Risk factors for urinary incontinence among postmenopausal Mexican women

The incidence of urinary incontinence in Chinese hypertensive women and the relationship between hypertension and urinary incontinence

OBJECTIVES

To determine the incidence of UI (urinary incontinence) and its subtypes in hypertensive women and examine the association between hypertension and new-onset UI.

STUDY DESIGN

We conducted a cohort study on women aged ≥20 years in six regions of China. This cohort study was carried out from 2014 to 2016 at baseline, with follow-up completed in 2018. Information on sociodemographic characteristics, physiological and health behaviours were collected. We calculated the standardized person-year incidence of UI in hypertensive women, and used logistic regression to evaluate the association between hypertension and UI and its subtypes.

RESULTS

The standardized incidence of UI, stress UI (SUI), urgency UI (UUI), and mixed UI (MUI) in hypertensive women was 32.2, 21.9, 4.1, and 6.1 per 1000 person-years. Compared with normotensive women, the unadjusted and adjusted OR (odd ratio) for UI in hypertensive women was 2.62 (95 % confidence interval [CI], 2.16-3.18) and 1.70 (95 % CI, 1.14-2.53), respectively; The unadjusted and adjusted OR for SUI in women with hypertension was 2.44 (95 % CI, 1.92-3.09) and 2.60 (95 % CI, 1.68-4.04), respectively; The unadjusted and adjusted OR for UUI in women with hypertension was 2.80 (95 % CI, 1.79-4.37) and 0.54 (95 % CI, 0.13-3.66), respectively; The unadjusted and adjusted OR for MUI in women with hypertension was 2.49 (95 % CI, 1.92-3.09) and 0.60 (95 % CI, 0.19-1.91), respectively.

CONCLUSIONS

The incidence of UI in hypertensive women was 32.2/1000 person-years. Hypertension was an independent risk factor for new-onset UI and SUI in Chinese adult women.

Urinary incontinence and related quality of life among elderly women in Tabas, South Khorasan, Iran

BACKGROUND

Urinary incontinence (UI) is one of the most common problems in old age that is often seen in women, which causes not only physical problems but also psychological, social, economic problems and poor quality of life. The aim of the present study was to evaluate the UI and related quality of life (QoL) in elderly women.

METHODS

This cross-sectional study enrolled 369 women over 60 years old and living in Tabas city, Iran who were selected by cluster random sampling method. The instruments included the International Consultation on Incontinence Questionnaire-Short Form, the International Consultation on Incontinence Questionnaire Urinary Incontinence Quality of Life Module, and a demographic questionnaire. Data analysis was carried out using independent t-test, chi-square, and logistic regression in SPSS software.

RESULTS

The UI prevalence among participants was 24.9% and stress urinary incontinence was the most common type (40.2% of all elderly patients). The mean UI-related QoL score was 38.04 ± 11.67 from the score range of 22-76. There was a significant positive correlation between UI-related QoL score and UI score (r = 0.585, p < 0.001). Age, body mass index (BMI), constipation, history of cesarean section, hypertension, and the use of angiotensin receptor blockers are factors increasing the odds of having UI in this study population.

CONCLUSION

Aging, some chronic diseases, high BMI, and the use of some drugs are related to UI prevalence. Also, it is associated with lower QOL among elderly women. Designing appropriate intervention programs, controlling chronic diseases, training in the proper use of drugs, and also some physical exercises can be effective in controlling and improving this common syndrome of old age and promoting their QoL.

Age at first birth and risk of urinary incontinence after delivery: a dose-response meta-analysis

Studies investigating the impact of age at first birth on urinary incontinence after delivery have reached inconsistent conclusions. We performed this systematic review and meta-analysis of studies assessing the risk of urinary incontinence after delivery, regardless of the type, with age at first birth. MEDLINE via PubMed and Web of science databases were searched up to March 13, 2021. Restricted cubic splines were used to model the dose–response association. Twelve publications were included in this meta-analysis. The summary odds ratio (OR) and 95% confidence interval (CI) per 1-year increase in age at first birth were 1.01 (95% CI (0.99, 1.02)) for urinary incontinence (America: 1.00 (0.99, 1.00); Europe: 1.03 (1.00, 1.06); Asian: 0.99 (0.89, 1.10)). A non-linear dose–response (P_nonlinearity < 0.01) indicated that age at first birth older than 32 (P < 0.05) increases the risk of urinary incontinence. First birth before age 32 make decrease the risk of urinary incontinence after delivery.

