1879 ASSOCIATION OF PELVIC FLOOR SYMPTOMS AND BONE MINERAL DENSITY IN WOMEN PRESENTING FOR OSTEOPOROSIS EVALUATION

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology II1 Apr 20121879 ASSOCIATION OF PELVIC FLOOR SYMPTOMS AND BONE MINERAL DENSITY IN WOMEN PRESENTING FOR OSTEOPOROSIS EVALUATION Holly Richter, PhD, MD Sarah Morgan, MD Jonathan Gleason, MD Ligong Chen, PhD Jeffrey Szychowski, PhD Patricia Goode, MD Alice Howell, andRN, BSN, CCRC Kathryn BurgioPhD Holly RichterHolly Richter Birmingham, AL More articles by this author , Sarah MorganSarah Morgan Birmingham, AL More articles by this author , Jonathan GleasonJonathan Gleason Birmingham, AL More articles by this author , Ligong ChenLigong Chen Birmingham, AL More articles by this author , Jeffrey SzychowskiJeffrey Szychowski Birmingham, AL More articles by this author , Patricia GoodePatricia Goode Birmingham, AL More articles by this author , Alice HowellAlice Howell Birmingham, AL More articles by this author , and Kathryn BurgioKathryn Burgio Birmingham, AL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2033AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Connective tissue and other extracellular matrix abnormalities are associated with the development of pelvic floor disorders including incontinence (urinary and fecal) and pelvic organ prolapse in women. Low bone mineral density (BMD) also reflects deficits in bone connective tissue qualities including mass, matrix and microarchitectural abnormalities. Pelvic floor symptoms were characterized in post-menopausal women presenting for evaluation to an Osteoporosis Clinic. METHODS Validated pelvic floor symptom questionnaires were mailed to patients in an IRB-approved osteoporosis database (January, 2007-October, 2010). Questions assessed urinary incontinence (UI) in the past 3 months, UI frequency and severity, incontinence of liquid/solid stool over the past month, and bothersome prolapse symptoms. Multivariable logistic regression models controlling for age, race, body mass index, and COPD were performed to compare symptoms in women with osteopenia (T-score <−1 to >−2.5) and osteoporosis at any site (T-score: ≤−2.5) to women with normal BMD (T-score: ≥−1, referent). RESULTS 1774/4026 (44%) questionnaires were returned. 1655 postmenopausal women with BMD diagnoses were included in the analyses (423 normal BMD, 870 osteopenia, 362 osteoporosis). Mean (±SD) age was 63(±9) years. Overall prevalence of UI was 1226 (75%) with UI frequency ≥2-3 times/week in 699 (58%), fecal incontinence in 247 (16%), and bothersome prolapse symptoms in 162 (10%). Prevalence of prolapse symptoms did not differ by BMD group (p=0.87). Multivariable analyses revealed that women with osteoporosis had increased risk of incontinence of solid stool (OR: 1.8, 95% CI: 1.2-2.8) as compared to women with normal BMD. Risk of UI ≥2-3 times/week was not increased in women with osteoporosis (OR: 0.9, 95% CI: 0.6, 1.3) and was lower in women with osteopenia (OR: 0.7, 95% CI: 0.5-0.9). Multivariable analysis in the subset of women with osteoporosis revealed that the odds of moderate/large volume urine loss vs small/none was higher for lowest T-score quartile (lower BMD), OR: 1.42, 95% CI: 1.08-1.88. CONCLUSIONS In a cohort of women undergoing BMD evaluation, those with osteoporosis were at increased risk of solid stool incontinence, but not UI. Women with osteoporosis and lowest quartile T-scores (lowest BMD) had an increased risk of moderate/large volume UI. Further studies should target the evaluation of connective tissue markers and pathological mechanisms linking low BMD and pelvic floor symptoms. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e759 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Holly Richter Birmingham, AL More articles by this author Sarah Morgan Birmingham, AL More articles by this author Jonathan Gleason Birmingham, AL More articles by this author Ligong Chen Birmingham, AL More articles by this author Jeffrey Szychowski Birmingham, AL More articles by this author Patricia Goode Birmingham, AL More articles by this author Alice Howell Birmingham, AL More articles by this author Kathryn Burgio Birmingham, AL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...