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Yavuz M, Etiler N. Addressing urinary incontinence by gender: a nationwide population-based study in Turkiye. BMC Urol 2023; 23:205. [PMID: 38071293 PMCID: PMC10710702 DOI: 10.1186/s12894-023-01388-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Urinary incontinence (UI), which usually occurs in women but affects both sexes, is a significant public health challenge. This study aims to comprehensively investigate the prevalence and determinants of UI in men and women, considering gender-specific factors. METHODS The study performed a secondary analysis on data obtained from 13,383 individuals surveyed in the 2019 Turkish Health Survey, providing a representation of the Turkish population. The dataset included sociodemographic and health-related variables like UI, body mass index (BMI), physical activity, smoking, and chronic diseases-statistical analysis employed chi-square tests and gender-stratified logistic regression models to identify UI-associated factors. RESULTS Our results showed that UI affected 8.8% of the population, with a striking gender disparity. Women had a notably higher prevalence at 11.2%, while men had a lower rate of 5.5%. Importantly, this gender gap narrowed with age. For example, in the 34-44 age group, the female/male ratio was 6.9, but it decreased to 1.4 in the 65-74 age group. Marital status and employment status played significant roles. Separated, divorced, or widowed individuals, particularly women, had the highest prevalence at 19.3%. Employment status influenced UI prevalence, with employed men having the lowest rate (2.1%), while retired women faced the highest rate (15.0%). Higher BMI, especially in obese individuals, significantly raised UI prevalence, reaching 7.9% for men and 15.8% for women. Physical inactivity, notably in women (17.0%), and prolonged sedentary hours (13.9%) were associated with higher UI rates. Former smokers, especially women (15.9%), had a notable impact on UI. Poor perceived health and chronic conditions like Chronic Obstructive Pulmonary Disease (COPD), hypertension, and diabetes were significantly associated with higher UI prevalence. Logistic regression analysis revealed that age, education, perceived health status, COPD, and diabetes were significant factors associated with UI in both sexes, while in women, BMI, physical activity, and smoking also played notable roles. CONCLUSIONS This extensive UI study has unveiled notable gender disparities and determinants. Notably, these disparities decrease with age, underlining UI's changing nature over time. Modifiable factors impact women more, while non-modifiable factors are linked to men. The study underscores the importance of tailoring healthcare strategies to address UI based on gender.
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Affiliation(s)
- Melike Yavuz
- Faculty of Medicine, Department of Public Health, Bahcesehir University, Istanbul, Türkiye.
| | - Nilay Etiler
- School of Public Health, University of Nevada Reno, NV, USA
- Faculty of Medicine, Department of Public Health, Istanbul Okan University, Istanbul, Türkiye
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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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Risk Factors for Urinary Incontinence in Chinese Women: A Cross-sectional Survey. Female Pelvic Med Reconstr Surg 2021; 27:377-381. [PMID: 32282523 DOI: 10.1097/spv.0000000000000871] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Urinary incontinence is highly prevalent among women, with a substantial effect on health-related quality of life. This article aimed to investigate the independent factors for urinary incontinence (UI) and the relative importance of each factor. METHODS This study was a cross-sectional survey of Chinese women in Guangzhou. Female 20 years and older were invited to participate. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form was used to determine whether respondents are experiencing UI. Univariate and multivariate unconditional logistic regression analyses were performed to determine the significant risk factors associated with UI. RESULTS A total of 2626 women were invited to participate in the survey. The response rate was 80.5% (2114/2626). The prevalence of UI among the study population was 31.2%. Old age, increased body mass index, childbirth, family history of any female pelvic floor disorders, symptoms of chronic cough or rhinitis, wearing a corset, and often drinking were independent risk factors for UI. CONCLUSIONS Urinary incontinence is common among Chinese women in Guangzhou. Among the factors that we are concerned with, old age and vaginal delivery are the two with greatest impact. Moreover, wearing a corset and drinking are the 2 lifestyle factors associated with UI.
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Effects of Oxytocin for Induction and Augmentation of Labor on Pelvic Floor Symptoms and Support in the Postpartum Period. Female Pelvic Med Reconstr Surg 2021; 27:289-296. [PMID: 32097161 DOI: 10.1097/spv.0000000000000848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The aim of the study was to determine whether oxytocin for induction or augmentation of labor impacts the incidence or persistence of pelvic floor symptoms and support 5 to 10 weeks after first vaginal delivery. METHODS Participants in this prospective cohort study were nulliparous women 18 years or older that delivered vaginally at 37 weeks gestation or more and completed the Epidemiology of Prolapse and Incontinence Questionnaire (EPIQ) and the Pelvic Organ Prolapse Quantification examination in third trimester and 5 to 10 weeks postpartum. We compared the incidence and persistence of symptomatic EPIQ domains and worse vaginal support (maximal vaginal descent ≥0 cm) between women who received oxytocin with those that did not (with or without prostaglandin or mechanical methods in both groups). We performed modified binomial regression to calculate adjusted relative risks of each outcome with 95% confidence intervals. RESULTS The mean (SD) age of the 722 participants was 28.3 (5.2) years; 20% were Hispanic. There were no significant differences according to oxytocin exposure in either incidence or persistence of symptomatic EPIQ domains or worse vaginal support. We found similar results in sensitivity analyses comparing women who received oxytocin as the sole pharmacologic agent to women who received no pharmacologic agent. After adjusting for demographic and obstetric factors associated with incidence and persistence of symptoms and support, oxytocin exposure continued to have no effect. CONCLUSIONS Oxytocin during labor does not significantly increase the risks for the incidence or persistence of pelvic floor symptoms or worse vaginal support in the early postpartum period, although power for less frequent outcomes was limited.
