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Scharp D, Harkins SE, Topaz M. Comorbidities of community-dwelling older adults with urinary incontinence: A scoping review. Geriatr Nurs 2023; 53:280-294. [PMID: 37598432 PMCID: PMC10529939 DOI: 10.1016/j.gerinurse.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Identifying comorbidities is a critical first step to building clinical phenotypes to improve assessment, management, and outcomes. OBJECTIVES 1) Identify relevant comorbidities of community-dwelling older adults with urinary incontinence, 2) provide insights about relationships between conditions. METHODS PubMed, Cumulative Index of Nursing and Allied Health Literature, and Embase were searched. Eligible studies had quantitative designs that analyzed urinary incontinence as the exposure or outcome variable. Critical appraisal was performed using the Joanna Briggs Institute Critical Appraisal Checklists. RESULTS Ten studies were included. Most studies had methodological weaknesses in the measurement of conditions. Comorbidities affecting the neurologic, cardiovascular, psychologic, respiratory, endocrine, genitourinary, and musculoskeletal systems were found to be associated with urinary incontinence. CONCLUSION Existing literature suggests that comorbidities and urinary incontinence are interrelated. Further research is needed to examine symptoms, shared mechanisms, and directionality of relationships to generate clinical phenotypes, evidence-based holistic care guidelines, and improve outcomes.
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Affiliation(s)
- Danielle Scharp
- Columbia University School of Nursing, 560 West 168(th) Street, New York, NY 10032, United States.
| | - Sarah E Harkins
- Columbia University School of Nursing, 560 West 168(th) Street, New York, NY 10032, United States.
| | - Maxim Topaz
- Columbia University School of Nursing, 560 West 168(th) Street, New York, NY 10032, United States.
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2
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Mariani A, Gambazza S, Carta F, Ambrogi F, Brivio A, Bulfamante AM, Daccò V, Bassotti G, Colombo C. Prevalence and factors associated with urinary incontinence in females with cystic fibrosis: An Italian single-center cross-sectional analysis. Pediatr Pulmonol 2022; 57:132-141. [PMID: 34636479 DOI: 10.1002/ppul.25723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/29/2021] [Accepted: 10/10/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Individuals with cystic fibrosis (CF) are deemed to have a higher risk of developing urinary incontinence (UI), likely due to repeated increasing pressure on the pelvic floor. We aimed to determine the prevalence of female UI in a large CF referral center, and to assess the association between UI and severity of CF disease. METHODS We consecutively recruited female patients regularly attending our CF center, aged ≥6 years and with a confirmed diagnosis of CF. Prevalence, severity, and impact of UI were assessed by administering two validated questionnaires. Relationship between variables was evaluated by means of multiple correspondence analysis, whereas a logistic model was fitted to capture the statistical association between UI and independent variables. RESULTS UI was present in 51/153 (33%, 95% confidence interval [CI]: 26%-41%) females. Among children and adolescents, the prevalence was 12/82 (15%, 95% CI: 8%-25%) whereas among adults was 39/71 (55%, 95% CI: 43%-67%). The only explanatory variable associated with UI was age, with children presenting the lowest risk (odds ratio, 0.32; 95% CI: 0.05-0.93). Females presenting low or high nutritional status show higher profile risk of having UI. CONCLUSIONS Stress UI is a common complication in females with CF since childhood. Although it frequently occurs in older patients with a more severe phenotype, much attention should be paid to adults and to their nutritional status.
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Affiliation(s)
- Alessandra Mariani
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Simone Gambazza
- Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Federica Carta
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Federico Ambrogi
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Anna Brivio
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Anna M Bulfamante
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Valeria Daccò
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giacomo Bassotti
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Direzione delle Professioni Sanitarie, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Carla Colombo
- Cystic Fibrosis Centre, Fondazione IRCCS Ca', Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
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Haukeland-Parker S, Frisk B, Spruit MA, Stafne SN, Johannessen HH. Treatment of urinary incontinence in women with chronic obstructive pulmonary disease-a randomised controlled study. Trials 2021; 22:900. [PMID: 34895285 PMCID: PMC8665568 DOI: 10.1186/s13063-021-05816-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known regarding treatment of urinary incontinence (UI) in women with chronic obstructive pulmonary disease (COPD). The aim of the study was to explore the efficacy of pelvic floor muscle training (PFMT) or cough-suppression techniques (CST) on UI in women with COPD. METHODS A three-armed, two-centred, single-blinded, randomised controlled study was performed. Subjects were randomised to (a) PFMT for 16 weeks, (b) 2-3 educational sessions in CST, or (c) written information only. All participants completed questionnaires about UI, cough symptoms, and health status and underwent clinical examinations to evaluate the strength of the pelvic floor muscles and exercise capacity. Daily physical activity levels were measured using an activity monitor and lung function with spirometry. With a significance level of 5% and an 80% chance of detecting a significant difference between groups of 2.5 points on the ICIQ UI SF score, our sample size calculation showed that a total of 78 women, 26 in each group, was required to complete the study. RESULTS During the period 2016 to 2018, 95 women were invited to the study. A total of 42 were recruited, three were excluded and 10 (24%) dropped out during the follow-up period. Mean ICIQ-UI SF total baseline score was 9.6 (range: 1-17) and 7.0 (range: 0-16) at follow-up. Changes in subjective UI as measured with the ICIQ-UI SF questionnaire were seen in the PFMT group and control group, but not in the CST group. CONCLUSION Due to the low number of available participants and recruitment difficulties including practical issues such as travel distance, lack of interest, poor state of health, and high number of comorbidities, our results are inconclusive. However, reduced subjective UI was observed in the PFMT and control groups with a trend towards best effect in the PFMT group. Screening for UI is advisable in all women with COPD to be able to identify and treat these women to reduce symptom burden and improve quality of life. Future studies should focus on barriers to recruitment as well as randomised controlled studies with larger sample sizes. TRIAL REGISTRATION ClinicalTrials.gov NCT02614105. 25th November 2015.
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Affiliation(s)
| | - Bente Frisk
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Martijn A Spruit
- Department of Research and Development, CIRO+, Horn, The Netherlands.,Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.,Faculty of Health, Medicine and Life Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Signe Nilssen Stafne
- Department of Public Health and Nursing, NTNU Faculty of Medicine and Health Sciences, Trondheim, Norway.,Clinical Services, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Hege Hølmo Johannessen
- Department of Physical Medicine and Rehabilitation, Østfold Hospital Trust, Grålum, Norway.,Faculty of Nursing, health and laboratory science, Østfold University College, Fredrikstad, Norway
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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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