1
|
Huang H, Ding G, Li M, Deng Y, Cheng Y, Jin H. Menopause and stress urinary incontinence: The risk factors of stress urinary incontinence in perimenopausal and postmenopausal women. J Obstet Gynaecol Res 2023; 49:2509-2518. [PMID: 37443520 DOI: 10.1111/jog.15742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE The prevalence of stress urinary incontinence (SUI) increases around menopause. The quality of life of perimenopausal and postmenopausal women with SUI is significantly affected. This study aimed to investigate the prevalence of SUI and the associated risk factors in a population of Chinese perimenopausal and postmenopausal women. METHODS A total of 273 perimenopausal and postmenopausal women were enrolled, and a cross-sectional study was conducted. SUI was defined as an involuntary loss of urine with increases in abdominal pressure. Data including personal characteristics, menopause information, estrogen levels, and pelvic floor muscle strength levels were statistically analyzed. RESULTS The study enrolled 158 (57.9%) perimenopausal and 115 (42.1%) postmenopausal women. Sixty-six (41.8%) perimenopausal women and 56 (48.7%) postmenopausal women complained of SUI. The mean age was 49.42 ± 5.58 years. Body mass index over 24 kg/m2 (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.07-3.81), vaginal delivery (OR 2.47, 95% CI 1.33-4.58), and diabetes (OR 4.65, 95% CI 1.23-17.62) were high-risk factors for SUI. Climacteric symptoms (evaluated by Kupperman index scores) were statistically related to SUI, and among the 13 symptoms, insomnia, nervousness, weakness and fatigue, arthralgia and myalgia, headache, palpitation, and sexual complaints were all correlated with SUI in perimenopausal and postmenopausal women. CONCLUSIONS Several factors are associated with SUI in Chinese perimenopausal and postmenopausal women. Obesity, vaginal delivery, climacteric symptoms, and diabetes were identified as the most notable risk factors. The management strategy could focus on the prevention and management of risk factors.
Collapse
Affiliation(s)
- He Huang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Guowei Ding
- Division of HCV and STD Prevention and Treatment National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mei Li
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Yu Deng
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Yan Cheng
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Hongyan Jin
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| |
Collapse
|
2
|
Shabani F, Montazeri M, Alizadeh A, Bani S, Hassanpour S, Nabighadim M, Mirghafourvand M. The relationship between urinary incontinence with sexual function and quality of life in postmenopausal women. Post Reprod Health 2023; 29:15-23. [PMID: 36749321 DOI: 10.1177/20533691231155734] [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: 02/08/2023]
Abstract
BACKGROUND Urinary incontinence has a significant impact on the psychosocial well-being of postmenopausal women. This study aimed to determine the relationship between urinary incontinence with sexual function and quality of life. METHOD It was a cross-sectional study using cluster sampling on 433 postmenopausal women in Tabriz-Iran, 2021-2022. Data were collected using questionnaires of socio-demographic and obstetrics characteristics, female sexual function index (FSFI), Menopause-Specific Quality of Life (MENQOL), and Urinary Incontinence Diagnosis (UIDQ). Independent sample t-test and general linear model (GLM) were used to compare the quality of life and sexual function score between the two groups of women with and without stress, urgency, and mixed urinary incontinence. RESULTS Independent sample t-test showed a significant difference in the quality of life and sexual function between women with and without stress, urgency, and mixed urinary incontinence (p < 0.05). Based on the GLM with adjusting the socio-demographic and obstetrics characteristics, women without stress incontinence reported a lower mean score of MENQOL (B = - 23.38; 95% CI = -30.1 to -16.6; p < 0.001) and a higher mean score of sexual function (B = 4.5; 95% CI = 2.1-7.0; p < 0.001) compared to women with stress incontinence; a lower MENQOL score and a higher sexual function score indicate better condition. However, there was no significant relationship between urgency and mixed incontinence with quality of life and sexual function (p > 0.05). CONCLUSION As urinary incontinence remarkably affects sexual function and quality of life of postmenopausal women, health care providers should consider better solutions for this issue in their work program.
