1
|
Cao C, Zhang C, Sriskandarajah C, Xu T, Gotto G, Sutcliffe S, Yang L. Trends and Racial Disparities in the Prevalence of Urinary Incontinence Among Men in the USA, 2001-2020. Eur Urol Focus 2022; 8:1758-1767. [PMID: 35562253 DOI: 10.1016/j.euf.2022.04.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/09/2022] [Accepted: 04/26/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Male urinary incontinence (UI) affects quality of life and leads to a significant burden to the health care system. However, the contemporary prevalence and recent trends in UI and its subtypes among US men remain unknown. OBJECTIVE We evaluated 20-yr trends in the prevalence of UI and its subtype in US men aged ≥20 yr. DESIGN, SETTING, AND PARTICIPANTS A serial, cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Survey among men from 2001 to 2020. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Prevalence of any, stress, urgency and overflow UI were derived. The frequency of UI was assessed in four categories: less than one time per month, a few times per month, a few times per week, and every day and/or night. All analyses were conducted using sample weights, stratification, and clustering of the complex sampling design. Sociodemographic and lifestyle correlates of UI over time were identified using multivariable logistic regressions. RESULTS AND LIMITATIONS Data on 22994 US men (mean age, 46.6 yr [standard error, 0.20]; weighted population, 848642150) were analyzed. The prevalence of any UI increased from 2001-2002 (11.5% [95% confidence interval {CI}, 10.0-13.0]) to 2017-2020 (19.3% [95% CI, 17.2-21.3]), driven by urgency (from 9.0% [95% CI, 7.5-10.4]) to 15.2% [95% CI, 13.4-16.9]) and overflow UI (from 3.3% [95% CI, 2.7-4.0] to 5.5% [95% CI, 4.5-6.4]; all p for trend < 0.01). UI affects 38.5% US men ≥60 yr of age, with increasing trends in urgency and overflow UI and a decreasing trend in stress UI (all p for trend < 0.05). Racial/ethnic disparities were noted, with patterns differed by UI subtype. Compared with non-Hispanic White, non-Hispanic Black men were more likely to report urgency UI (odds ratio [OR], 1.94 [95% CI, 1.71-2.20]). Hispanic men were more likely to report urgency UI (OR, 1.33 [95% CI, 1.14-1.56]), but less likely to report stress (OR, 0.74 [95% CI, 0.56-0.98]) and overflow (OR, 0.75 [95% CI, 0.58-0.98]) UI. Men with higher body mass index and current smokers were more likely to report any, stress, and urgency UI than their counterparts. A higher prevalence of any UI was found in men with low family poverty ratios and chronic diseases, and those who were physically inactive. CONCLUSIONS From 2001 to 2020, the overall prevalence of UI increased among US men, particularly for urgency and overflow UI. PATIENT SUMMARY In this report, we looked at the prevalence of urinary incontinence among US men in a nationally representative sample. We found that urinary incontinence increased in the past 20 yr driving by the urgency and overflow urinary incontinence.
Collapse
Affiliation(s)
- Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St Louis, MO, USA; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Christie Zhang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
| | - Cynthia Sriskandarajah
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
| | - Tianlin Xu
- Department of Biostatistics, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Geoffrey Gotto
- Southern Alberta Institute of Urology and Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA; Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO, USA
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada.
| |
Collapse
|
2
|
Lead acetate versus cadmium sulfate in the modulation of main physiological pathways controlling detrusor muscle contractility in rat. Saudi Pharm J 2022; 30:306-316. [PMID: 35498220 PMCID: PMC9051969 DOI: 10.1016/j.jsps.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 01/13/2022] [Indexed: 11/22/2022] Open
Abstract
Heavy metals have a deleterious effect on lower urinary tract functions. Scant data has been reported about metals’ effect on altering detrusor muscle contractility. Rats were given lead acetate (3, 30 mg/kg), cadmium sulfate (0.1, 1 mg/kg) or ferrous sulfate-iron overload-(3, 30 mg/kg), in a subacute toxicity study (21 days, ip). In-vitro tension experiments were conducted using isolated rat detrusor muscle. Measurement of heavy metal concentrations in blood and tissue homogenates was performed, as well as histopathological examinations. Subacute toxicity induced by treatment with lead and cadmium was manifested as a decrease in EFS, ACh, and ATP-mediated contraction of isolated detrusor muscle. Iron overload only decreased EMAX of EFS and ACh-mediated contraction. Lead (30 mg/kg) caused an upward shift in the dose response curve of isoprenaline-induced relaxation, with a significant decrease in EMAX. Lead (30 mg/kg) or cadmium (1 mg/kg) inhibited adenosine (10−5 M)-induced relaxation. Comparisons to control tissues showed a selective accumulation of metals in the detrusor muscle. Histopathological examinations revealed edema and inflammation in the urinary bladder. Directly added lead (10 mM) inhibited detrusor muscle contraction in-vitro, and its effect was decreased in presence of atropine, and potentiated in presence of TEA, L-NAME, or MB. Cadmium's (0.1 mM) inhibitory effect was reduced in presence of nifedipine or trifluoperazine. In conclusion, lead, cadmium, or iron induce detrusor hypoactivity: The inhibitory effect of lead may be mediated by modulating muscarinic receptors but not the K+/NO/cGMP pathway, whereas cadmium inhibitory effect may be mediated by inhibiting the Ca2+/calmodulin pathway.