Prevalence of urinary incontinence subtypes in women

Abstract Introduction: Urinary incontinence (UI) is present in the lives of a considerable number of women worldwide. This condition and its associated factors have been sufficiently investigated in recent years, however, prevalence estimates are still not fully clarified, as UI is seen as stigmatizing in a cultural context, and the search for treatment is not always considered by affected individuals. So, this dysfunction and its subtypes must be better understood so that it is possible to alleviate its consequences. Objective: To identify the prevalence of urinary incontinence subtypes, in women from a reference clinic in a public hospital in Curitiba, PR, Brazil. Methods: This was an observational and analytical study, with 227 women affected by UI, evaluated by means of a questionnaire including sociodemographic and general health information, in addition to defining the UI subtype. The SPSS version 25 was used for statistical analysis. Results: The patients presented a mean age of 60.33 ± 12.26 years. Mixed UI was the prevalent subtype (87.2%; n = 198), followed by stress (7.5%; n = 17), and urge (5.3%; n = 12). Among women with mixed UI, 60.6% had only completed elementary school, 59.1% were housewives, and 87.6% had experienced two or more pregnancies. Conclusion: Outlining UI subtypes, and the general and obstetric characteristics of the studied population enables the development of coping strategies for this condition, ranging from planning, diagnosis and treatment, to costs and public health management.

Prevalência dos subtipos de incontinência urinária em mulheres

Resumo Introdução: A incontinência urinária (IU) está presente na vida de considerável número de mulheres no mundo. Essa condição e fatores associados a ela vêm sendo suficientemente investigados nos últimos anos, no entanto, as estimativas de prevalência ainda não são totalmente esclarecidas visto que a IU é vista como estigmatizante em âmbito cultural e a procura por tratamento nem sempre é considerada por indivíduos acometidos. Torna-se importante, portanto, esclarecer cada vez mais essa disfunção e seus subtipos para que seja possível amenizar suas consequências. Objetivo: Identificar a prevalência dos subtipos de IU em mulheres de um ambulatório de referência em um hospital público de Curitiba, PR. Métodos: Estudo observacional e analítico com 227 mulheres com IU, avaliadas por meio de um questionário para coleta de informações sociodemográficas e de saúde geral, além da definição do subtipo de IU. Utilizou-se o pacote estatístico SPSS versão 25 para a análise estatística. Resultados: A idade média da amostra foi de 60,33 ± 12,26 anos. IU mista foi o subtipo mais prevalente (87,2%; n = 198), seguida por esforço (7,5%; n = 17) e urgência (5,3%; n = 12). Das mulheres com IU mista, 60,6% tinham apenas o ensino fundamental, 59,1% eram donas de casa e 89,4% passaram por duas ou mais gestações. Conclusão: Delinear os subtipos de IU e as características gerais e obstétricas da população estudada permite que sejam elaboradas estratégias de enfrentamento desta condição, que vão desde planejamento envolvendo diagnóstico e tratamento até custos e gestão de saúde pública.

Impact of Urinary Incontinence on Quality of Life Among Older Adults Living in a Rural Area of Turkey

The current study aimed to identify the frequency of urinary incontinence (UI), its effects on quality of life, and risk factors in older adults living in rural areas of Turkey. For this descriptive study, 400 older adults aged 65 to 96 years were interviewed. Data were collected using a sociodemographic form and the Incontinence-Quality of Life Scale (I-QOL). Among those interviewed, 56.3% experienced UI. Logistical regression analysis revealed chronic illness, gender, and level of education as risk factors for UI. Significantly lower (p < 0.05) I-QOL scores were found for older adults having UI, holding urine, leaking urine while coughing/sneezing, involuntarily urinating more than once per day, or wetting themselves. Most participants did not seek help, citing embarrassment or viewing UI as normal. UI significantly reduces older adults' quality of life. Educational and consultation services, especially for older, illiterate, married women with chronic illness, would help these individuals sustain healthy lives. [Journal of Gerontological Nursing, 47(6), 43-52.].

Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies

BACKGROUND

Urinary incontinence is a common condition in the general population and, in particular, the older adults population, which reduces the quality of life of these people, so this study aims to systematically examine and meta-analyse the overall prevalence of urinary incontinence in older women around the world and the related and influential factors.

METHODS

This report is a comprehensive systematic review and meta-analysis of the findings of research on urinary incontinence in older adults people across the world through looking for MEDLINE, Cochrane Library Sciencedirect, Embase, Scopus, ProQuest and Persian databases, namely iranmedex, magiran, and SID from January 2000 to April 2020, the heterogeneity of the experiments was measured using the I2 index and the data processing was done in the Systematic Meta-Analysis programme.

RESULTS

In 29 studies and the sample size of 518,465 people in the age range of 55-106 years, urinary incontinence in older adults' women in the world based on a meta-analysis of 37.1% (95% CI: 29.6-45.4%) was obtained. The highest prevalence of urinary incontinence was reported in older adults' women in Asia with 45.1% (95% CI: 36.9-53.5%). Meta-regression also showed that with increasing the sample size and year of the study, the overall prevalence of urinary incontinence in the older adults women of the world decreased and increased, respectively, which were statistically significant differences (P <  0.05). According to studies, the most important factors influencing the incidence of urinary incontinence in older women are women's age (p <  0.001), obesity (p <  0.001), diabetes (p <  0.001), women's education (p <  0.001), delivery rank (p <  0.001), hypertension (p <  0.001), smoking (p <  0.001). They also have urinary tract infections (p <  0.001).

CONCLUSION

Given the high prevalence of urinary incontinence in older women around the world, health policy makers must consider control and diagnostic measures in older women and prioritize treatment and rehabilitation activities.

The Impact of Urinary Incontinence on Quality of Life: A Cross-Sectional Study in the Metropolitan City of Naples

Urinary incontinence is a hygienic and psychosocial problem that often brings people to restrict their social life and to experience depression. The main aim of this study was to evaluate the impact of urinary incontinence on quality of life among residents of the Metropolitan City of Naples, Italy, using a newly designed multidimensional questionnaire. The secondary objective was to find which variables affect the quality of life and symptom severity in these patients. To do so, a sample composed of twenty-eight patients was recruited in a multicentre cross-sectional study. Most of the participants had a mild impairment (60%) concerning social life and self-perception, especially those whose education was above the primary level (p = 0.036) and those who followed a pelvic floor rehabilitation program (p = 0.002). Overflow urinary incontinence was associated with a greater deterioration in the aspirational and occupational domain (p = 0.044). Symptom severity was worse in those who had comorbidities (p = 0.038), who had a high body mass index (p = 0.008) or who used diuretics (p = 0.007). In conclusion, our results suggest that there is a significant impairment of quality of life in patients who have only primary education and who follow a pelvic floor rehabilitation program.

Prevention of Urinary Incontinence in Women

PURPOSE OF REVIEW

Despite available treatments for urinary incontinence, the data regarding prevention is less established. This review sought to identify prevention measures and discuss their underlying evidence base with an attempt to include the most recent updates in the field.

RECENT FINDINGS

Urinary incontinence is a prevalent issue among women, particularly surrounding pregnancy and menopause. Interventions regarding pregnancy include not only general health promotion but also potentially interventions such as pelvic floor muscle training and decisions regarding method of delivery. With regard to menopause, the literature suggests avoiding treatments that have adverse effects on continence. Lastly, promoting healthy life style and reducing effects of co-morbid conditions can impact a woman's continence. The literature indicates that preventative strategies exist for urinary incontinence, though the data is limited in this area. Further work is needed to determine the impact of prevention measures and how best to implement them.

The Relationship between Urinary Incontinence Quality of Life and Sleep Quality in Women Over the Age of 60 Years

Aim

The study aimed to investigate the relationship between urinary incontinence quality of life and sleep quality in women over the age of 60 years.

Method

This cross-sectional study was conducted between May 15 and July 5, 2013. Data were collected from a total of 332 women including 68 women from 3 nursing homes in a provincial center of Eskisehir and 269 women living alone or with family in their own homes in a street of that city. Women’s urinary incontinence quality of life was assessed using the incontinence quality of life scale and sleep quality was assessed using the Pittsburgh sleep quality index.