Collapse
Affiliation(s)
- Fatemeh Shabani
- Midwifery Department, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- Midwifery Department, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Afsaneh Alizadeh
- Midwifery Department, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Soheila Bani
- Physical Medicine and Rehabilitation Research Center, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shirin Hassanpour
- Women's Reproductive Health Research Center, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsan Nabighadim
- Department of Medicine, Faculty of Medicine, 48413Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
3
|
Whitney KE, Holtzman B, Cook D, Bauer S, Maffazioli GDN, Parziale AL, Ackerman KE. Low energy availability and impact sport participation as risk factors for urinary incontinence in female athletes. J Pediatr Urol 2021; 17:290.e1-290.e7. [PMID: 33622629 DOI: 10.1016/j.jpurol.2021.01.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/24/2020] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Relative Energy Deficiency in Sport (RED-S) is a clinical syndrome that includes the many complex health and performance consequences of low energy availability (EA) in athletes, when there is insufficient caloric intake to meet exercise-related energy expenditure and to support basic physiologic functions. There is a high prevalence of urinary incontinence (UI) in female athletes and it is more common in female athletes than non-athletes. The objective of this study was to determine if low EA is associated with UI in a population of adolescent and young adult female athletes and to evaluate for an association between sport categories and UI. MATERIAL AND METHODS 1000 nulliparous female patients, ages 15-30 years, presenting to a sports medicine subspecialty clinic, provided informed consent/assent to participate in a cross-sectional study involving a comprehensive survey, anthropomorphic measurements, and medical record review. Low EA was defined as meeting ≥1 criterion: self-reported history of eating disorder/disordered eating (ED/DE), and/or a high score on the Brief Eating Disorder in Athletes Questionnaire (BEDA-Q), and/or a high score on the Eating Disorder Screen for Primary Care (ESP). UI was assessed using questions adapted from the International Consultation on Incontinence-Urinary Incontinence Short Form (ICIQ-UI-SF), questions regarding timing of UI onset/duration, and a binary question regarding UI during sport activities. A total of 36 sport types were included in the survey and sub-divided into categories. RESULTS AND DISCUSSION Of the 1000 female athletes surveyed, 165 (16.5%) reported a history of experiencing UI during athletic activities. ICIQ- UI-SF responses indicated that 14% (137/1000) of the cohort experienced slight incontinence, 4% (35/1000) moderate incontinence, and 2 athletes experienced severe incontinence. There was a significant difference between UI categories in age (p = 0.01), low EA (p < 0.001), and sport category (p < 0.001). Females who had low EA had twice the likelihood (OR = 1.97; 95% CI = 1.39 to 2.81; p < 0.001) of UI compared to those with adequate EA, controlling for sports category and menstrual dysfunction. Females who participated in high impact sports were 4.5 times more likely (OR = 4.47; 95% CI = 2.29 to 8.74; p < 0.001) to have had UI compared to females who participated in ball sports, controlling for EA and menstrual dysfunction. CONCLUSIONS UI during athletic activities is a common problem among nulliparous adolescent and young adult female athletes, occurring in 16.5% of female athletes surveyed. UI was significantly associated with low EA across all sport categories. Sport type was significantly associated with UI, with the highest impact sport group demonstrating a higher prevalence and symptom severity compared to other sport categories.
Collapse
Affiliation(s)
- Kristin E Whitney
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, Ste 6, Boston, MA, 02115, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Bryan Holtzman
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, Ste 6, Boston, MA, 02115, USA; Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Danielle Cook
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, Ste 6, Boston, MA, 02115, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Stuart Bauer
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Department of Urology, Boston Children's Hospital 300 Longwood Ave, Boston, MA, 02115, USA.
| | - Giovana D N Maffazioli
- Departamento de Obstetricia e Ginecologia, Hospital Das Clinicas da Faculdade de Medicina, Universidade de Sao Paulo, Rua, Av. Dr. Enéas Carvalho de Aguiar, 255 - Cerqueira César, São Paulo, SP, 05403-000, Brazil.
| | - Allyson L Parziale
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, Ste 6, Boston, MA, 02115, USA; Johns Hopkins University School of Nursing 525 N Wolfe St, Baltimore, MD, 21205, USA.
| | - Kathryn E Ackerman
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, Ste 6, Boston, MA, 02115, USA; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA; Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, 457B, Boston, MA, 02114, USA.