Collapse
|
3
|
Abstract
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.
Collapse
Affiliation(s)
- Amanda R Swanton
- Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH, 03756, USA
| | - E Ann Gormley
- Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH, 03756, USA.
| |
Collapse
|
4
|
Pelvic Floor Dysfunction in Women. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2020. [DOI: 10.1007/s40141-020-00259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
5
|
Prevention of Stress Urinary Incontinence in Women. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-019-00570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
6
|
Kim SY, Bang W, Choi HG. Analysis of the prevalence of and factors associated with overactive bladder in adult Korean women. PLoS One 2017; 12:e0185592. [PMID: 28957446 PMCID: PMC5619804 DOI: 10.1371/journal.pone.0185592] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 09/17/2017] [Indexed: 01/27/2023] Open
Abstract
Background Overactive bladder (OAB) is one of the most prevalent lower urinary tract conditions and has been suggested to be related to various factors. We assessed the prevalence of and factors associated with OAB in women based on a large cross-sectional, population-based study of adult Korean women. Methods The Korean community health survey (KCHS) of 2012 was reviewed, and 107,950 female participants aged 19 to 107 years were identified for inclusion in this study. The overactive bladder symptom score (OABSS) was used to define and classify OAB as mild, moderate, or severe. Numerous variables, including marital status; physical activity; education and income levels; type of occupation; body mass index (BMI); smoking; alcohol; sleep time; and medical history of hypertension, diabetes mellitus, hyperlipidemia, or cerebral stroke, were evaluated. The correlation of these variables with the prevalence of OAB was analyzed using simple and multiple logistic regression analyses with complex sampling. Results The results showed that 5.2% of adult women experienced OAB. Multiple regression analyses showed a significant correlation between the following variables and OAB: older age (adjusted odds ratio [AOR] = 1.44, 95% confidence interval [CI] = 1.39–1.50, P < 0.001 as 10 years older); married status (AOR = 0.83, 95%CI = 0.70–0.96, P = 0.016); lower level of income (AOR = 1.50, 95%CI = 1.34–1.68, P < 0.001); high BMI (AOR = 1.33, 95%CI = 1.23–1.44, P < 0.001); smoking (AOR = 1.24, 95%CI = 1.04–1.47, P < 0.001); long sleep time (AOR = 1.95, 95%CI = 1.69–2.26); and medical history of hypertension (AOR = 1.11, 95%CI = 1.03–1.21, P = 0.011), diabetes mellitus (AOR = 1.38, 95%CI = 1.25–1.53, P < 0.001), hyperlipidemia (AOR = 1.27, 95%CI = 1.16–1.39, P < 0.001), and cerebral stroke (AOR = 2.04, 95%CI = 1.73–2.41, P < 0.001). The level of stress showed a dose-dependent association with OAB (AOR [95%CI] = 3.28 [2.81–3.83] > 2.11 [1.91–2.33] >1.28 [1.16–1.41] for severe > moderate > some stress, respectively, P < 0.001). Conclusion The prevalence of OAB was approximately 5.2% among adult Korean women. Older age; high BMI; stress level; sleep duration; levels of income and education; marital status; smoking; and medical history of hypertension, diabetes mellitus, hyperlipidemia, and cerebral stroke were significantly related to OAB in women.
Collapse
Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Woojin Bang
- Department of Urology, Hallym University College of Medicine, Seoul, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Seoul, Korea
- * E-mail:
| |
Collapse
|
7
|
Kılıç M. Incidence and risk factors of urinary incontinence in women visiting Family Health Centers. SPRINGERPLUS 2016; 5:1331. [PMID: 27563526 PMCID: PMC4980849 DOI: 10.1186/s40064-016-2965-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 07/29/2016] [Indexed: 11/30/2022]
Abstract
Background The objective of this study is to determine the incidence and the risk factors of the urinary incontinence in women visiting the Health Family Center. Methods 430 women, who visited three Family Health Centers in the city center of Erzurum for any reason between 25 November and 20 January 2016, were included in this study without any sampling. The data were collected by using the face-to-face interview method. Percentage distribution, Chi square test, and logistic regression analysis were used in order to analyze the data. Results It was determined that 37.2 % of these women had urinary incontinence, but only 29.3 % of them visited a physician because of this complaint. Among a total of 160 women with urinary incontinence findings, stress type incontinence was observed at the highest rate (33.7 %), which was followed by mixed type (31.8 %), urge type (20.6 %) and other types (overflow, continuous urinary incontinence) (13.7 %). It was found that urinary incontinence had a significant correlation with the number of children, genital prolapse, duration of delivery longer than 24 h, diabetes and urogenital infection, but not with the age at the first and last childbirth, presence of the episiotomy, birth weight over 4 kg, and smoking. Conclusions It was determined that one-third of the women had urinary incontinence and certain medical and obstetric conditions were affecting the development of urinary incontinence. It is thought that it is important for the healthcare personnel to take the progression of the urinary incontinence under control by preventing the risk factors and to encourage the patients to seek treatment with the help of the proper information indicating that urinary incontinence is a treatable and preventable condition.