Results

Mean age of the participating women was 71.00±7.42 years. Only 10.8% of the women had incontinence diagnosis; prevalence of anamnesis-based incontinence was 87.7%. Those who lived in their own homes, who had a urinary incontinence diagnosis, who experienced urinary incontinence according to their anamnesis, who were smokers, and who had a poor sleep quality had lower Incontinence Quality of Life Scale scores. Additionally, their quality of life was negatively affected (p<0.05). Poor sleep quality and diagnosis of urinary incontinence were important predictors of the Incontinence Quality of Life Scale of women over 60 years of age and explained 18% of the total variance. The Incontinence Quality of Life Scale scores of the women decreased by 5.67 points in the presence of poor sleep quality and 6.48 points in the presence of urinary incontinence diagnosis.

Conclusion

Urinary incontinence is a common problem seen in older women, is considered as a usual problem due to aging, and is ignored or not taken care of. It also has a negative impact on the quality of life and sleep.

Urinary incontinence status and risk factors in women aged 50-70 years: a cross-sectional study in Hunan, China

INTRODUCTION AND HYPOTHESIS

Urinary incontinence (UI) is a common condition that may decrease women's quality of life. Risk factors remain debatable based on previous research. We aimed to determine the prevalence of UI and associated risk factors among women aged 50-70 years in Hunan, China.

METHODS

A cross-sectional study was conducted from May to August 2018 using a face-to-face questionnaire. In total, 2790 women aged 50-70 years were recruited using multi-stage stratified random sampling in Hunan. Dependent variable was UI. Independent variables were demographic characteristics, health behaviours, obstetric history and comorbidity. Data were entered into EpiData and analysed using SPSS. Chi-square tests were used to assess associations between categorical variables. Statistically significant variables (p ≤ 0.05) were then analysed by logistic regression.

RESULTS

The prevalence of UI was 14.84% (414/2790). Of the women with UI, 61.1% (253/414) had stress urinary incontinence (SUI), 21.5% (89/414) had urgency urinary incontinence (UUI), and 17.1% (72/414) had mixed urinary incontinence (MUI). Risk factors for UI included ageing, living in the countryside, history of gynaecological disease, hypertension and cardiovascular disease.

CONCLUSIONS

UI in women aged 50-70 years in Hunan was not as prevalent as reported in previous studies. Some possible reasons are addressed; for example, the primary survey in this study was not a UI-focused survey. Women who were older, lived in the countryside and had histories of gynaecological disease, hypertension or cardiovascular disease were more likely to have UI. Health departments and medical staff should target patients with factors that potential contribute to UI development.

Symptoms of urinary incontinence and pelvic organ prolapse and physical performance in middle-aged women from Northeast Brazil: a cross-sectional study

Background

Reproductive history and urogynecological disorders have been associated with limitations in physical function. However, little is known about the relationship between symptoms of urinary incontinence and pelvic organ prolapse, and physical performance. Therefore, the purpose of this study was to examine whether symptoms of urinary incontinence and pelvic organ prolapse are independently associated factors with indicators of lower physical performance in middle-aged women from Northeast Brazil.

Methods

This is a cross-sectional study of 381 women between 40 to 65 years old living in Parnamirim, Northeast Brazil. Physical performance was assessed by gait speed, chair stand and standing balance tests. Urinary incontinence and pelvic organ prolapse were self-reported. Multiple linear regression analyses were performed to model the effect of self-reported urinary incontinence and pelvic organ prolapse on each physical performance measure, adjusted for covariates (age, family income, education, body mass index, parity).

Results

In the analysis adjusted for confounders, women reporting urinary incontinence spent, on average, half a second longer to perform the chair stand test (β = 0.505 95% CI: 0.034: 0.976). Those reporting pelvic organ prolapse shortened the balance time with eyes open by 2.5 s on average (β = − 2.556; CI: − 4.769: − 0.343).

Conclusions

Symptoms of pelvic organ prolapse and urinary incontinence are associated to worse physical performance in middle-aged women. These seemingly small changes in physical performance levels are of clinical importance, since these conditions may influence women’s physical ability, with implications for other tasks important to daily functioning and should be addressed by health policies targeting women’s health and functionality.

