Factors Of Stress Urinary Incontinence Research Articles

Incidence and risk factors of stress urinary incontinence after laparoscopic hysterectomy

ObjectiveTo observe the long-term effects of total hysterectomy on urinary function, evaluate the effects of preoperative nutritional status, urinary occult infection, and surgical factors on the induction of postoperative stress urinary incontinence (SUI), and explore the incidence and risk factors of SUI.Study designFrom January 2017 to December 2017, 164 patients with benign non-prolapsing diseases who underwent a laparoscopic total hysterectomy in the First People's Hospital of Taicang were selected as the analysis objects. The International Incontinence Standard Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Pelvic Floor Impact Questionnaire-short version 20 (PFDI-20) were used for telephone follow-up to subjectively assess the urinary function of patients, collect their medical records, and statistically analyze the number of postoperative SUI cases. Logistic multivariate analysis was used to analyze the influencing factors of postoperative female SUI, presented as adjusted odds ratios with 95% confidence intervals.ResultsOnly 97 out of 164 patients completed the ICIQ-FLUTS and PFDI-20 questionnaires. Among these participants, 28 patients (28.86%) were diagnosed with SUI (study group), while 69 patients (71.13%) were classified as women without SUI (control group). The age, menopause, parity ≥ 2 times, Body mass index (BMI) ≥ 28 kg/m2, neonatal weight ≥ 4000 g, history of chronic cough, preoperative hemoglobin ≤ 100 g/L, preoperative urine bacteria ≥ 100u/L, preoperative uterine volume ≥ 90 cm3, intraoperative blood loss, and operation time of the study group were compared with those of the control group. The differences were statistically significant (P < 0.05). Further Logistic multivariate analysis showed that menopause, preoperative hemoglobin ≤ 100 g/L, preoperative urine bacteria ≥ 100u/L, uterine volume ≥ 90 cm3, history of chronic cough, BMI ≥ 28 kg/m2 were risk factors for postoperative SUI in patients undergoing hysterectomy (P < 0.05).ConclusionsHysterectomy for benign non-prolapse diseases has a long-term potential impact on the urinary system of patients, and the risk of postoperative SUI increases. The main risk factors of SUI are parity, menopausal status, obesity, preoperative nutritional status, and occult infection of the urinary system.

Menopause and stress urinary incontinence: The risk factors of stress urinary incontinence in perimenopausal and postmenopausal women.

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. 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. 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. 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.

The Role of Body Mass Index and Waist Circumference in Gender-Specific Risk Factors for Stress Urinary Incontinence: A Cross-Sectional Study.

Background Urinary incontinence is the loss of bladder control and is a common condition found more often in women. Incontinence can present in several ways. The various forms of incontinence include urgency urinary incontinence, stress urinary incontinence, and mixed urinary incontinence (a combination of both stress urinary incontinence and urgency urinary incontinence). Studies have been conflicting on the prevalence of UI in obese women compared to non-obese women. The subtypes of incontinence may play a role in the discrepancy currently found in research.In addition to the discrepancy seen between subtypes, there may be a reason to believe there is a difference in incontinence presentation and treatment across genders. Our research strives to understand the influences of gender, obesity, and waist circumference on different types of incontinence. Methodology Data were gathered from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey dataset. Questionnaire data from March 2017 through March 2020 categorized as "Kidney Conditions - Urology" and "Weight History" were collected. Binary logistic regressions were performed to examine the association between variables associated with obesity including body mass index (BMI) and waist circumference and if the participant had a urine leak during physical activities. Covariates such as waist circumference, gender, age, race, educational level, and marital status were controlled for. Results We found that stress incontinence was positively associated with BMI, waist circumference, and age in men with regression coefficients of 0.038, 0.014, and 0.027, respectively, with a p-value <0.05. In women, stress incontinence was also associated with BMI, waist circumference, and age in addition to being white and being married. Linear regression coefficients were 0.036, 0.019, 0.015, -0.473, and -0.285, respectively, with p-values <0.05. Conclusions Our results suggest that BMI, waist circumference, and age are positively correlated with stress incontinence in both men and women. This is consistent with previous literature yet novel in evaluating stress incontinence in men. This would indicate that stress incontinence is similar among men and women which would indicate that weight loss is a therapeutic target for the treatment of stress incontinence in men. However, our findings additionally highlight the correlation between stress incontinence in women and race, a relationship not seen in men. This identifies a possible difference in the pathophysiology of stress incontinence across genders and would require further investigation into therapeutic treatments in men.