Collapse
Affiliation(s)
- Meral Kılıç
- Department of Midwifery, Faculty of Health Science, Ataturk University, Erzurum, Turkey
| |
Collapse
|
8
|
Imamura M, Williams K, Wells M, McGrother C. Lifestyle interventions for the treatment of urinary incontinence in adults. Cochrane Database Syst Rev 2015; 2015:CD003505. [PMID: 26630349 PMCID: PMC8612696 DOI: 10.1002/14651858.cd003505.pub5] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Low cost, non-invasive alterations in lifestyle are frequently recommended by healthcare professionals or those presenting with incontinence. However, such recommendations are rarely based on good evidence. OBJECTIVES The objective of the review was to determine the effectiveness of specific lifestyle interventions (i.e. weight loss; dietary changes; fluid intake; reduction in caffeinated, carbonated and alcoholic drinks; avoidance of constipation; stopping smoking; and physical activity) in the management of adult urinary incontinence. SEARCH METHODS We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and MEDLINE in process, and handsearching of journals and conference proceedings (searched 3 July 2013), and the reference lists of relevant articles. We incorporated the results of these searches fully in the review. We undertook an updated search of the Specialised Register, which now includes searches of ClinicalTrials.gov and WHO ICTRP, on 27 October 2014; potentially eligible studies from this search are currently awaiting classification. SELECTION CRITERIA Randomised and quasi-randomised studies of community-based lifestyle interventions compared with no treatment, other conservative therapies, or pharmacological interventions for the treatment of urinary incontinence in adults. DATA COLLECTION AND ANALYSIS Two authors independently assessed study quality and extracted data. We collected information on adverse effects from the trials. Data were combined in a meta-analysis when appropriate. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS We included 11 trials in the review, involving a total of 5974 participants.Four trials involving 4701 women compared weight loss programmes with a control intervention. Low quality evidence from one trial suggested that more women following weight loss programmes reported improvement in symptoms of incontinence at six months (163/214 (76%) versus 49/90 (54%), risk ratio (RR) 1.40, 95% confidence interval (CI) 1.14 to 1.71), and this effect was sustained at 18 months (N = 291, 75% versus 62%, RR not estimable, reported P value 0.02). No data were available for self-reported cure and quality of life. One of the weight loss trials involving 1296 women reported very low quality evidence for a reduction in weekly urinary incontinence a mean of 2.8 years after following a lifestyle weight loss intervention that had been compared with a pharmacological weight loss intervention.Three trials involving 181 women and 11 men compared change in fluid intake with no change. Limited, very low quality evidence suggested that symptom-specific quality of life scores improved when fluid intake was reduced, although some people reported headaches, constipation or thirst. A further three trials involving 160 women and nine men compared reduction in caffeinated drinks with no change, and one trial involving 42 women compared a soy-rich diet with soy-free diet. However, it was not possible to reach any conclusions about the effects of these changes, due to methodological limitations, that resulted in very low quality evidence.Adverse effects appeared relatively uncommon for all interventions studied.All included studies had a high or unclear risk of bias across all bias parameters, but most notably for allocation concealment. The main factors for our downgrading of the evidence were risk of bias, indirect evidence (less than 12 months of follow-up; and not all participants having confirmed urinary incontinence at baseline in some studies), and imprecise results with wide confidence intervals.Other interventions such as reduction in consumption of sweetened fizzy or diet drinks; reduction in alcohol consumption; avoiding constipation; smoking cessation; restricting strenuous physical forces; or reducing high levels of, or increasing low levels of, physical activity, could not be assessed in this review, as no evidence from randomized controlled trials or quasi-randomised trials was available. AUTHORS' CONCLUSIONS Evidence for the effect of weight loss on urinary incontinence is building and should be a research priority. Generally, there was insufficient evidence to inform practice reliably about whether lifestyle interventions are helpful in the treatment of urinary incontinence.