Prevalence of urinary incontinence in women powerlifters: a pilot study

INTRODUCTION AND HYPOTHESIS

Increased intra-abdominal pressure is associated with urinary incontinence (UI) as is increasing age, obesity, and participating in sport at an elite level. We aimed to determine the prevalence of UI in competitive women powerlifters and establish if commonly cited risk factors affect the incidence of UI.

METHODS

The authors developed a 17-item questionnaire to investigate the prevalence of UI and the relationship of UI with age, body mass, resistance training experience, and competition grade in competitive women powerlifters. The questionnaire was distributed through three major powerlifting federations in Australia for 16 months. The data of 134 competitive women powerlifters were collected anonymously using Qualtrics, and were analysed using multivariate analysis.

RESULTS

In combination, the age of lifters, resistance training experience, body weight categories, and competition grade accounted for a significant 28% of the variability in the Incontinence Severity Index (ISI) (p < 0.01). However, the ISI was not significantly different among age groups, body weight categories, or competition grade. Approximately, 41% of women powerlifters had experienced UI at some stage in life, and 37% of women powerlifters currently experienced UI during training, competition, or maximum effort lifts. However, the rate of UI experienced during daily life activities was approximately 11%.

CONCLUSIONS

This study showed that competitive women powerlifters experience a higher rate of UI during lifting-related activities than in daily life and that the rate of UI correlates positively with age, body weight categories, resistance training experience, and competition grade.

The effect of pelvic pain and urinary incontinence on women's self-rated health in northern Mexico

INTRODUCTION AND HYPOTHESIS

This study was designed to assess the effect of gynecological morbidities on Mexican women's self-rated health status and emotional health.

METHODS

A cross-sectional population-based study was conducted among Mexican women aged 25-54. We analyzed information on 1,303 participants living in Hermosillo, Mexico. Multiple logistic regression was used to assess the effect of having any one of three kinds of pelvic pain, urinary incontinence or both of these conditions on women's self-rated health. Additionally, we conducted analysis of variance and multiple linear regression to test the effect of these gynecological morbidities on women's self-reported emotional health.

RESULTS

Nearly one-third (31.2%) of participants rated their health as fair to very poor. Women reporting of at least one gynecological morbidity were more likely to rate their health as fair to very poor. In adjusted analyses, in addition to older age, low educational attainment, marital status other than single, lack of access to medical care, recurrent kidney infection, asthma, diabetes, and, reporting one or concurrent gynecological morbidities were associated with increased odds (adjusted odds ratios = 1.53-3.91) of reporting fair to very poor self-rated health. Women who did not report any gynecological morbidity had significantly lower mean scores for anxiety/fear 0.30 (±0.30) than women with two to four conditions (anxiety/fear 0.45 ± 0.31).

CONCLUSION

Pelvic pain, urinary incontinence, and the co-occurrence of these conditions have a negative impact on women's perception of their health status and their emotional health.

Urinary incontinence in hospital patients: prevalence and associated factors

OBJECTIVES

to analyze the prevalence of urinary incontinence and its associated factors in hospital patients.

METHOD

this is a cross-sectional epidemiological study whose data were collected using the instruments Sociodemographic and Clinical Data, Characteristics of Urinary Leakage and International Consultation on Incontinence Questionnaire - Short Form. Prevalence was surveyed on a single day for four consecutive months. Data were analyzed using Chi-square test, Fisher's exact test, Student t-test, Mann-Whitney test and logistic regression (forward stepwise).

RESULTS

the final sample consisted of 319 hospital adults (57.1% female), mean age of 47.9 years (SD=21.1). The prevalence of urinary incontinence was 22.9% (28% in women and 16.1% in men) and the associated factors were: female sex (OR=3.89), age (OR=1.03), asthma (OR=3.66), use of laxatives (OR=3.26), use of diaper during the evaluation (OR=2.75), use of diaper at home (OR=10.29), and use of diaper at some point during the hospital stay (OR=6.74).

CONCLUSION

the findings of this study differ from those found in the scarce existing literature on the subject in hospital patients. There is a need for previous studies such as this before proposing the implementation of preventive and therapeutic actions during the hospital stay.