Postpartum stress urinary incontinence: a clinical study of 6,302 cases in Jiangsu Province.

To investigate the prevalence and influencing factors of stress urinary incontinence (SUI) within 6-8 weeks postpartum in Jiangsu Province. We designed a multi-center cross-sectional study involving seven hospitals in Jiangsu province, and enrolled women who underwent postpartum examination at 6-8 weeks in these hospitals between July 2019 and June 2021. According to the presence or absence of SUI, the enrolled patients were divided into two groups: the SUI group and the non-SUI group, respectively. We assessed the general health status, noted the details of delivery, and checked the pelvic floor electromyographic parameters of the postpartum women in both groups. Among 6,302 cases of postpartum women in Jiangsu province, there were 1,579 cases of SUI, with a prevalence of 25.06%. The prevalence of SUI increased significantly with age, BMI, increasing parity, coexisting constipation, organ prolapse, and diastasis recti abdominis. Compared to the non-SUI group, the SUI group had a lower mean value of the pre-baseline rest phase, shorter rise and fall times of fast muscle contractions, and a lower mean value of the endurance contraction phase. Multiple regression analysis revealed associations with weight (especially overweight and obesity), coexisting organ prolapse, constipation, parity, gestational week of delivery, mode of delivery, and mean value of endurance contraction phase. The prevalence of postpartum stress urinary incontinence in Jiangsu Province was 25.06%, and was linked to being overweight, parity > 2, coexisting organ prolapse, constipation, and a decrease in the mean value of the endurance contraction phase of the electromyograph. In this report, we offer a theoretical basis for the effective prevention of postpartum SUI clinically.

Overview of risk factors for stress urinary incontinence and strategies in its prevention and treatment

Stress urinary incontinence is a medical problem that afflicts women worldwide. The causes can be mainly divided into 4 parts: increased abdominal pressure and chronic ischemia of pelvic floor muscles, endocrine changes, pelvic structural damages, inflammatory and consumptive states. The choice of prevention and treatment should also be based on a comprehensive assessment of individualized factors. Treatment techniques which are more minimally invasive or even non-invasive than surgery are currently a hot topic of research in the field of pelvic floor and urinary control, including laser and radiofrequency therapy, periurethral injection therapy, exogenous stem cell therapy and technology for activation of endogenous stem cells. They are expected to solve the clinical problem of stress urinary incontinence with a wider scope of application, lower trauma and fewer complications in the future.

Identification of potential associated factors for stress urinary incontinence in women: a retrospective study.

BackgroundThis study sought to analyze the potential associated factors for female stress urinary incontinence (SUI).MethodsA total of 5,013 women were screened for pelvic floor function at the West China Second Hospital of Sichuan University from January 2015 to January 2019. Of these, 410 patients were diagnosed with SUI. A single-factor Chi-square test and multi-factor logistic regression analysis were conducted to examine the relationship between pre-pregnancy urinary incontinence, vaginal delivery, menopause, and hormone therapy, chronic cough, and smoking, and postpartum SUI.ResultsThe postpartum SUI rate in patients with urinary incontinence during pregnancy was 19.33%, while that of patients without urinary incontinence was only 5.44%. The rates of urinary incontinence in patients experiencing vaginal delivery or cesarean delivery were 13.62% and 4.36%, respectively. The SUI incidences in patients with or without a family genetic history of SUI were 28.46% and 7.48%, respectively. The incidence rates of SUI in smoking and non-smoking patients were 18.92% and 8.39%. The rate of SUI in patients with chronic cough (16.46%) behaved significantly differently from those with non-chronic cough (8.21%). The occurrence of SUI was highly correlated with the following factors, including pre-pregnancy urinary incontinence (OR =5.256; 95% CI: 2.061–13.409; P<0.001), urological incontinence during the pregnancy period (OR =2.965; 95% CI: 2.111–4.163; P<0.001), vaginal delivery (OR =4.028; 95% CI: 2.909–5.577; P<0.001), and genetic history (OR =4.341; 95% CI: 2.8–6.73; P<0.001).ConclusionsThe occurrence of SUI is highly related to a history of urinary incontinence, the delivery mode, chronic cough, smoking, and genetic history. Further, urinary incontinence before and during pregnancy, natural delivery, and genetic history are important independent high-associated factors for SUI. Our findings show the importance of screening for the above associated factors in association with SUI.

