URINARY INCONTINENCE AND QUALITY OF LIFE: A LONGITUDINAL ANALYSIS FROM THE ENGLISH LONGITUDINAL STUDY OF AGEING

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

OBJECTIVES

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

STUDY DESIGN

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

RESULTS

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

CONCLUSIONS

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

Minor impact of anastomotic leakage in anterior resection for rectal cancer on long-term male urinary and sexual function

PURPOSE

Anastomotic leakage after anterior resection for rectal cancer induces bowel dysfunction, but the influence on urinary and sexual function is largely unknown. This cross-sectional cohort study evaluated long-term effect of anastomotic leakage on urinary and sexual function in male patients.

METHODS

Patients operated with anterior resection for rectal cancer in 15 Swedish hospitals 2007-2013 were identified. Anastomotic leakage and other clinical variables were retrieved from the Swedish Colorectal Cancer Registry and medical records. Urinary and sexual dysfunction were evaluated at 4 to 11 years after surgery using the International Prostate Symptom Score, International Index of Erectile Function, and European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire CR29. The effect of anastomotic leakage on average scores of urinary and sexual dysfunction was evaluated as a primary outcome, and the single items permanent urinary catheter and sexual inactivity as secondary outcomes. The association of anastomotic leakage and functional outcomes was analyzed using regression models with adjustment for confounders.

RESULTS

After a median follow-up of 84 months (interquartile range: 67-110), 379 out of 864 eligible men were included. Fifty-nine (16%) patients had anastomotic leakage. Urinary incontinence was more common in the leakage group, with an adjusted mean score difference measured by EORTC QLQ ColoRectal-29 of 8.69 (95% confidence interval: 0.72-16.67). The higher risks of urinary frequency, permanent urinary catheter, and sexual inactivity did not reach significance.

CONCLUSION

Anastomotic leakage after anterior resection had a minor negative impact on urinary and sexual function in men.

Female urinary incontinence on TikTok and YouTube: is online video content sufficient?

INTRODUCTION AND HYPOTHESIS

The objective of the study is to evaluate the reliability and quality of the most-viewed female urinary incontinence-related TikTok and YouTube posts. Our second goal is to analyze the differences in the quality and content of videos between these platforms.

METHODS

We searched for the keyword "female urinary incontinence" on TikTok and YouTube on 1 March 2023. We sorted the videos that appeared out of searches for this keyword by "top" results on TikTok and by "relevance" on YouTube. We excluded the videos that were not in English, whose narrator was unclear, unrelated videos, advertising videos, and duplicate videos. In this study, we included the top 50 videos on both platforms that were directly related to female urinary incontinence. The characteristics of the videos, such as likes, video duration, views, and type of narrator (patient, physician, nonphysician practitioner, and health care company), and DISCERN scores were analyzed.

RESULTS

We observed that the median view count (p<0.001) and the median video duration (p<0.001) were higher and longer respectively on YouTube than on TikTok. In addition, the median DISCERN score of these videos was higher on YouTube than on TikTok (p<0.001). Similarly, the overall quality of videos was higher on YouTube than on TikTok (p=0.002). Only in two TikTok and two YouTube videos have the narrators cited a reference.

CONCLUSIONS

Our findings emphasize the present lack of high-quality content available on TikTok and YouTube from both health care and nonhealth care experts. To address this lack of information, health care providers, especially urologists, should take an active role in creating video content.

Multimorbidity increased the risk of urinary incontinence in community-dwelling adults: Results from the English Longitudinal Study On Ageing

Multimorbidity (MM) is common in older people. Recent evidence, largely from cross-sectional studies, suggests that MM could be a risk factor for urinary incontinence (UI). For this reason, we aimed to explore the association between MM at baseline and incident UI, and which individual chronic medical conditions/factors might explain the association between MM and UI, using data from the English Longitudinal Study on Ageing, during ten years of follow-up. MM was defined as having two or more chronic medical conditions; the presence of UI was assessed using self-reported information. A logistic regression analysis, adjusted for baseline potential confounders, was used to assess the association between MM and UI, reporting the data as odds ratios (ORs) with their 95 % confidence intervals (CIs). Of 9432 initial participants, 6742 (mean age: 64.8 years; 53.2 % females) without UI at baseline were included in the analysis. MM was present at baseline in 48.8 % of the participants. People with MM had a significantly higher cumulative incidence of UI than their counterparts, leading to a significantly higher risk of UI also after adjusting for potential confounders at baseline (OR = 1.30; 95 % CI: 1.14-1.48). Among the medical conditions, only three were significantly associated with incident UI, namely asthma, Parkinson's disease, and psychiatric disorders. In conclusion, MM at baseline was associated with an increased risk of UI during ten years of follow-up, suggesting that UI is more likely to be present in people with several chronic medical conditions.

The effect of perceived social support levels on coping methods for urinary incontinence in elderly men

OBJECTIVE

This study aimed to determine the effect of the perceived social support level on coping methods for urinary incontinence among men aged 65 years and over with urinary incontinence.

METHODS

A total of 92 male patients over the age of 65 years with urinary incontinence and adequate cognitive levels were included in the study. The coping methods, the environmental support, and the Multidimensional Scale of Perceived Social Support were used to collect data.