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Hill JE, Christian D, Shaw K, Clegg A. Weight loss interventions as an option for a lifestyle treatment in urinary incontinence. Br J Community Nurs 2020; 25:616-619. [PMID: 33275503 DOI: 10.12968/bjcn.2020.25.12.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Danielle Christian
- Senior Research Assistant, Stroke Research Team, University of Central Lancashire, Preston
| | - Kelly Shaw
- Specialist Physiotherapist in Women's Health, Lancashire Teaching Hospitals
| | - Andrew Clegg
- Professor of Health Services Research, Health Technology Assessment Group University of Central Lancashire, Preston
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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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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]
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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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Battaglia S, Benfante A, Principe S, Basile L, Scichilone N. Urinary Incontinence in Chronic Obstructive Pulmonary Disease: A Common Co-morbidity or a Typical Adverse Effect? Drugs Aging 2019; 36:799-806. [DOI: 10.1007/s40266-019-00687-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Kizilkaya Beji N, Güngör İ, Onat G, Erkan HA, Gökyildiz Ş, Yalçin Ö. Risk factors for urinary incontinence among Istanbul women: a hospital based case-control study. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2018. [DOI: 10.15452/nm.2018.09.0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Markland A, Chu H, Epperson CN, Nodora J, Shoham D, Smith A, Sutcliffe S, Townsend M, Zhou J, Bavendam T. Occupation and lower urinary tract symptoms in women: A rapid review and meta-analysis from the PLUS research consortium. Neurourol Urodyn 2018; 37:2881-2892. [PMID: 30272814 DOI: 10.1002/nau.23806] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/11/2018] [Indexed: 12/30/2022]
Abstract
AIMS Chronic, infrequent voiding may be a risk factor for lower urinary tract symptoms (LUTS) in women. To inform this hypothesis, we conducted a rapid literature review and meta-analysis of LUTS by occupation as an indirect measure of infrequent voiding behaviors. METHODS Two independent medical librarians searched Pubmed.gov studies (1990-2017) on adult women for occupations, industries, and workplace environment and LUTS outcomes: overactive bladder (OAB), urinary incontinence (UI), urinary tract infections (UTIs), and individual voiding and storage LUTS. Two authors reviewed full text articles meeting content criteria. Among studies with similar UI definitions, we estimated the prevalence of monthly UI using a random effects meta-analysis model. RESULTS Of 1078 unique citations identified, 113 underwent full article review and 33 met inclusion criteria. Twenty-six of these studies examined specific occupation groups, including nurses/midwives (n = 6 studies), healthcare workers/support staff (n = 6), military personnel (n = 3), teachers (n = 3), and other groups (n = 7), whereas eight compared findings across broad occupation groups. UI was reported in 30 studies (23% using validated measures), OAB in 6 (50% validated), and UTIs in 2 (non-validated). In pooled models, the degree of heterogeneity was too high (I2 = 96.9-99.2%) among the studies to perform valid prevalence estimates for LUTS. CONCLUSIONS Current literature limits the ability to evaluate LUTS by occupation types. Future studies should characterize voiding frequency and toilet access in a consistent manner by occupation and explore its relation to LUTS development.
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Affiliation(s)
- Alayne Markland
- Department of Medicine, University of Alabama at Birmingham, Birmingham Geriatric Research, Education, and Clinical Center at the Birmingham VA Medical Center, Birmingham, Alabama
| | - Haitao Chu
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | - C Neill Epperson
- Departments of Psychiatry and Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jesse Nodora
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
| | - David Shoham
- Public Health Sciences, Loyola University, Chicago, Illinois
| | - Ariana Smith
- Department of Surgery, Division of Urology, University of Pennsylvania, Philadelphia, PennsylvaniaPennsylvania
| | - Siobhan Sutcliffe
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri
| | | | - Jincheng Zhou
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota
| | - Tamara Bavendam
- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, Maryland
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- National Institutes of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, Maryland
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Hagan KA, Erekson E, Austin A, Minassian VA, Townsend MK, Bynum JPW, Grodstein F. A prospective study of the natural history of urinary incontinence in women. Am J Obstet Gynecol 2018; 218:502.e1-502.e8. [PMID: 29425839 DOI: 10.1016/j.ajog.2018.01.045] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/15/2018] [Accepted: 01/31/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Symptoms of urinary incontinence are commonly perceived to vary over time; yet, there is limited quantitative evidence regarding the natural history of urinary incontinence, especially over the long term. OBJECTIVE We sought to delineate the course of urinary incontinence symptoms over time, using 2 large cohorts of middle-aged and older women, with data collected over 10 years. STUDY DESIGN We studied 9376 women from the Nurses' Health Study, age 56-81 years at baseline, and 7491 women from the Nurses' Health Study II, age 39-56 years, with incident urinary incontinence in 2002 through 2003. Urinary incontinence severity was measured by the Sandvik severity index. We tracked persistence, progression, remission, and improvement of symptoms over 10 years. We also examined risk factors for urinary incontinence progression using logistic regression models. RESULTS Among women age 39-56 years, 39% had slight, 45% had moderate, and 17% had severe urinary incontinence at onset. Among women age 56-81 years, 34% had slight, 45% had moderate, and 21% had severe urinary incontinence at onset. Across ages, most women reported persistence or progression of symptoms over follow-up; few (3-11%) reported remission. However, younger women and women with less severe urinary incontinence at onset were more likely to report remission or improvement of symptoms. We found that increasing age was associated with higher odds of progression only among older women (age 75-81 vs 56-60 years; odds ratio, 1.84; 95% confidence interval, 1.51-2.25). Among all women, higher body mass index was strongly associated with progression (younger women: odds ratio, 2.37; 95% confidence interval, 2.00-2.81; body mass index ≥30 vs <25 kg/m2; older women: odds ratio, 1.93; 95% confidence interval, 1.62-2.22). Additionally, greater physical activity was associated with lower odds of progression to severe urinary incontinence (younger women: odds ratio, 0.86; 95% confidence interval, 0.71-1.03; highest vs lowest quartile of activity; older women: odds ratio, 0.68; 95% confidence interval, 0.59-0.80). CONCLUSION Most women with incident urinary incontinence continued to experience symptoms over 10 years; few had complete remission. Identification of risk factors for urinary incontinence progression, such as body mass index and physical activity, could be important for reducing symptoms over time.