Collapse
Affiliation(s)
- Mari Imamura
- University of AberdeenAcademic Urology UnitHealth Sciences BuildingForesterhillAberdeenUKAB25 2ZD
| | - Kate Williams
- University of LeicesterDepartment of Health Sciences22‐28 Princess Road WestLeicesterUKLE2 6GS
| | - Mandy Wells
- NHS DevonIntegrated Bladder and Bowel Care ServicesFranklyn House, Franklyn DriveSt ThomasExeterDevonUKEX2 9HS
| | - Catherine McGrother
- University of LeicesterDept of Health SciencesUniversity RoadLeicesterLeicestershireUKLE1 7RH
| | | |
Collapse
|
9
|
Long CG, West R, Siddique R, Rigg S, Banyard E, Stillman SK, Butler S, Dolley O. Screening for incontinence in a secure psychiatric service for women. Int J Ment Health Nurs 2015; 24:451-9. [PMID: 26146962 DOI: 10.1111/inm.12141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Incontinence is associated with mental illness and neuroleptic medications but diagnosis and treatment is often poor or non-existent. Problems of incontinence are compounded in secure psychiatric services for women by poor health, obesity, and a sedentary lifestyle. Addressing the physical health of this group necessitates a more accurate picture of the nature, incidence, and management of incontinence. A point-in-time survey of 108 women who agreed to be interviewed (93%) covered presence, frequency, and nature of incontinence, and information on management case note data was used to gather demographic and previous medical history, comparisons were made between patients with and without problems of incontinence. Findings indicate a problem of incontinence in 48% of women with a dominance of problems of stress and urge enuresis. Of modifiable factors that contribute to enuresis, the current study highlighted the contribution of obesity, smoking and clozapine medication. A further finding was the preference for managing rather than treating problems of incontinence. Actions to improve the detection and treatment of this problem are described.
Collapse
Affiliation(s)
- Clive G Long
- St Andrew's Academic Centre, Northampton, UK.,University of Northampton, Northampton, UK
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Madhu CK, Hashim H, Enki D, Drake MJ. Risk factors and functional abnormalities associated with adult onset secondary nocturnal enuresis in women. Neurourol Urodyn 2015; 36:188-191. [DOI: 10.1002/nau.22912] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/01/2015] [Indexed: 01/23/2023]
Affiliation(s)
- Chendrimada K. Madhu
- Department of Women's Health and Bristol Urological Institute; Southmead Hospital; Bristol England
| | - Hashim Hashim
- Urodynamics Unit; Bristol Urological Institute; Southmead Hospital; University of Bristol; Bristol England
| | - Doyo Enki
- Plymouth University Peninsula Schools of Medicine and Dentistry; Plymouth England
| | - Marcus J. Drake
- Bristol Urological Institute; Southmead Hospital; University of Bristol; Bristol England
| |
Collapse
|
11
|
Madhu C, Enki D, Drake MJ, Hashim H. The Functional Effects of Cigarette Smoking in Women on the Lower Urinary Tract. Urol Int 2015; 95:478-82. [DOI: 10.1159/000438928] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 07/23/2015] [Indexed: 11/19/2022]
|
12
|
Madhu C, Hashim H, Enki D, Yassin M, Drake M. Coital incontinence: what can we learn from urodynamic assessment? Urology 2015; 85:1034-1038. [PMID: 25917729 DOI: 10.1016/j.urology.2015.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/02/2015] [Accepted: 02/07/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the association of coital incontinence (CI) with lower urinary tract symptoms (LUTS) and to understand the pathophysiology of CI. METHODS A database of all women who underwent urodynamic testing in a tertiary referral center in the United Kingdom, from January 1991 to December 2009, was retrospectively analyzed. All women reporting CI were included in the study. Urodynamic testing and interpretation of results were performed in accordance with the recommendations of the International Continence Society. RESULTS The prevalence of CI in women with LUTS undergoing urodynamics was 11.8%, and they were significantly younger (mean age = 45.3 years; P <.001) than the rest of the group (mean age = 53.4 years). Obesity (body mass index >30 kg/m(2)) and parity were significantly associated with CI (P <.001). Women reporting CI significantly smoked cigarettes and used antidepressants (P <.001). There were fewer postmenopausal women (P <.001) with CI, and previous hysterectomy had a negative association with CI (P = .005). The majority of women had overactive bladder symptoms and stress urinary incontinence (P <.001). CI was significantly associated with urodynamic stress incontinence (UDSI; odds ratio = 2.35) and detrusor overactivity (DO; odds ratio = 1.22) but not DO incontinence (P <.001). Parity, overactive bladder symptoms, and UDSI reached statistical significance when analysis was performed for age-matched controls. CONCLUSION CI is not uncommon in women with LUTS, and they present earlier than women with LUTS and no CI. CI is significantly associated with risk factors like parity, obesity, cigarette smoking, and antidepressant usage. CI is multifactorial and associated with UDSI and DO but not DO incontinence.