Factors influencing stress urinary incontinence in elite female athletes

IntroductionPractising high-impact sports, especially on a competitive level, has been identified nowadays as one of the risk factors of stress urinary incontinence (SUI). The purpose of our study was to verify the effect of selected factors, like age, parity, the intensity of trainings, achieved sports level, type of discipline, or the duration of sports experience, on SUI symptoms in a group of elite female athletes.MethodsThe study involved 112 elite women athletes: 55 practising running and 57 practising cross-country skiing. A combined questionnaire, which included Urogenital Distress Inventory, Incontinence Impact Questionnaire, King’s Health Questionnaire, and own career development questionnaire, was used as a research tool.ResultsThe prevalence of SUI in the studied female elite athletes was high (62.5%). No statistically significant differences regarding SUI symptoms were found between the group of skiers and the group of runners. A relationship between SUI occurrence and childbirth, but not age, was observed. A statistically significant relationship was revealed between the duration of sports practice and SUI occurrence (higher occurrence in the less experienced group). However, SUI occurrence did not correlate with the achieved sports level. A higher subjective assessment of the trainings intensity was correlated with a higher occurrence of SUI symptoms.ConclusionsThe occurrence of SUI in female runners and skiers depends on a history of giving birth, length of practising sports, and training intensity; it does not depend on age or the sports class.

A retrospective study of risk factors for stress urinary incontinence 1year after delivery in multiparous women.

Stress urinary incontinence (SUI) is a common postpartum disorder. In this study, we aim to identify the risk factors for SUI in multiparous women 1year after delivery. A retrospective cohort study was conducted in multiparous women who gave birth from January 2016 to March 2018 in Peking University Third Hospital. We interviewed all of the participants with the help of The International Consultation on Incontinence questionnaire short form (ICI-Q-SF) 1year after delivery by telephone to identify symptoms of SUI. Univariate and multivariate analyses were applied to assess the potential risk factors of SUI. A decision tree was used to assess the prevalence of SUI in the different subgroups. A total of 172 multiparous women were recruited. The prevalence of SUI was 30.2% (52/172) 1year after delivery. In univariate analysis, maternal age ≥ 35 years, SUI after the first delivery, GDM and birth exclusively by vaginal delivery increased the risk for SUI 1year after delivery. Multivariate analysis indicated that SUI after the first delivery (OR: 3.937, 95% CI: 1.764-8.787), gestational diabetes mellitus (GDM) (OR: 3.754, 95% CI: 1.599-8.810) and age ≥ 35 years (OR: 2.964, 95% CI: 1.208-7.274) were independent risk factors for SUI 1year after delivery. A decision tree showed that participants who had SUI after the first delivery and patients with GDM were more likely to have SUI than patients without GDM (73.3% vs. 50%). For multiparous women, SUI after the first delivery, GDM and age ≥ 35 years increase the risk of SUI 1year after delivery.

Impact of bariatric surgery in patients with stress urinary incontinence.