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Affiliation(s)
- Kaitlin A Hagan
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA.
| | - Elisabeth Erekson
- Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Hanover, NH; Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Andrea Austin
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Vatche A Minassian
- Division of Urogynecology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA
| | - Mary K Townsend
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Julie P W Bynum
- Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Francine Grodstein
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
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Munaganuru N, Van Den Eeden SK, Creasman J, Subak LL, Strano-Paul L, Huang AJ. Urine leakage during sexual activity among ethnically diverse, community-dwelling middle-aged and older women. Am J Obstet Gynecol 2017; 217:439.e1-439.e8. [PMID: 28602772 DOI: 10.1016/j.ajog.2017.05.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/11/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Urinary incontinence is associated with decreased female sexual function, but little is known about the prevalence, predictors, and impact of urine leakage during sexual activity among women in the community. OBJECTIVE The purpose of this study was to evaluate the prevalence and impact of urine leakage during sex in ethnically diverse, community-dwelling midlife and older women. STUDY DESIGN Urinary incontinence and sexual function were assessed by structured questionnaire in a multiethnic, community-based cohort of women enrolled in Kaiser Permanente Northern California, an integrated healthcare delivery system in California. All women were aged 40-80 years and sampled from 1 of 4 racial/ethnic groups (20% black, 20% Latina, 20% Asian, and 40% non-Latina white). Differences in frequency, bother, and fear of urine leakage during sexual activity were examined among women with monthly, weekly, and daily urinary incontinence and across different types of urinary incontinence (stress, urgency, mixed, and other type urinary incontinence), with the use of chi-square tests. Independent risk factors for urine leakage during sexual activity were identified through multivariable logistic regression. RESULTS Of the 509 women who reported being sexually active and having at least monthly urinary incontinence, 127 of them (25%) reported experiencing any urine leakage during sex during the past 3 months. Nineteen percent of the women reported being subjectively bothered by leakage during sex, and 16% of them reported restricting sexual activity because of fear of leakage. Women with more frequent underlying urinary incontinence were more likely to report experiencing or being bothered by leakage during sex and restricting sexual activity because of fear of leakage (P<.001 for all). Participants with predominantly stress or mixed type urinary incontinence were more likely to report experiencing leakage during sex and being subjectively bothered by this leakage (P<.002 for all). Factors independently associated with leakage during sex were depression (odds ratio,1.96; 95% confidence interval, 1.20-3.20), symptomatic pelvic organ prolapse (odds ratio, 2.10; 95% confidence interval, 1.11-3.98), mixed vs urgency type urinary incontinence (odds ratio, 3.16; 95% confidence interval, 1.70-5.88), stress vs urgency type urinary incontinence (odds ratio, 1.94; 95% confidence interval, 1.01-3.70), and frequency of sexual activity (odds ratio, 1.6395% confidence interval, 1.05-2.55), but not age or race/ethnicity. CONCLUSIONS Up to a quarter of women with at least monthly urinary incontinence in the community may experience urine leakage during sexual activity. Many incontinent women who leak urine during sex remain sexually active, which indicates that the preservation of sexual function should still be a priority in this population. Among incontinent women, depression, pelvic organ prolapse, and stress mixed-type urinary incontinence may be associated with urine leakage during sexual activity.
