Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up.

Hsiao-Jen Chung,Alex Tong-Long Lin,Chih-Chieh Lin,Tzeng-Ji Chen,Kuang-Kuo Chen,Weili Zhang

doi:10.1371/journal.pone.0161223

Hsiao-Jen Chung, Alex Tong-Long Lin + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0161223

Copy DOI

Abstract

This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values < 0.0001). Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70–2.34, p < 0.001). Age and metabolic syndrome status were both associated with developing upper urinary tract stones (both p-values < 0.0001). After adjusting for metabolic syndrome, regression analysis showed that urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76–2.26, p < 0.0001). Long-term follow-up of Taiwanese patients with primary urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones.

Highlights

Primary urinary incontinence (UI) is loss of bladder control, which can be as simple as mild leakage of urine or as severe as uncontrolled voiding
The prevalence of UI is of great concern, but an even greater concern may be its possible association with development of upper urinary tract stones, as suggested by the dual associations between metabolic syndrome (MetS) and UI and between MetS and development of urinary calculi [3]
Analysis revealed that a greater percentage of subjects with UI developed upper urinary tract stones than did those in all control groups without UI, 334 (18.8%) of the study subjects, 865 (9.7%) of control group A subjects, 888 (10%) of control group B subjects, and 930 (10.5%) of control group C developed upper urinary tract stones (Table 1)

Summary

Introduction

Primary urinary incontinence (UI) is loss of bladder control, which can be as simple as mild leakage of urine or as severe as uncontrolled voiding. It is commonly associated with aging, and women are affected more than men, primarily pre-menopausal and menopausal women [1]. MetS is closely linked to the severity of lower urinary tract symptoms and voiding dysfunction, especially overactive bladder and UI [3,4]. In community-dwelling Taiwanese men and women, overactive bladder or urge incontinence was reported by 19.8% of subjects and UI was reported by 19.5% of subjects [1]. The prevalence of UI is of great concern, but an even greater concern may be its possible association with development of upper urinary tract stones, as suggested by the dual associations between MetS and UI and between MetS and development of urinary calculi [3]

Objectives

Methods

Results

Discussion

Conclusion