| |
Collapse
|
4
|
Geng L, Zheng Y, Zhou Y, Li C, Tao M. The prevalence and determinants of genitourinary syndrome of menopause in Chinese mid-life women: a single-center study. Climacteric 2018; 21:478-482. [PMID: 29734845 DOI: 10.1080/13697137.2018.1458832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study aimed to explore the prevalence and determinants of genitourinary syndrome of menopause (GSM) in Chinese mid-life women. METHODS A cross-sectional single-center study was performed among 40-65-year-old women who participated in physical examinations at Shanghai Jiao Tong University Affiliated Sixth People's Hospital from December 2015 to December 2016. The participating women were questioned about their genitourinary symptoms, and the relationships between these symptoms and the women's demographic characteristics were evaluated. RESULTS The prevalence of GSM was 30.8%, the most frequent symptom was decreased sexual desire (18.4%), and the frequency of vulvovaginal symptoms and lower urinary tract symptoms was 17.5% and 14.8%, respectively. In addition, most of the symptoms were mild. In postmenopausal women, the prevalences of GSM and the three aforementioned symptoms were higher than those in perimenopausal women (p < 0.05). Based on binary logistic regression analysis, GSM was found to be associated with postmenopause (p = 0.007; odds ratio (OR) 1.52), at least two abortions (p = 0.035; OR 1.42), body mass index (BMI) ≥ 30 kg/m2 (p = 0.032; OR 1.91) and diabetes (p = 0.041; OR 1.94). CONCLUSIONS GSM is common in Chinese mid-life women, and associations between GSM and postmenopause, abortion, BMI and diabetes were identified. Health-care practitioners should actively discuss urogenital symptoms with middle-aged female patients and take appropriate interventions to improve the health of their urogenital tract and quality of life.
Collapse
Affiliation(s)
- L Geng
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Y Zheng
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Y Zhou
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - C Li
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - M Tao
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| |
Collapse
|
5
|
Application of the 21-item Vulvovaginal Symptoms Questionnaire in postmenopausal Spanish women. Menopause 2017; 24:1295-1301. [DOI: 10.1097/gme.0000000000000948] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Martinho NM, Silva VR, Marques J, Carvalho LC, Iunes DH, Botelho S. The effects of training by virtual reality or gym ball on pelvic floor muscle strength in postmenopausal women: a randomized controlled trial. Braz J Phys Ther 2017; 20:248-57. [PMID: 27437716 PMCID: PMC4946841 DOI: 10.1590/bjpt-rbf.2014.0148] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/12/2015] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the effectiveness of abdominopelvic training by virtual reality
compared to pelvic floor muscle training (PFMT) using a gym ball (a previously
tested and efficient protocol) on postmenopausal women’s pelvic floor muscle (PFM)
strength. Method A randomized controlled trial was conducted with 60 postmenopausal women, randomly
allocated into two groups: Abdominopelvic training by virtual reality – APT_VR
(n=30) and PFMT using a gym ball – PFMT_GB (n=30). Both types of training were
supervised by the same physical therapist, during 10 sessions each, for 30
minutes. The participants’ PFM strength was evaluated by digital palpation and
vaginal dynamometry, considering three different parameters: maximum
strength, average strength and endurance. An
intention-to-treat approach was used to analyze the participants according to
original groups. Results No significant between-group differences were observed in most analyzed
parameters. The outcome endurance was higher in the APT_VR group (p=0.003; effect
size=0.89; mean difference=1.37; 95% CI=0.46 to 2.28). Conclusion Both protocols have improved the overall PFM strength, suggesting that both are
equally beneficial and can be used in clinical practice. Muscle endurance was
higher in patients who trained using virtual reality.
Collapse
Affiliation(s)
- Natalia M Martinho
- Curso de Fisioterapia, Escola de Enfermagem, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, MG, Brazil
| | - Valéria R Silva
- Curso de Fisioterapia, Escola de Enfermagem, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, MG, Brazil.,Departamento de Cirurgia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Joseane Marques
- Curso de Fisioterapia, Escola de Enfermagem, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, MG, Brazil.,Departamento de Cirurgia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Leonardo C Carvalho
- Curso de Fisioterapia, Escola de Enfermagem, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, MG, Brazil
| | - Denise H Iunes
- Curso de Fisioterapia, Escola de Enfermagem, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, MG, Brazil
| | - Simone Botelho
- Curso de Fisioterapia, Escola de Enfermagem, Universidade Federal de Alfenas (UNIFAL-MG), Alfenas, MG, Brazil.,Departamento de Cirurgia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| |
Collapse
|
7
|
Trutnovsky G, Dietz HP. The complexity of hormone therapy in urogynaecology. Maturitas 2014; 78:71. [DOI: 10.1016/j.maturitas.2014.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
|
8
|
Otunctemur A, Dursun M, Ozbek E, Sahin S, Besiroglu H, Koklu I, Erkoc M, Danis E, Bozkurt M. Impact of metabolic syndrome on stress urinary incontinence in pre- and postmenopausal women. Int Urol Nephrol 2014; 46:1501-5. [DOI: 10.1007/s11255-014-0680-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/19/2014] [Indexed: 10/25/2022]
|