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Christiansen UJ, Hansen MJ, Lauszus FF. Hysterectomy is not associated with de-novo urinary incontinence: A ten-year cohort study. Eur J Obstet Gynecol Reprod Biol 2017. [PMID: 28633096 DOI: 10.1016/j.ejogrb.2017.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine prevalence, incidence proportion, and changes of urinary incontinence (UI) 10-13 years after hysterectomy compared to two control groups. STUDY DESIGN A longitudinal cohort study of 661 women with follow-up for ten years. Originally, 866 women answered a questionnaire on continence status preoperatively. Ten years postoperatively the queries were repeated in 371 with a hysterectomy, 89 with laparoscopic cholecystectomy (LC), and 201 with transcervical endometrial resection (TCRE). Significant incontinence was UI at least once a week. The main outcome measures were prevalence and incidence proportions of UI. RESULTS The overall prevalence of stress UI ten years after surgery was 23% compared to 12% preoperatively. Urge UI was prevalent in 12% compared to 5% preoperatively. Incidence proportions of stress UI were in hysterectomies 21%, in LC 15%, and in TCRE 18%. Similarly, incidence proportions of urge UI were in hysterectomies 11%, in LC 11%, and in TCRE 8%. No significant differences between surgical procedures were found; however, we found substantial amount of changes in continence status from continent to incontinent and vice versa in all three groups. CONCLUSIONS No significant difference was found after hysterectomy compared to controls in the prevalence or incidence proportions of UI after 10 years follow-up. Hysterectomy is not a risk factor of UI.
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Affiliation(s)
- Ulla J Christiansen
- Department of Gynaecology and Obstetrics, Herning Hospital, Gl. Landevej 61, 7400 Herning, Denmark
| | - Mette J Hansen
- Department of Gynaecology and Obstetrics, Herning Hospital, Gl. Landevej 61, 7400 Herning, Denmark
| | - Finn F Lauszus
- Department of Gynaecology and Obstetrics, Herning Hospital, Gl. Landevej 61, 7400 Herning, Denmark.
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Sugimoto T, Yoshida M, Ono R, Murata S, Saji N, Niida S, Toba K, Sakurai T. Frontal Lobe Function Correlates with One-Year Incidence of Urinary Incontinence in Elderly with Alzheimer Disease. J Alzheimers Dis 2017; 56:567-574. [DOI: 10.3233/jad-160923] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Taiki Sugimoto
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
- Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences, Kobe, Japan
| | - Masaki Yoshida
- Department of Urology, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Rei Ono
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences, Kobe, Japan
| | - Shunsuke Murata
- Department of Community Health Sciences, Kobe University, Graduate School of Health Sciences, Kobe, Japan
| | - Naoki Saji
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Shumpei Niida
- Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Toba
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
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Feng C, Hu J, Liu C, Liu S, Liao G, Song L, Zeng X. Association of 17-β Estradiol with Adipose-Derived Stem Cells: New Strategy to Produce Functional Myogenic Differentiated Cells with a Nano-Scaffold for Tissue Engineering. PLoS One 2016; 11:e0164918. [PMID: 27783699 PMCID: PMC5081199 DOI: 10.1371/journal.pone.0164918] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 10/03/2016] [Indexed: 01/01/2023] Open
Abstract
The increased incidence of stress urinary incontinence (SUI) in postmenopausal women has been proposed to be associated with a reduction in the level of 17-β estradiol (E2). E2 has also been shown to enhance the multi-differentiation ability of adipose-derived stem cells (ASCs) in vitro. However, studies on the potential value of E2 for tissue engineering in SUI treatment are rare. In the present study, we successfully fabricated myogenically differentiated ASCs (MD-ASCs), which were seeded onto a Poly(l-lactide)/Poly(e-caprolactone) electrospinning nano-scaffold, and incorporated E2 into the system, with the aim of improving the proliferation and myogenic differentiation of ASCs. ASCs were collected from the inguinal subcutaneous fat of rats. The proliferation and myogenic differentiation of ASCs, as well as the nano-scaffold biocompatibility of MD-ASCs, with or without E2 supplementation, were investigated. We demonstrated that E2 incorporation enhanced the proliferation of ASCs in vitro, and the most optimal concentration was 10-9 M. E2 also led to modulation of the MD-ASCs phenotype toward a concentrated type with smooth muscle-inductive medium. The expression of early (alpha-smooth muscle actin), mid (calponin), and late-stage (myosin heavy chain) contractile markers in MD-ASCs was enhanced by E2 during the different differentiation stages. Furthermore, the nano-scaffold was biocompatible with MD-ASCs, and cell proliferation was significantly enhanced by E2. Taken together, these results demonstrate that E2 can enhance the proliferation and myogenic differentiation of ASCs and can be used to construct a biocompatible cell/nano-scaffold. These scaffolds with desirable differentiation cells show promising applications for tissue engineering.
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Affiliation(s)
- Chunxiang Feng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinqian Hu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chang Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiliang Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guiying Liao
- School of Material Science and Chemistry Engineering, China University of Geosciences (Wuhan), Wuhan, Hubei, China
| | - Linjie Song
- School of Material Science and Chemistry Engineering, China University of Geosciences (Wuhan), Wuhan, Hubei, China
| | - Xiaoyong Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- * E-mail:
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17
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Predicting urinary incontinence in women in later life: A systematic review. Maturitas 2016; 94:110-116. [PMID: 27823729 DOI: 10.1016/j.maturitas.2016.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/09/2016] [Indexed: 11/21/2022]
Abstract
Urinary incontinence (UI) affects 10-40% of the population and treatment costs in the UK are estimated to be £233 million per annum. A systematic review of online medical databases between July 1974 and 2016 was conducted to identify studies that had investigated risk and prediction strategies of UI in later life. Eighteen prospective longitudinal studies fulfilled the search criteria. These were analysed systematically (as per the PRISMA checklist) and bias risk through study design was minimised where possible upon data analysis. One paper proposed a predictive assessment tool called the 'continence index'. It was derived following secondary analysis of a cohort study and its predictive threshold had suboptimal sensitivity (79%) and specificity (65%) rates. Seventeen studies identified multiple strong risk factors for UI but despite a large selection of papers on the topic, no robust risk assessment tool prospectively identified patients at risk of UI in later life. Thus more research in this field is required. Clinicians should be aware particularly of modifiable UI risk factors to help reduce the clinical burden of UI in the long term.