ABSTRACTObjective:To examine epidemiologic, anthropometric and clinical variables associated with stress urinary incontinence in obese women, before and after bariatric surgery, and to identify predictive factors of stress urinary incontinence resolution.Methods:Prospective observational study with women enrolled in a bariatric surgery program between 2015 and 2016. Patients were assessed prior to and 6 months after bariatric surgery using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Patient Global Impression of Improvement and the Visual Analogue Scale. Patient assessment also included physical examination and bladder stress tests.Results:A total of 43 women completed the study. There was a 72.7% reduction in stress urinary incontinence (p=0.021). Predictive factors for preoperative diagnosis of stress urinary incontinence included age (p=0.024) and abdominal waist circumference (p=0.048). Urinary symptoms improved after weight loss, especially nocturia (p=0.001) and stress urinary incontinence (p=0.026). Menopause was the most significant predictive factor for persistence of stress urinary incontinence within six months of bariatric surgery (p=0.046). Self-reported outcomes and scores obtained in the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Patient Global Impression of Improvement and the Visual Analogue Scale were associated with significant improvement (p=0.012, p=0.025, and p=0.002 respectively).Conclusion:Older women with larger waist circumference have a higher risk of developing stress urinary incontinence prior to bariatric surgery. Menopausal women are highly prone to persistent stress urinary incontinence, even after weight loss. Weight loss achieved through bariatric surgery improved stress urinary incontinence symptoms and mitigated related impacts on quality of life in the vast majority of women.

Stress urinary incontinence after holmium laser enucleation of prostate: incidence and risk factors

Background and objective: To evaluate the incidence and the risk factors of stress urinary incontinence (SUI) during the first year following Holmium Laser Enucleation of the Prostate (HoLEP). Materials and methods: Our monocentric and retrospective study includes 155 patients who underwent HoLEP for benign prostatic hyperplasia. Surgeries were performed by 2 expert surgeons. The continence was evaluated before and after surgery at 1, 3, 6 and 12 months. The predictive factors of SUI were analysed using logistic regression.Results: The SUI rate at 1, 3, 6 and 12 months was respectively 7.3%, 8.1%, 3.4% and 2.7%. SUI remained present in 4 patients (2.6%) at 12 months. The mean International Consultation Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-SF) score for patients with SUI was respectively 11.69 ± 5.28, 8.70 ± 4.24, 1.81 ± 3.53 and 8 ± 4.24 at 1, 3, 6 and 12 months (p 30 (Odds Ratio (OR), 4.69; 95% Confidence Interval (CI), 1.51–14.52; p = 0.007) and patients over 70 years old (OR, 16.23; 95% CI, 1.96–134.09; p = 0.010) were respectively identified as independent risk factors for SUI at 1 and 3 months.Conclusions: SUI after HoLEP is transitory in most cases. It is favoured by a high BMI and an age over 70. These criteria should be considered before choosing the operative technique and preventive measures must be taken in high-risk patients.

Collagen type 3A1 and 1A1 polymorphisms in women with pelvic organ prolapse and urinary incontinence assessed with Sanger sequencing method.

IntroductionThis case-control trial investigates the prevalence of COL3A1 and COL1A1 gene polymorphisms in female patients suffering pelvic organ prolapse (POP) and stress urinary incontinence (SUI) in comparison with controls.Material and methodsInclusion criteria were having one or more risk factors for SUI and POP. Exclusion criteria were hereditary connective tissue diseases as well as surgeries for POP/SUI for the control group. The rs1800255 polymorphism in COL3A1 gene was considered as a local substitution of guanine (G) for adenine (A). The rs1800012 polymorphism in COL1A1 gene was considered as a local substitution of guanine (G) for thymine (T). Genotyping was performed by Sanger sequencing method, followed by estimation of sensitivity and specificity for POP and SUI.ResultsFifty-two patients with POP and SUI (mean age 64.4 years) and 21 women were included in the control group (mean age 63.2 years). Homozygous genotype (AA) in COL3A1 was found in 10% of patients suffering from POP or SUI. No women in the control group had this genotype. The single nucleotide polymorphism (SNP) had high specificity (1.0) for POP/SUI, but low sensitivity (0.1). Heterozygous genotype (AG) in COL3A1 had a sensitivity equal to 0.47 and specificity of 0.62. Homozygous genotype (TT) in COL1A1 was found in only 2% of patients with POP/SUI, but was not found in controls. Heterozygous genotype (TG) in COL1A1 has sensitivity equal to 0.25 and specificity of 0.74.ConclusionsPOP/SUI patients have specific SNPs in COL1A1 and COL3A1 sequenced by Sanger method.

Do future healthcare professionals have adequate knowledge about risk factors for stress urinary incontinence in women?

