Prevalence of overactive bladder and stress urinary incontinence in women who have sex with women: an internet-based survey.

Abstract

Women who have sex with women (WSW) are a medically underserved population. Data on urologic health in WSW are scant. We hypothesized that the prevalence of urinary symptoms in WSW is similar to population norms and that urinary symptoms in WSW would be associated with known risk factors for urologic problems. WSW were recruited to participate in an internet-based survey via invitations, listserves, and social media. Primary outcome measures were the validated Overactive Bladder Questionnaire (OAB-q) and a single question assessing stress urinary incontinence (SUI). OAB status was dichotomized by OAB-q score (0-8=none/mild; >8=moderate/severe). SUI was dichotomized by single item response (none/little bit of the time=none/mild; sometimes through always=moderate/severe). Ethnodemographic, health, sexuality, and relationship data was also collected. Multivariable logistic regression utilizing 17 factors was performed with SAS V9.2, followed by multivariable analysis with stepwise selection based on the initial analysis (included factors, p<0.25). The final study population consisted of 1,566 adult WSW with mean age 34.6±10.4 years. Moderate/severe OAB was present in 354 (23%) women; 275 (18%) reported moderate /severe SUI. Concomitant OAB and SUI were present in 183 (12%). In multivariable analysis with stepwise selection, OAB symptoms were significantly associated with diabetes, history of urinary tract infection, gynecologic surgery, routine health care, and consultation with a provider regarding urinary symptoms. SUI symptoms were associated with sexual bother. This is the first survey report of prevalence and associations of OAB and SUI in a population of WSW. SUI and OAB were prevalent in WSW. Further attention to urological health in WSW is warranted.