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Abstract
OBJECTIVE This study aims to identify factors associated with greater impact of vaginal symptoms on the functioning and well-being of postmenopausal women. METHODS Postmenopausal women who reported vaginal dryness, itching, irritation, or pain with sexual activity completed the multidimensional Day-to-day Impact of Vaginal Aging (DIVA) questionnaire and underwent assessment of multiple sociodemographic and clinical factors that have the potential to influence the impact of vaginal symptoms. Multivariable linear regression analyses examined relationships between selected participant characteristics and DIVA scale scores assessing symptom impact on activities of daily living, emotional well-being, self-concept and body image, and sexual functioning. RESULTS Among 745 symptomatic participants, the mean (SD) age was 56 (9) years, and 66% were racial/ethnic minorities. Women with comorbid depression reported greater impact of vaginal symptoms on all dimensions of functioning and well-being measured by the DIVA questionnaire (11%-22% estimated increase in impact scores associated with every three-point increase in Hospital and Anxiety Depression Scale scores). Women with urinary incontinence also reported greater impact of vaginal symptoms on activities of daily living, emotional well-being, and self-concept and body image (27%-37% estimated increase in impact scores). Age, partner status, frequency of sexual activity, general health, and body mass index also predicted greater impact on at least one domain. CONCLUSIONS Findings suggest that special efforts should be made to identify and treat vaginal symptoms in postmenopausal women known to have depression or urinary incontinence, as these women may experience greater impact of vaginal symptoms on multiple domains of functioning and quality of life.
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Komesu YM, Schrader RM, Ketai LH, Rogers RG, Dunivan GC. Epidemiology of mixed, stress, and urgency urinary incontinence in middle-aged/older women: the importance of incontinence history. Int Urogynecol J 2016; 27:763-72. [PMID: 26670573 PMCID: PMC4957945 DOI: 10.1007/s00192-015-2888-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 11/02/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) is common and the relationship among its subtypes complex. Our objective was to describe the natural history and predictors of the incontinence subtypes stress, urgency, and mixed, in middle-aged and older US women. We tested our hypothesis that UI subtype history predicted future occurrence, evaluating subtype incidence/remission over multiple time points in a stable cohort of women. METHODS We analyzed longitudinal urinary incontinence data in 10,572 community-dwelling women aged ≥50 in the 2004-2010 Health and Retirement Study. Mixed, stress, and urgency incontinence prevalence (2004, 2006, 2008, 2010) and 2-year cumulative incidence and remissions (2004-2006, 2006-2008, 2008-2010) were estimated. Patient characteristics and incontinence subtype status 2004-2008 were entered into a multivariable, transition model to determine predictors for incontinence subtype occurrence in 2010. RESULTS The prevalence of each subtype in this population (median age 63-66) was 2.6-8.9 %. Subtype incidence equaled 2.1-3.5 % and remissions for each varied between 22.3 and 48.7 %. Incontinence subtype incidence predictors included ethnicity/race, age, body mass index, and functional limitations. Compared with white women, black women had decreased odds of incident stress incontinence and Hispanic women had increased odds of stress incontinence remission. The age range 80-90 and severe obesity predicted incident mixed incontinence. Functional limitations predicted mixed and urgency incontinence. The strongest predictor of incontinence subtype was subtype history. The presence of the respective incontinence subtypes in 2004 and 2006 strongly predicted 2010 recurrence (odds ratio [OR] stress incontinence = 30.7, urgency OR = 47.4, mixed OR = 42.1). CONCLUSIONS Although the number of remissions was high, a previous history of incontinence subtypes predicted recurrence. Incontinence status is dynamic, but tends to recur over the longer term.