BackgroundStress urinary incontinence worsens living conditions as far as the occupational, social, mental, physical and sexual aspects of a woman’s life. Despite its real impact on the everyday lives of millions of women around the world, this problem is still disregarded and treated only as a discomfort associated with personal hygiene. Could this be due to negligence on the part of medical personnel in this matter and perhaps this lack of knowledge and proper information intended for women with stress urinary incontinence? Implementing educational activities to increase knowledge about urinary incontinence will translate into better educated women and earlier implementation of urinary incontinence treatment in the future. To properly educate women at risk of urinary incontinence, one needs to be familiar with the condition, in particular the risk factors for its development. The purpose of the study was to evaluate the degree of knowledge of students graduating from medical faculties have regarding risk factors for stress urinary incontinence in women and assess where the students’ knowledge of this problem came from.MethodsThe research involved 1581 final year students of medical faculties: nursing and midwifery (258), medicine (432), physiotherapy (402) and other medical (489). The author’s survey was used for the research. The chi2 test was used for analysis.ResultsStudents in faculties of nursing and midwifery, general medicine, physiotherapy, and other medical faculties could correctly list stress urinary incontinence risk factors in 88.8%, 81.7%, 74.4% and 51.9% of their answers respectively (p < 0.01). The most frequently mentioned source of knowledge about stress urinary incontinence was higher level education in 82.6%, 89.8%, 90.0% and 34.4% of the respective groups’ replies (p < 0.001).ConclusionsNursing and midwifery students had the greatest theoretical knowledge of stress urinary incontinence, and lesser knowledge was found among general medicine students, while physiotherapy students and students of other medical faculties had the least theoretical knowledge about risk factors for urinary incontinence. It is advisable that more emphasis be placed on educating students about stress urinary incontinence due to their insufficient knowledge, in particular for future doctors and physiotherapists who will have direct contact with patients.

Obesity as a risk factor for poor outcomes after sling surgery in women with stress urinary incontinence: A systematic review and meta-analysis.

Obesity is one of the main risk factors for stress urinary incontinence (SUI) and has also been associated with worse surgical outcomes. However, the literature is heterogeneous and inconclusive. The goal of this study was to perform a systematic review and meta-analysis to evaluate cure rates and perioperative complications in obese women. A literature search of OVID, MEDNAR, Embase, Scopus, Web of Science, PubMed, and CENTRAL databases was conducted. Randomized controlled trials comparing cure rates and failure of treatment in normal and obese patients, who underwent mid-urethral sling surgery, were identified. A systematic review of subjective and objective cure rates, and complications was performed. Meta-analyses of dichotomous data under the random-effects model were applied using Review Manager 5.3. Nonrandomized comparative studies and gray literature were excluded. A total of 219 studies were identified. Four randomized controlled trials were included for evaluation. The risk of bias evaluation was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. One study was excluded due to missing data on the outcomes. Patients were stratified according to their body mass index as obese (>30 kg/m2 ) and nonobese (<30 kg/m2 ). Complications could not be meta-analyzed. The meta-analysis of subjective (risk ratio [RR] = 1.69 [95% confidence interval [CI]: 1.32-2.16]) and objective (RR = 1.62 [95% CI: 1.26-2.07]) cure rates disfavored obese women. This meta-analysis shows that obesity is a risk factor for the nonsuccessful treatment of SUI with tension-free mid-urethral sling. Differences in regards to the surgical approach and its association with obesity could not be established with the current evidence.

Prevalence of symptomatic urinary incontinence and pelvic organ prolapse among women in rural Nepal.

Although pelvic floor disorders (PFDs) are a significant public health issue in higher income countries, less is known about these disorders and associated risk factors in low income countries. We aimed to determine prevalence and associated risk factors for stress urinary incontinence (SUI), urge urinary incontinence (UUI), and pelvic organ prolapse (POP) in reproductive age women in Sarlahi District in rural Nepal. We conducted a community-based cross-sectional survey of parous, reproductive age women in rural Nepal and screened for pelvic floor disorders using validated screening questions for PFDs. Overall frequency of self-reported symptoms for SUI, UUI, and POP was estimated and compared across demographic and pregnancy history information. Of 14,469 women available for analysis, the mean (SD, range) age was 33.5 (8.2, 13-52) years, and median (range) number of pregnancies was 4 (1-15). The prevalence of SUI was 24.1% (95% CI: 23.3-24.8), of UUI was 13.5% (95% CI: 13.0-14.1), and of POP was 8.0% (95% CI: 7.5-8.4). Bivariate analysis identified the risk of PFD increased incrementally with age and number of vaginal deliveries; these covariates were highly correlated. Multivariable logistic regression revealed age, vaginal deliveries, and previous pelvic surgeries were independently associated with PFD. PFDs are common in a community of parous, reproductive age women in rural Nepal. Risk factors for these conditions are similar to risk factors found in higher income countries.