Collapse
Affiliation(s)
- Chendrimada Madhu
- Department of Urogynecology, Derriford Hospital, Plymouth, Devon, UK; Department of Urogynecology, Bristol Urological Institute, Southmead Hospital, Bristol, UK.
| | - Hashim Hashim
- Department of Urogynecology, Bristol Urological Institute, Southmead Hospital, Bristol, UK; Department of Urogynecology, University of Bristol, Bristol, UK
| | - Doyo Enki
- Department of Urogynecology, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, UK
| | - Musaab Yassin
- Department of Urogynecology, Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Marcus Drake
- Department of Urogynecology, Bristol Urological Institute, Southmead Hospital, Bristol, UK; Department of Urogynecology, University of Bristol, Bristol, UK
| |
Collapse
|
13
|
Sheyn D, James RL, Taylor AK, Sammarco AG, Benchek P, Mahajan ST. Tobacco use as a risk factor for reoperation in patients with stress urinary incontinence: a multi-institutional electronic medical record database analysis. Int Urogynecol J 2015; 26:1379-84. [PMID: 26071281 DOI: 10.1007/s00192-015-2721-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 04/16/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Recurrence rates of stress urinary incontinence after surgery are reported to be between 8 to 15%. Both surgical technique and non-surgical risk factors have been shown to affect post-operative outcomes. Tobacco use is a possible risk factor that may increase the surgical failure rate, however, there are currently conflicting reports in the literature regarding the affect of tobacco use on surgical outcomes. Our objective is to evaluate the effect of tobacco use on the risk of repeat surgery for stress urinary incontinence (SUI). METHODS We performed a retrospective cohort analysis using a de-identified clinical database from a large multi-institution electronic health records data web application EPM:ExploreTM (Explorys Inc, Cleveland, Ohio) to identify women with and without a history of tobacco use who underwent reoperation for stress urinary incontinence within 2 years of the first surgery. We then evaluated previously described risk factors for reoperation: diabetes mellitus (DM), pelvic organ prolapse (POP), anti-muscarinic (AM) use at initial surgery, obesity, and advanced age on rate of reoperation and the impact of tobacco use on these risk factors. RESULTS Tobacco use was associated with an increased rate of a second surgery for SUI (OR=1.43, p <0.001), as was anti-muscarinic use (OR = 1.68, p<0.001), DM (OR = 1.21, p = 0.005), age >50 years (OR= 1.16, p = 0.040), and BMI > 30 kg/m2 (OR = 2.97 p<0.001). The odds of a second surgery for SUI in patients who used tobacco and anti-muscarinic medications or had pelvic organ prolapse were lower when compared to non-users. The odds of a second surgery for SUI were higher in patients who used tobacco and had asthma when compared to non-users who had asthma. CONCLUSIONS Tobacco increases the overall risk of second surgery for SUI, however, in patients with specific risk factors, tobacco use is associated with a decrease risk of reoperation.
Collapse
Affiliation(s)
- David Sheyn
- Division of Female Pelvic Medicine and Reconstruction, University Hospitals Case Medical Center, 11100 Euclid Ave, Mail Stop: 5034, Cleveland, OH, 44106, USA,
| | | | | | | | | | | |
Collapse
|
14
|
Prudencio CB, Nava GTDA, Cardoso MA, Marreto RB, Sousa ÉA, Valenti VE, Barbosa AMP. Evolution of female urinary continence after physical therapy and associated factors. Int Arch Med 2014; 7:24. [PMID: 24839462 PMCID: PMC4024111 DOI: 10.1186/1755-7682-7-24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 04/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary incontinence (UI) is defined as any involuntary loss of urine that can influence the quality of life, personal hygiene and social interaction. The types of UI that most affect women are stress urinary incontinence, urge incontinence and mixed urinary incontinence. There are several risk factors that result in specific treatments. We aimed to investigate the evolution of female urinary continence after physical therapy intervention and its associated factors. METHOD A retrospective cross-sectional study was conducted with 71 participants who were discharged from physiotherapy sector from August 2006 to April 2012 and met the inclusion criteria. RESULTS Among the studied variables, the number of sessions and completion of home pelvic floor exercises showed a significant association. The urinary continence appeared in 43.7% of the cases, and factors, performance of home exercises, and number of sessions showed a significant association. CONCLUSION The number of sessions and completion of home pelvic floor exercises showed a significant relationship with each other.