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Affiliation(s)
- Yuko M Komesu
- Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, MSC10-5580 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
| | - Ronald M Schrader
- University of New Mexico Clinical and Translational Science Center, Albuquerque, NM, USA
| | - Loren H Ketai
- Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, MSC10-5580 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Rebecca G Rogers
- Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, MSC10-5580 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Gena C Dunivan
- Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, MSC10-5580 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
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20
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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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21
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Seshan V, AlKhasawneh E, Al Hashmi IH. Risk factors of urinary incontinence in women: a literature review. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2016. [DOI: 10.1111/ijun.12107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vidya Seshan
- Maternal and Child Health Nursing, College of Nursing; Sultan Qaboos University; P.O. Box 66 Al-Khoud Muscat Oman
| | - Esra AlKhasawneh
- College of Nursing; Sultan Qaboos University; P.O. Box 66 Al-Khoud Muscat Oman
| | - Iman Hamed Al Hashmi
- Maternal and Child Health Nursing, College of Nursing; Sultan Qaboos University; P.O. Box 66 Al-Khoud Muscat Oman
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22
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Griebling TL. Re: Correlates of 1-Year Incidence of Urinary Incontinence in Older Latino Adults Enrolled in a Community-Based Physical Activity Trial. J Urol 2015; 195:135-6. [PMID: 26699978 DOI: 10.1016/j.juro.2015.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Prevalence and correlates of urinary incontinence among older community-dwelling women. Female Pelvic Med Reconstr Surg 2015; 20:328-33. [PMID: 25185631 DOI: 10.1097/spv.0000000000000093] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES As the aging population in the United States grows, the investigation of urinary incontinence (UI) issues becomes increasingly important, especially among women. Using data from the California Health Interview Survey (CHIS), we sought to determine the prevalence and correlates of UI among an ethnically diverse population of older community-dwelling women. METHODS A total of 5374 female Californians aged 65 years or older participated in a population-based, cross-sectional random-digit-dialing telephone survey. The CHIS 2003 adult survey included 1 question for Californians aged 65 years or older about UI. Additional information collected via the self-reported survey included demographics (age, race/ethnicity, education, and household income), general health data (self-reported health status, height and weight, fall history, and special equipment needs), medical comorbidities, and health behaviors (tobacco use, physical activity, and hormone replacement therapy). RESULTS The estimated statewide female prevalence rate for UI was 24.4%. Prevalence rates increased with age. Urinary incontinence was significantly associated with poorer overall health (adjusted odds ratio [OR], 3.43; P < 0.001), decreased mobility (OR, 1.81; P = 0.004), current use of hormone replacement therapy (OR, 1.72; P < 0.001), being overweight or obese (OR, 1.60; P < 0.001), a history of falls (OR, 1.53; P = 0.002), and a history of heart disease (OR, 1.38; P = 0.010). After adjusting for all health factors, UI was not found to have any significant association with the level of education, household poverty status, or smoking status. CONCLUSIONS Urinary incontinence prevalence among this diverse group of older community-dwelling Californian women parallels that of other population-based studies. The CHIS demonstrated that poor health, increased BMI, falls, and decreased mobility are strongly correlated with UI.
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24
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Phelan S, Kanaya AM, Ma Y, Vittinghoff E, Barrett-Connor E, Wing R, Kusek JW, Orchard TJ, Crandall JP, Montez MG, Brown JS. Long-term prevalence and predictors of urinary incontinence among women in the Diabetes Prevention Program Outcomes Study. Int J Urol 2015; 22:206-12. [PMID: 25352018 PMCID: PMC4387889 DOI: 10.1111/iju.12654] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 09/12/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To examine the long-term prevalence and predictors of weekly urinary incontinence in the Diabetes Prevention Program Outcomes Study, a follow-up study of the Diabetes Prevention Program randomized clinical trial of overweight adults with impaired glucose tolerance. METHODS This analysis included 1778 female participants of the Diabetes Prevention Program Outcomes Study who had been randomly assigned during the Diabetes Prevention Program to intensive lifestyle intervention (n = 582), metformin (n = 589) or placebo (n = 607). The study participants completed semi-annual assessments after the final Diabetes Prevention Program visit and for 6 years until October 2008. RESULTS At the study entry, the prevalence of weekly urinary incontinence was lower in the intensive lifestyle intervention group compared with the metformin and placebo groups (44.2% vs 51.8%, 48.0% urinary incontinence/week, P = 0.04); during the 6-year follow-up period, these lower rates in intensive lifestyle intervention were maintained (46.7%, 53.1%, 49.9% urinary incontinence/week; P = 0.03). Statistically adjusting for urinary incontinence prevalence at the end of the Diabetes Prevention Program, the treatment arm no longer had a significant impact on urinary incontinence during the Diabetes Prevention Program Outcomes Study. Independent predictors of lower urinary incontinence during the Diabetes Prevention Program Outcomes Study included lower body mass index (odds ratio 0.988, 95% confidence interval 0.982-0.994) and greater physical activity (odds ratio 0.999, 95% confidence interval 0.998-1.000) at the Diabetes Prevention Program Outcomes Study entry, and greater reductions in body mass index (odds ratio 0.75, 95% confidence interval 0.60-0.94) and waist circumference (odds ratio 0.998, 95% confidence interval 0.996-1.0) during the Diabetes Prevention Program Outcomes Study. Diabetes was not significantly related to urinary incontinence. CONCLUSIONS Intensive lifestyle intervention has a modest positive and enduring impact on urinary incontinence, and should be considered for the long-term prevention and treatment of urinary incontinence in overweight/obese women with glucose intolerance.