High level rhythmic gymnasts and urinary incontinence: Prevalence, risk factors, and influence on performance.

Urinary incontinence (UI) is common among exercising women, but no studies have been found in rhythmic gymnasts. The aims of the present study were to investigate the prevalence and risk factors for UI in rhythmic gymnasts and the impact of UI on performance. This was a cross‐sectional study including all rhythmic gymnasts competing at the highest national and international level in Norway. One hundred and thirty‐three gymnasts from 22 sports clubs were invited to participate. Background data and possible risk factors were collected via electronic questionnaires. UI was assessed by Urinary Incontinence short form (ICIQ‐UI SF). The "Triad‐specific self‐report questionnaire" was applied to assess the female athlete triad. Joint mobility was assessed by Beighton score. Logistic regression analysis was used to assess possible risk factors. One hundred and seven nulliparous rhythmic gymnasts (80.5% response rate) from 21 sports clubs, with mean age of 14.5 (SD 1.6) years, participated in the study. Thirty‐four (31.8%) reported UI with 21 (61.8%), 3 (8.8%), 6 (17.6%), and 4 (11.8%) reporting stress, urgency, mixed urinary incontinence, and leakage for no obvious reason, respectively. BMI, hypermobility, menarche, disordered eating, and hours of training were not found to be risk factors for stress urinary incontinence. Twenty‐four gymnasts with UI (70.6%) reported incontinence to influence sports performance; 10 (29.4%) reported to be afraid of visible leakage and 5 (14.7%) that the leakage would happen again. Seventy‐four (69.1%) had never heard about the pelvic floor. In conclusion, UI is common in rhythmic gymnasts and may influence sports performance.

Prevalence and Risk Factors of Stress Urinary Incontinence Among Perimenopausal Women and Its Influence on Daily Life in Women with Sexual Desire Problem.

The prevalence of, and related factors to, stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigated. In this study, 1519 perimenopausal women aged 40 to 65 years were selected from three urban communities in the Wuhan area, and two impoverished, mountainous communities in Hubei province, and followed from April to October 2014. Detailed information about demographic characteristics, menstruation, pregnancy, sexual life and chronic diseases was collected. A cross-sectional survey was carried out following information collection by Chi-square test and multiple logistic regression analysis. Univariate and multivariate logistic regression analysis demonstrated that the potential factors associated with developing SUI were old age (OR=3.4, 95% CI: 1.92-6.04), vaginal delivery (OR=0.623, 95% CI: 0.45-0.87), low income (OR=0.063, 95% CI: 0.40-0.92), atrophic vaginitis (OR=1.4, 95% CI: 1.03-1.80), pelvic organ prolapse (OR=2.81, 95% CI: 1.36-5.80), chronic pelvic pain (OR=2.17, 95% CI: 1.90-4.03), constipation (OR=1.44, 95% CI: 1.07-1.93) and incontinence of feces (OR=3.32, 95% CI: 2.03-5.43). Moreover, the ratio of SUI (33.2%) was higher than the ratio of urgency urinary incontinence (24.1%) or the ratio of mixed urinary incontinence (17.4%), and SUI had a greater impact on daily life among women with decreased sexual desire. In conclusion, SUI is a common disorder affecting over one third of the women surveyed, and has a severe impact on the daily life of perimenopausal women with declined sexual desire. Age, mode of delivery, and monthly income are major risk factors involved in the development of SUI.

