors beyond the lower urinary tract. While the study of extra-lower urinary tract factors has increased recently, current urological research does not systematically account for the broad set of potential contributing factors spanning biological, behavioral, psychological/executive function and sociocultural factors. A comprehensive assessment of potential contributors to risk, treatment response and progression is necessary to reduce the burden of this condition in the United States. MATERIALS AND METHODS We considered challenges to continuing the predominantly lower urinary tract dysfunction centric approach that has dominated previous research of lower urinary tract symptoms. RESULTS We developed a new, comprehensive framework for urology research that includes a broader set of potential factors contributing to lower urinary tract symptoms. This framework aims to broaden research to consider a comprehensive set of potential contributing factors and to engage a broad range of researchers in the investigation of as many extra-lower urinary tract factors as possible, with the goal of improving clinical care and prevention. CONCLUSIONS We propose a new framework for future urology research, which should help to reduce the medical and economic burden of lower urinary tract symptoms in the United States population.
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Affiliation(s)
- Tamara G Bavendam
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Jenna M Norton
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Ziya Kirkali
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Chris Mullins
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - John W Kusek
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Robert A Star
- Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Griffin P Rodgers
- Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
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22
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Bazi T, Takahashi S, Ismail S, Bø K, Ruiz-Zapata AM, Duckett J, Kammerer-Doak D. Prevention of pelvic floor disorders: international urogynecological association research and development committee opinion. Int Urogynecol J 2016; 27:1785-1795. [PMID: 26971276 DOI: 10.1007/s00192-016-2993-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/18/2016] [Indexed: 12/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Pelvic floor disorders (PFD), including urinary incontinence, anal incontinence, and pelvic organ prolapse, are common and have a negative effect on the quality of life of women. Treatment is associated with morbidity and may not be totally satisfactory. Prevention of PFDs, when possible, should be a primary goal. The purpose of this paper is to summarise the current literature and give an evidence-based review of the prevention of PFDs METHODS: A working subcommittee from the International Urogynecological Association (IUGA) Research and Development (R&D) Committee was formed. An initial document addressing the prevention of PFDs was drafted, based on a review of the English-language literature. After evaluation by the entire IUGA R&D Committee, revisions were made. The final document represents the IUGA R&D Committee Opinion on the prevention of PFDs. RESULTS This R&D Committee Opinion reviews the literature on the prevention of PFDs and summarises the findings with evidence-based recommendations. CONCLUSIONS Pelvic floor disorders have a long latency, and may go through periods of remission, thus making causality difficult to confirm. Nevertheless, prevention strategies targeting modifiable risk factors should be incorporated into clinical practice before the absence of symptomatology.
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Affiliation(s)
- Tony Bazi
- Department of Obstetrics and Gynecology, Faculty of Medicine, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Sharif Ismail
- Brighton and Sussex Medical School, Brighton and Sussex University Hospitals NHS Trust, Brighton, England, UK
| | - Kari Bø
- Norwegian School of Sport Sciences, Oslo, Norway
| | - Alejandra M Ruiz-Zapata
- Department of Obstetrics and Gynecology, Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jonathan Duckett
- Directorate of Women's Health, Medway NHS Foundation Trust, Gillingham, UK
| | - Dorothy Kammerer-Doak
- Women's Pelvic Specialty Care of New Mexico, University of New Mexico Hospital, Albuquerque, NM, USA
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23
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Reynolds WS, Fowke J, Dmochowski R. The Burden of Overactive Bladder on US Public Health. CURRENT BLADDER DYSFUNCTION REPORTS 2016; 11:8-13. [PMID: 27057265 PMCID: PMC4821440 DOI: 10.1007/s11884-016-0344-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Overactive bladder (OAB) is a highly prevalent symptom condition that affects millions of US men and women. Not only can the symptoms of OAB be very bothersome, but OAB can have significant detrimental effects on many aspects of individuals' lives, representing a particularly impactful health burden to quality of life and productivity. Estimates of the individual and societal costs for the management of OAB continue to rise, particularly as effective treatments remain elusive. As such, OAB represents a significant public health burden to the USA.
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Affiliation(s)
- W. Stuart Reynolds
- Department of Urologic Surgery, Female Pelvic Medicine and Reconstructive Surgery, Vanderbilt University Medical Center, A1302 Medical Center North, Nashville, TN 37232, USA
| | - Jay Fowke
- Department of Urologic Surgery, Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Vanderbilt University Medical Center, 12th floor, Nashville, TN 37232, USA
| | - Roger Dmochowski
- Department of Urologic Surgery, Female Pelvic Medicine and Reconstructive Surgery, Vanderbilt University Medical Center, A1302 Medical Center North, Nashville, TN 37232, USA
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24
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Takehara K, Dagvadorj A, Hikita N, Sumya N, Ganhuyag S, Bavuusuren B, Ota E, Haruna M, Yoshida M, Kita S, Noma H, Mori R. Maternal and Child Health in Mongolia at 3 Years After Childbirth: A Population-Based Cross-Sectional Descriptive Study. Matern Child Health J 2015; 20:1072-81. [DOI: 10.1007/s10995-015-1893-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Felde G, Ebbesen MH, Hunskaar S. Anxiety and depression associated with urinary incontinence. A 10-year follow-up study from the Norwegian HUNT study (EPINCONT). Neurourol Urodyn 2015; 36:322-328. [PMID: 26584597 DOI: 10.1002/nau.22921] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/09/2015] [Indexed: 01/05/2023]
Abstract
AIMS Firstly, to investigate the association between depression, anxiety and urinary incontinence (UI) in a 10-year longitudinal study of women. Secondly, to investigate the association between possible differences in the stress- and urgency components of UI and different severities of depression and anxiety by age groups. METHODS In a longitudinal, population-based survey study, the EPINCONT part of the HUNT study in Norway, we analyzed questionnaire data on UI, depression and anxiety from 16,263 women from 20 years of age. A multivariate logistic regression model was used to predict the odds of developing anxiety and depression among the women with and without UI at baseline and the odds of developing UI among the women with and without anxiety or depression at baseline. RESULTS For women with any UI at baseline we found an association with the incidence of depression and anxiety symptoms, OR 1.45 (1.23-1.72) and 1.26 (1.8-1.47) for mild depression and anxiety respectively. For women with depression or anxiety symptoms at baseline we found an association with the incidence of any UI with OR 2.09 (1.55-2.83) and 1.65 (1.34-2.03) for moderate/severe symptom-score for depression and anxiety, respectively, for the whole sample. CONCLUSIONS In this study, both depression and anxiety are shown to be risk factors for developing UI with a dose-dependent trend. UI is associated with increased incidence of depression and anxiety. Neurourol. Urodynam. 36:322-328, 2017. © 2015 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Gunhild Felde
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Marit Helen Ebbesen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Steinar Hunskaar
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway
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26
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Depression and the incidence of urinary incontinence symptoms among young women: Results from a prospective cohort study. Maturitas 2015; 81:456-61. [PMID: 26059920 DOI: 10.1016/j.maturitas.2015.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 05/13/2015] [Accepted: 05/14/2015] [Indexed: 11/18/2022]
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27
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Matthews CA. Risk factors for urinary, fecal, or double incontinence in women. Curr Opin Obstet Gynecol 2014; 26:393-7. [DOI: 10.1097/gco.0000000000000094] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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28
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You are what you eat: The impact of diet on overactive bladder and lower urinary tract symptoms. Maturitas 2014; 79:8-13. [DOI: 10.1016/j.maturitas.2014.06.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 06/11/2014] [Indexed: 11/21/2022]
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