RESULTS

The most common method of coping was changing clothes (64 [69.6%]). The Multidimensional Scale of Perceived Social Support total mean score was 55.83±14.8, which was considered above the medium-level support. The perception level of social support caused significant differences in coping methods in individuals with urinary incontinence.

CONCLUSION

The view that urinary incontinence is a problem related to aging is regarded as an obstacle to seeking healthcare. Society should be made aware that urinary incontinence is not a normal condition related to aging and that it is not an insoluble problem that the elderly must endure.

Urinary Incontinence and Sleep Quality in Older Women with Type 2 Diabetes: A Cross-Sectional Study

BACKGROUND

Urinary incontinence (UI) and poor sleep negatively affect health-related quality of life (HRQoL). This study explored the UI-related factors and the relationships between UI, sleep quality, and HRQoL.

METHODS

This cross-sectional study collected data from 237 women with type 2 diabetes. Multivariate logistic regression was conducted to identify the factors associated with UI. One-way analysis of variance was used to compare the mean sleep quality and HRQoL scores of women without UI and those who experienced UI of varying severities. Correlation coefficients were estimated, and multivariate linear regression was conducted to examine the relationships between UI severity, sleep quality, and HRQoL.

RESULTS

Of the 237 women, 115 (48.52%) experienced UI and 139 (58.65%) were poor sleepers. The three factors associated with UI were advanced age, a higher body mass index, and a history of vaginal delivery. Significant associations between UI severity and sleep quality and between sleep quality and HRQoL were revealed. UI severity and night-time voiding frequency were both associated with sleep quality.

CONCLUSIONS

One factor associated with UI (body mass index) is modifiable. UI severity is associated with sleep quality as the possible influence of night-time voiding frequency on sleep quality has been considered.

Incidence and risk factors for postoperative urinary incontinence after various prostate enucleation procedures: systemic review and meta-analysis of PubMed literature from 2000 to 2021

PURPOSE

To evaluate the risk of urinary incontinence (UI) after various prostate enucleation procedures (PEP).

METHODS

PubMed was searched from January 2000 to July 2021 for studies investigating UI after PEP. The articles were divided into 5 subgroups: holmium, thulium, greenlight laser, electrocautery, and simple prostatectomy. Meta-analysis was performed to examine rate of stress (SUI), urge (UUI) or unspecified UI at short (< 3 months), intermediate (3-6 months), and long-term (> 6 months). The impact of age, prostate size, surgery time, laser time, postoperative nadir PSA level and technical modifications on UI was analyzed.

RESULTS

Most (69.4%) of 49 articles included employed holmium laser. There was no significant difference in incidence of short-, intermediate-, and long-term UI, SUI and UUI between five sub-groups and within different technical modifications. Although not statistically significant, the incidence of UI was higher (15%) at short-term with green-light and simple prostatectomy (95% CI 9-23 and 1-84), and higher (4%) at intermediate-term with holmium laser (95% CI 2-8). SUI was more prevalent at short-term with holmium laser (4%; 95% CI 2-5%), and at intermediate term with simple prostatectomy (3%; 95% CI 1-14). UUI was higher in the thulium group (10%, 95% CI 7-16). Increased age, surgery time, laser time and prostate size up to 80 cc were associated with higher UI. There was no correlation between postoperative PSA and UI.

CONCLUSIONS

There is no significant difference in incidence of UI, SUI and UUI after various PEP. Patients age, prostate size, surgery and laser time are linearly associated with UI.

Sarcopenia reduces quality of life in the long-term: longitudinal analyses from the English longitudinal study of ageing

Aim

To examine the association between sarcopenia at baseline and changes in quality of life at 10 years follow-up in a large representative sample of older English adults.

Findings

After considering numerous confounders, sarcopenia at baseline was associated with a higher incidence of poor quality of life. People having sarcopenia at baseline reported significantly lower values in CASP-19 after ten years of follow-up.

Message

Sarcopenia is an important and independent risk factor for poor quality of life in older people.

Purpose

Mixed findings exist for sarcopenia/quality of life (QoL) relationship. Moreover, the majority of studies in this area have utilized a cross-sectional design or specific clinical populations. Therefore, the aim of the present study was to examine the association between sarcopenia at baseline and QoL at 10 years follow-up in a large representative sample of older English adults.

Methods

Sarcopenia was diagnosed as having low handgrip strength and low skeletal muscle mass index. QoL was measured using the CASP (control, autonomy, self-realisation and pleasure)-19, with higher values reflecting higher QoL. Multivariable logistic regression analysis was conducted to assess prospective associations between sarcopenia at baseline and poor QoL at follow-up; generalized linear model with repeated measures was used for reporting mean changes during follow-up between sarcopenia and not.

Results

Among 4044 older participants initially included at baseline (mean age: 70.7 years; 55.1% females), 376 had sarcopenia. In the multivariable analysis, after adjusting for several potential confounders, sarcopenia at baseline was associated with a higher incidence of poor QoL (odds ratio, OR = 5.82; 95% confidence interval, CI 3.45–9.82). After matching for QoL values at baseline and adjusting for potential confounders, people with sarcopenia reported significantly lower values in CASP-19 (mean difference = − 3.94; 95% CI − 4.77 to − 3.10).

Conclusions

In this large representative sample of older English adults, it was observed that sarcopenia at baseline was associated with worse scores of QoL at follow-up compared to those without sarcopenia at baseline. It may be prudent to target those with sarcopenia to improve QoL.