Collapse
Affiliation(s)
| | | | - Marco Aurélio Cardoso
- Post Graduate Program in Physiotherapy, Faculty of Sciences and Technology, UNESP, Presidente Prudente, SP, Brazil
| | - Rafaela Bresciani Marreto
- Departament of Physical Therapy and Ocuppational Therapy, Faculty of Philosophy Sciences, UNESP, Av. Hygino Muzzi Filho 747 Marília, SP, Brazil
| | - Érica Almeida Sousa
- Departament of Physical Therapy and Ocuppational Therapy, Faculty of Philosophy Sciences, UNESP, Av. Hygino Muzzi Filho 747 Marília, SP, Brazil
| | - Vitor E Valenti
- Post Graduate Program in Physiotherapy, Faculty of Sciences and Technology, UNESP, Presidente Prudente, SP, Brazil
| | | |
Collapse
|
15
|
Affiliation(s)
- R Kavia
- Northwick Park Hospital, Harrow, UK
| | - Tg Rashid
- University College Hospital, London, UK
| | - Jl Ockrim
- University College Hospital, London, UK
| |
Collapse
|
16
|
HARAI M, OURA A, MORI M. Risk Factors for Urinary Incontinence in Japanese Elderly Women. Low Urin Tract Symptoms 2013; 6:94-7. [DOI: 10.1111/luts.12026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/13/2013] [Accepted: 06/03/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Mika HARAI
- Department of Nursing, School of Nursing; Sapporo City University; Sapporo Japan
- Department of Public Health; Sapporo Medical University School of Medicine; Sapporo Japan
| | - Asae OURA
- Department of Public Health; Sapporo Medical University School of Medicine; Sapporo Japan
- Department of Public Health; Kochi University School of Medicine; Kochi Japan
| | - Mitsuru MORI
- Department of Public Health; Sapporo Medical University School of Medicine; Sapporo Japan
| |
Collapse
|
17
|
Allahdin S, Oo N. An overview of treatment of overactive bladder syndrome in women. J OBSTET GYNAECOL 2012; 32:217-21. [DOI: 10.3109/01443615.2011.649317] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
18
|
Lower urinary tract symptoms in primiparous women before and during pregnancy. Arch Gynecol Obstet 2011; 285:1205-10. [PMID: 22042166 DOI: 10.1007/s00404-011-2124-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 10/17/2011] [Indexed: 10/16/2022]
Abstract
OBJECTIVE Lower urinary tract symptoms (LUTS), in particular urinary incontinence (UI), commonly develops during pregnancy or following delivery. This study was conducted to investigate the prevalence of the LUTS before and during pregnancy, and to demonstrate the relationships between various obstetric parameters and UI. METHODS For this observational study, 1,501 consecutive primiparae who delivered at ≥ 36 gestational weeks were recruited in a tertiary hospital. A urogynecological questionnaire was used to assess the prevalence of LUTS before and during pregnancy. The relationships between various obstetric parameters and UI were analyzed. RESULTS Prevalence of LUTS increased over the course of pregnancy. The most commonly reported LUTS symptoms, regardless of pregnancy trimester, were nocturia (51.1%) and frequency (40.3%), UI (37.5%), urgency (31.1%), incomplete bladder emptying (26.3%), straining (15.3%), and voiding difficulty (14.5%). Stress UI (SUI) (26.7%) was more common during pregnancy than mixed UI (6.1%) or urge UI (4.7%). Women with a prepregnancy BMI >30 were at increased risk of developing de novo SUI during pregnancy. Urge incontinence during pregnancy was associated with smoking. CONCLUSIONS The prevalence of LUTS generally increased with gestational age. UI during pregnancy was associated with prepregnancy BMI and smoking.
Collapse
|
19
|
Brito LMO, Sousa ADPS, Figueiredo Neto JAD, Duarte TB, Pinheiro GDL, Chein MBDC. Comparison of the outcomes of the sling technique using a commercial and hand-made polypropylene sling. Int Braz J Urol 2011; 37:519-27. [DOI: 10.1590/s1677-55382011000400012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2010] [Indexed: 11/22/2022] Open
|
20
|
Abstract
Objectives: In this review, we discuss the treatment of refractory overactive bladder (OAB) that has not adequately responded to medication therapy and we propose an appropriate care pathway to the treatment of OAB. We also attempt to address the cost of OAB treatments. Materials and Methods: A selective expert review of the current literature on the subject of refractory OAB using MEDLINE was performed and the data is summarized. We also review our experience in treating refractory OAB. The role and outcomes of various treatment options for refractory OAB are discussed and combined therapy with oral anticholinergics is explored. Emerging remedies including intravesical botulinum toxin injection and pudendal neuromodulation are also reviewed, along with conventional surgical options. Results: In general behavioral therapy, pelvic floor electrical stimulation, magnetic therapy and posterior tibial nerve stimulation (PTNS), have shown symptom decreases in 50-80% of patients with OAB. Depending on the study, combination therapy with oral anticholinergics seems to improve efficacy of behavioral therapy and PTNS in approximately 10-30%. In multicenter, long-term randomized controlled trials, sacral neuromodulation has been shown to improve symptoms of OAB and OAB incontinence in up to 80% of the patients treated. Studies involving emerging therapies such as pudendal serve stimulation suggest that there may be a 15-20% increase in efficacy over sacral neuromodulation, but long-term studies are not yet available. Another emerging therapy, botulinum toxin, is also showing similar success in reducing OAB symptoms in 80-90% of patients. Surgical approaches, such as bladder augmentation, are a last resort in the treatment of OAB and are rarely used at this point unless upper tract damage is a concern and all other treatment options have been exhausted. Conclusion: The vast majority of OAB patients can be managed successfully by behavioral options with or without anticholinergic medications. When those fail, neuromodulation or intravesical botulinum toxin therapies are successful alternatives for most of the remaining group. We encourage practitioners responsible for the care of OAB patients to gain experience with these options. More research is needed to assess the cost-effectiveness of various OAB treatments