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Affiliation(s)
- Suzanne Phelan
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, California
| | - Alka M. Kanaya
- Department of General Internal Medicine, University of California, San Francisco (UCSF), San Francisco, California
| | - Yong Ma
- Biostatistics Center, The George Washington University, Rockville, Maryland
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF), San Francisco, California
| | | | - Rena Wing
- Department of Psychiatry and Human Behavior, Warren Albert School of Medicine at Brown University; The Miriam Hospital, Providence, Rhode Island
| | - John W. Kusek
- Division of Kidney, Urologic, and Hematologic Disease, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | | | | | - Maria G. Montez
- University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Jeanette S. Brown
- Departments of Obstetrics, Gynecology and Reproductive Sciences, Urology and Epidemiology, UCSF Women’s Health Clinical Research Center, San Francisco, California
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25
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Association of Depression and Anxiety in Underserved Women With and Without Urinary Incontinence. Female Pelvic Med Reconstr Surg 2014; 20:349-53. [DOI: 10.1097/spv.0000000000000071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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26
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Handa VL, Pierce CB, Muñoz A, Blomquist JL. Longitudinal changes in overactive bladder and stress incontinence among parous women. Neurourol Urodyn 2014; 34:356-61. [PMID: 24633996 DOI: 10.1002/nau.22583] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 02/14/2014] [Indexed: 11/07/2022]
Abstract
AIMS To describe longitudinal changes in symptoms of overactive bladder (OAB) and stress urinary incontinence (SUI) among parous women. METHODS At annual examinations, beginning at least 5 years from first delivery, OAB and SUI were assessed using the Epidemiology of Prolapse and Incontinence Questionnaire. Published thresholds were used to define "bothersome" symptom scores. The prevalence, the incidence of bothersome symptoms, and treatment rates were calculated. In separate analyses for women who delivered by cesarean versus vaginal delivery, odds of SUI or OAB symptoms (score > 0) were modeled as a function of time since childbirth, age, race, and obesity. Among those with persistent symptoms, severity symptom score was modeled as a function of time since childbirth and these same covariates. RESULTS One thousand four hundred and eighty-one participants completed up to 5 annual assessments (2,722 woman-years). During follow-up, the incidences of bothersome SUI and OAB were 2.5/100 woman-years and 1.7/100 woman-years, respectively. Although SUI and OAB symptoms were more common in the vaginal birth group (P < 0.001), the odds of symptoms increased since increasing time from delivery in the cesarean group. Symptom severity did not change substantially over time in either group. Obesity was strongly associated with symptoms related to SUI and OAB. CONCLUSIONS Five years from first delivery, symptoms related to SUI and OAB were more common and of greater severity after vaginal than cesarean birth. However, differences between these two groups lessen as time from childbirth increases. Obesity control should be a primary target for reduction of incontinence and incontinence severity among parous women.
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Affiliation(s)
- Victoria L Handa
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
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27
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Morrisroe SN, Rodriguez LV, Wang PC, Smith AL, Trejo L, Sarkisian CA. Correlates of 1-year incidence of urinary incontinence in older Latino adults enrolled in a community-based physical activity trial. J Am Geriatr Soc 2014; 62:740-6. [PMID: 24618012 DOI: 10.1111/jgs.12729] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The prevalence of urinary incontinence (UI) among older urban Latinos is high. Insight into etiologies of and contributing factors to the development of this condition is needed. This longitudinal cohort study identified correlates of 1-year incidence of UI in older community-dwelling Latino adults participating in a senior center-based physical activity trial in Los Angeles, California. Three hundred twenty-eight Latinos aged 60 to 93 participating in Caminemos, a randomized trial to increase walking, were studied. Participants completed an in-person survey and physical performance measures at baseline and 1 year. UI was measured using the International Consultation on Incontinence item: "How often do you leak urine?" Potential correlates of 1-year incidence of UI included sociodemographic, behavioral, medical, physical, and psychosocial characteristics. The overall incidence of UI at 1 year was 17.4%. Incident UI was associated with age, baseline activity of daily living impairment, health-related quality of life (HRQoL), mean steps per day, and depressive symptoms. Multivariate logistic regression models revealed that improvement in physical performance score (odds ratio (OR) = 0.69, 95% confidence interval (CI) = 0.50-0.95) and high baseline physical (OR = 0.60, 95% CI = 0.40-0.89) and mental (OR = 0.62, 95% CI = 0.43-0.91) HRQoL were independently associated with lower rates of 1-year incident UI. An increase in depressive symptoms at 1 year (OR = 4.48, 95% CI = 1.02-19.68) was independently associated with a higher rate of incident UI. One-year UI incidence in this population of older urban Latino adults participating in a walking trial was high but was lower in those who improved their physical performance. Interventions aimed at improving physical performance may help prevent UI in older Latino adults.
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Affiliation(s)
- Shelby N Morrisroe
- Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
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28
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Maserejian NN, Minassian VA, Chen S, Hall SA, McKinlay JB, Tennstedt SL. Treatment status and risk factors for incidence and persistence of urinary incontinence in women. Int Urogynecol J 2014; 25:775-82. [PMID: 24477545 DOI: 10.1007/s00192-013-2288-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/19/2013] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objective of this analysis was to describe urinary incontinence (UI) incidence and persistence over 5 years in association with treatment status, sociodemographic, medical, and lifestyle factors, in a racially/ethnically diverse population-based female sample. METHODS The Boston Area Community Health Survey enrolled 3,201 women aged 30-79 years of black, Hispanic, and white race/ethnicity. Five-year follow-up was completed by 2,534 women (conditional response rate 83.4 %), allowing population-weighted estimates of UI incidence and persistence rates. Predictors of UI were determined using multivariate logistic regression models. RESULTS Incidence of UI at least monthly was 14.1 % and weekly 8.9 %. Waist circumference at baseline and increasing waist circumference over 5-year follow-up were the most robust predictors of UI incidence in multivariate models (P ≤ 0.01). Among 475 women with UI at baseline, persistence was associated with depression symptoms [monthly UI, odds ratio (OR) = 2.39, 95 % confidence interval (CI) 1.14-5.02] and alcohol consumption (weekly UI, OR = 3.51, 95 % CI 1.11-11.1). Among women with weekly UI at baseline, 41.7 % continued to report weekly UI at follow-up, 14.1 % reported monthly UI, and 44.2 % had complete remission. Persistence of UI was not significantly higher (58.2 % vs. 48.0 %, chi-square P = 0.3) among untreated women. Surgical or drug treatment for UI had little impact on estimates for other risk factors or for overall population rates of persistence or remission. CONCLUSIONS Women with higher gains in waist circumference over time were more likely to develop UI, but waist circumference was not predictive of UI persistence. UI treatments did not affect associations for other risk factors. Additional research on the role of alcohol intake in UI persistence is warranted.