Collapse
Affiliation(s)
- Ronald W Glinski
- Center for Continence Care and Female Urology, Metro Urology Specialists, 2550 University Avenue West, Suite 240N, St. Paul, MN 55114
| | | |
Collapse
|
21
|
Mason L, Roe B, Wong H, Davies J, Bamber J. The role of antenatal pelvic floor muscle exercises in prevention of postpartum stress incontinence: a randomised controlled trial. J Clin Nurs 2010; 19:2777-86. [DOI: 10.1111/j.1365-2702.2010.03297.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
22
|
Imamura M, Williams K, Wells M, McGrother C. Lifestyle interventions for the treatment of urinary incontinence in adults. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2010. [DOI: 10.1002/14651858.cd003505.pub4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
23
|
Nishizawa O, Ishizuka O, Okamura K, Gotoh M, Hasegawa T, Hirao Y. Guidelines for management of urinary incontinence. Int J Urol 2008; 15:857-74. [DOI: 10.1111/j.1442-2042.2008.02117.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Bradley CS, Kennedy CM, Nygaard IE. Pelvic Floor Symptoms and Lifestyle Factors in Older Women. J Womens Health (Larchmt) 2005; 14:128-36. [PMID: 15775730 DOI: 10.1089/jwh.2005.14.128] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To measure the prevalence of pelvic floor symptoms in noncare-seeking older women and the association between symptoms and lifestyle factors. METHODS Women enrolled at one site of the Women's Health Initiative Hormone Therapy clinical trial completed a questionnaire, modified from the Pelvic Floor Distress Inventory, on bladder, bowel, and prolapse symptoms. Individual symptoms and symptom groups were examined in a cross-sectional analysis. RESULTS In the 297 women who participated, mean age was 68.2 years, mean body mass index (BMI) was 30.2 kg/m(2), and median vaginal parity was 3. The median number of symptoms endorsed was 3 (range 0-18). The most prevalent symptoms were stress urinary incontinence (51.2%), urge urinary incontinence (49.2%), urinary frequency (29.0%), straining for bowel movements (25.0%), a sense of incomplete bowel movements (34.8%), and involuntary loss of gas (33.0%). The symptom groups most frequently endorsed were stress urinary incontinence, overactive bladder, obstructive voiding, and obstructive colorectal groups (>/=1 symptom per group in 51.2%, 61.3%, 40.8%, and 48.3%, respectively). In analyses adjusted for age, BMI, caffeine ingesting, smoking, and exercise, older women more frequently reported incomplete bladder emptying (adjusted OR 3.4, 95% CI 1.3, 9.2), weak urinary stream (adjusted OR 6.4, 95% CI 2.0, 20.0), intermittent urinary stream (adjusted OR 4.0, 95% CI 1.6, 10.4), and a feeling of incomplete bowel movements (adjusted OR 2.7, 95% CI 1.2, 5.9). Women who exercised weekly had less fecal urgency (adjusted OR 0.3, 95% CI 0.2, 0.8). Coffee drinking was associated with difficulty emptying the bladder (adjusted OR 8.6, 95% CI 1.4, 55.0) and weak stream (adjusted OR 5.3, 95% CI 1.5, 19.0). CONCLUSIONS Pelvic floor symptoms, especially urinary incontinence and irritative and obstructive urinary and bowel symptoms, are common in older women. Some symptoms are associated with potentially modifiable lifestyle factors.
Collapse
Affiliation(s)
- Catherine S Bradley
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
| | | | | |
Collapse
|
25
|
|
26
|
Dallosso HM, McGrother CW, Matthews RJ, Donaldson MMK. The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int 2003; 92:69-77. [PMID: 12823386 DOI: 10.1046/j.1464-410x.2003.04271.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To investigate the role of diet and other lifestyle factors in the incidence of overactive bladder and stress incontinence in women. Studies have suggested relationships between different aspects of lifestyle and symptoms of urinary incontinence, but there is a lack of firm evidence about their role in its cause. SUBJECTS AND METHODS A random sample of women aged >or= 40 years living at home took part in a prospective cohort study. Baseline data on urinary symptoms, diet and lifestyle were collected from 7046 women using a postal survey and food-frequency questionnaire. Follow-up data on urinary symptoms were collected from 6424 of the women in a postal survey 1 year later. Logistic regression was used to investigate the association of food and drink consumption and other lifestyle factors with the incidence of overactive bladder and stress incontinence. RESULTS In the multivariate model for the onset of an overactive bladder, there were significantly increased risks associated with obesity, smoking and consumption of carbonated drinks, and reduced risks with higher consumption of vegetables, bread and chicken. Obesity and carbonated drinks were also significant risk factors for the onset of stress incontinence, while consumption of bread was associated with a reduced risk. CONCLUSIONS Causal associations with obesity, smoking and carbonated drinks are confirmed for bladder disorders associated with incontinence, and additional associations with diet are suggested. Behavioural modification of lifestyle may be important for preventing and treating these disorders.
Collapse
Affiliation(s)
- H M Dallosso
- Department of Epidemiology and Public Health, University of Leicester, Leicester, UK.
| | | | | | | |
Collapse
|
27
|
Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG 2003. [DOI: 10.1046/j.1471-0528.2003.02327.x] [Citation(s) in RCA: 334] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
28
|
Wyman JF. Treatment of urinary incontinence in men and older women: the evidence shows the efficacy of a variety of techniques. Am J Nurs 2003; Suppl:26-35. [PMID: 12612491 DOI: 10.1097/00000446-200303001-00005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jean F Wyman
- Center for Nursing Research on Elders at the School of Nursing at the University of Minnesota, Minneapolis, MN, USA.
| |
Collapse
|
29
|
|
30
|
|
31
|
Smoke alarm: a review of the clinical impact of smoking on women. PRIMARY CARE UPDATE FOR OB/GYNS 2000; 7:207-214. [PMID: 11025273 DOI: 10.1016/s1068-607x(00)00048-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article is a review of the health impacts of smoking on women and their newborns, with an overview of the prevalence of smoking, mortality statistics, and costs. Over 50 disorders related to smoking are identified. These include many chronic and severe problems that are often overshadowed by the more well-known impacts of cancer and cardiac disease. Female impacts of smoking include two-fold rates of ectopic pregnancy, premature delivery, and low-birthweight infants; earlier menopause; pelvic-floor disorders, including urinary incontinence; menstrual disturbances; decreased fertility; greater risk of oral contraceptive failure; and babies with increased rates of sudden infant death syndrome, asthma, and attention-deficit disorders. From a clinical perspective, one in five women is addicted to nicotine. In addition, women smokers experience a stronger response to nicotine and incur higher rates of lung cancer and cardiovascular disease than their male counterparts.
Collapse
|
32
|
Abstract
Incontinence is a common and complex condition affecting women of all ages, social and cultural backgrounds. 'Coping strategies' play an important role for managing incontinence and include changes in lifestyle, protection, aids, and catheters, whether they are indwelling or intermittent. By the time women seek medical advice for urinary incontinence they have usually tried various tactics to either limit the leakage or protect themselves from it. The most common tactics to limit leakage include fluid restriction, regular toileting, exercises and weight reduction. With medical advice, women can change concomitant medication that may be exacerbating the problem. Aids for mobilization can also have a dramatic effect on the ability to cope with urinary problems. Pads used for protection are often unsuitable and some even wear 'home-made' pads in the form of rolled up tissue, commonly to save money. Many different types of pads are available although women are often ignorant as to what is best for them. Catheters should only be used for intractable incontinence and following appropriate investigation. When possible intermittent catheterization should be considered. It is essential that all women are assessed and investigated before any form of containment becomes long-term management.
Collapse
Affiliation(s)
- K Anders
- King's College Hospital, Denmark Hill, London, UK
| |
Collapse
|
33
|
Abstract
Gynaecologists have become increasingly aware of the need to offer conservative therapy for genuine stress incontinence. There is good objective evidence from randomized controlled trials to support the use of supervised pelvic floor exercises. The efficacy of biofeedback therapy, vaginal cone weights and electrostimulation therapy is variable and requires further study to identify those women who will benefit the most. The mainstay of therapy for detrusor instability/sensory urgency remains bladder training, which has proven objective efficacy, but new treatments such as transcutaneous electrical nerve stimulation (TENS) offer promise. Finally, for certain groups of women with mixed stress and urge leak, a new range of vaginal and urethral devices provide useful additional options. The specific requirements for future research are discussed.
Collapse
Affiliation(s)
- K H Moore
- Pelvic Floor Unit, St George Hospital, University of New South Wales, Kogarah, Australia
| |
Collapse
|
34
|
Abstract
Pelvic floor dysfunction, including urinary incontinence, anal incontinence, and pelvic organ prolapse, is extremely common, affecting at least one-third of adult women. A minority of patients sustaining these conditions volunteer their symptoms. Risk factor identification and the development of tactics for prevention are significant priorities for future research. Understanding both the specific predisposing factors that place an individual woman at risk and the precise events of the labor and delivery process that initiate injury and dysfunction is important for primary prevention. Defining the relative importance of various promoting and decompensating factors is essential for secondary prevention.
Collapse
Affiliation(s)
- R C Bump
- Division of Gynecologic Specialties, Duke University Medical Center, Durham, North Carolina, USA
| | | |
Collapse
|
35
|
|