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Affiliation(s)
- Nancy N Maserejian
- Department of Epidemiology, New England Research Institutes, 9 Galen Street, Watertown, MA, 02472, USA,
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29
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Newman DK. In men and women with COPD the presence of urinary incontinence is associated with poorer quality of life. Evid Based Nurs 2014; 17:22-23. [PMID: 23677769 DOI: 10.1136/eb-2013-101290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Diane K Newman
- Division of Urology, University of Pennsylvania, , Philadelphia, Pennsylvania, USA
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Risk factors for prolapse development in white, black, and Hispanic women. Female Pelvic Med Reconstr Surg 2013; 17:80-90. [PMID: 22453694 DOI: 10.1097/spv.0b013e31820e5d06] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES : This study aimed to examine the risk factors for prevalence and incidence of pelvic organ prolapse (POP) in whites, Hispanics, and blacks. METHODS : This is a secondary analysis of the Women's Health Initiative (WHI) Estrogen plus Progestin Clinical Trial (E + P). Of the original E + P trial population of 16,608, 12,667 women (78.3%; 11,194 whites, 804 blacks, and 669 Hispanics) were included in the final study sample and evaluated during the 5-year period. The outcomes evaluated were any prolapse (WHI prolapse grades 1-3) and WHI prolapse grade 2 or 3. Descriptive analyses, logistic regression, and proportional hazard modeling were performed. RESULTS : Increasing parity correlates with increasing WHI prolapse grades (0-3) in whites and blacks but not Hispanics. The incidence of grade 2 or 3 POP increased by 250% in white women with 1 child (hazard ratio [HR], 2.50; 95% confidence interval [CI], 1.68-3.71) in comparison to nulliparous women and grew with higher parity. For blacks, a weak association between the parity and grade 2 or 3 POP was noted only in women who had 5 or more kids (HR, 10.41; 95% CI, 1.38-78.77). Blacks were less likely (HR, 0.53; 95% CI, 0.40-0.71) to develop grade 2 or 3 POP compared with whites. For grade 2 or 3 POP, age was found to be a risk factor in whites (odds ratio [OR], 1.03; 95% CI, 1.02-1.04) only and body mass index (≥25 kg/m, <30 kg/m) in whites (OR, 1.64; 95% CI, 1.34-2.02) and Hispanics (OR, 2.87; 95% CI, 1.03-2.02). CONCLUSIONS : White women are at a much greater risk for developing grade 2 or 3 POP compared with blacks. Parity correlates most strongly with the risk of prolapse development in whites and possibly in grand multiparous blacks.
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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
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Tannenbaum C, Gray M, Hoffstetter S, Cardozo L. Comorbidities associated with bladder dysfunction. Int J Clin Pract 2013; 67:105-13. [PMID: 23305472 DOI: 10.1111/ijcp.12085] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- C Tannenbaum
- Faculties of Pharmacy and Medicine, University of Montreal, Montreal, QC, Canada
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Fiegen MM, Benson KD, Hanson JD, Prasek J, Hansen KA, VanEerden P. The prevalence of urinary incontinence in American Indian women from a South Dakota tribe. Int Urogynecol J 2011; 23:473-9. [PMID: 22159561 DOI: 10.1007/s00192-011-1588-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 10/17/2011] [Indexed: 10/14/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The purpose of this pilot study was to evaluate the prevalence and associated risk factors for urinary incontinence in a Northern Plains tribe of American Indian women. METHODS The Urogenital Distress Inventory-Short Form was used to assess urinary incontinence in a sample of American Indian women from one tribe. This was a cross-sectional convenience sampling of 234 eligible participants. Participant's ages ranged from 18 to 80 years. Stata/Se 9.1 software was used in statistical analysis. RESULTS The overall prevalence of urinary stress incontinence was 15.4%, urgency incontinence 2.14%, and mixed incontinence 20.5%. Both stress and urgency incontinence was found to be low in this sample population. CONCLUSIONS A reduced prevalence of stress and urgency incontinence is seen in our sample. Our study group showed a high prevalence of known risk factors associated with urinary incontinence. We intend to extend our study for further understanding of this patient population.
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Affiliation(s)
- Michael M Fiegen
- Sanford Health, University of South Dakota, Sioux Falls, SD 57105, USA.
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