Risk factors for stress urinary incontinence following vaginal and caesarean delivery

Abstract&#x0D; &#x0D; Background: Most of the stress urinary incontinence (SUI) occurs after first delivery and related to the mode of delivery.&#x0D; Objective: To determine the factors that affects the incidence of stress urinary incontinence post partum&#x0D; Methods: Women experienced with stress urinary incontinence 3 months after birth vaginally or section caesarean were enrolled in the present cross sectional study. The strength of the pelvic floor muscle measured with perineometer. All of women were assessed for SUI using Sandvix Severity Index (SSI) dan The three incontinence question (3IQ) questionnaire. A person chi-square test was used to analysis with p value &lt;0.05 was considered significant.&#x0D; Results: Eighty-four women with stress urinary incontinence (SUI) after vaginal delivery or caesarean section enrolled in the study. There was a significant difference between mode of delivery and SUI following delivery (p&lt;0.05). Perineal tear (grade 1-2), BMI, newborn weight and circumference significantly affect the SUI after vaginal or caesarean section. Perineal tear increase SUI after delivery 7-fold compared to other factors (OR=7.367; 95% CI=1.815-29.904).&#x0D; Conclusion : SUI after delivery affected by Mode of delivery, pelvic muscle floor weakness, perineal tear, BMI, newborn weight and head circumference.&#x0D; &#x0D; Keywords: stress urinary incontinence, mode of delivery&#x0D; &#x0D; &#x0D; Abstrak&#x0D; &#x0D; Latar belakang: Sebagian besar kasus stress inkontinensia urin terjadi setelah partus pertama kali dan berhubungan dengan metode persalinan.&#x0D; Tujuan: Untuk mengetahui faktor-faktor yang mempengaruhi terjadinya stress inkontinensia urin post partum&#x0D; Metode: Wanita yang mengalami stres inkontinensia urin 3 bulan postpartum normal atau seksio dilibatkan dalam penelitian cross sectional ini. Kekuatan otot dasar panggul diukur dengan perineometer. Penilaian SUI dilakuakn dengan menggunakan kuesioner Sandvix Severity Index (SSI) dan The three incontinence question (3IQ). Data dianalisis dengan uji Chi-square dengan tingkat kemaknaan p&lt;0,05.&#x0D; Hasil: Delapan puluh empat wanita dengan SIU postpartum per vaginam atau operasi caesar dilibatkan dalam penelitian ini. Terdapat perbedaan signifikan antara cara persalinan dan SIU setelah postpartum (p&lt;0,05). Ruptur perineum (grade 1-2), IMT, berat bayi lahir dan lingkar kepala secara signifikan mempengaruhi SIU postpartum. Ruptur perineum meningkatkan SUI postpartum 7 kali lipat dibandingkan dengan faktor-faktor lainnya (OR = 7,367; 95% CI = 1,815-29,904).&#x0D; Kesimpulan: SIU postpartum dipengaruhi oleh cara persalinan, kelemahan dasar otot panggul, robekan perineum, IMT, berat bayi lahir dan lingkar kepala.&#x0D; &#x0D; Kata kunci : stress inkontinensia urin, metode persalinan

Predicting stress urinary incontinence during pregnancy: combination of pelvic floor ultrasound parameters and clinical factors.

The aim of this study was to develop and validate a predictive tool that combines pelvic floor ultrasound parameters and clinical factors for stress urinary incontinence during pregnancy. A total of 535 women in the first or second trimester of pregnancy were included for an interview and transperineal ultrasound assessment from two hospitals. Imaging data sets were analyzed offline to assess for bladder neck vertical position, urethra angles (α, β and γ angles), hiatal area and bladder neck funneling. All significant continuous variables at univariable analysis were analyzed by receiver operating characteristics. Three multivariable logistic models were built on clinical factors, and combined with ultrasound parameters. The final predictive model with best performance and fewest variables was selected to establish a nomogram. Internal and external validation of the nomogram was performed by both discrimination represented by C-index and calibration measured by Hosmer-Lemeshow test. A decision curve analysis was conducted to determine the clinical utility of the nomogram. After excluding 14 women with invalid data, 521 women were analyzed. β angle, γ angle and hiatal area had limited predictive value for stress urinary incontinence during pregnancy, with area under curves of 0.558-0.648. The final predictive model included body mass index gain since pregnancy, constipation, previous delivery mode, β angle at rest, and bladder neck funneling. The nomogram based on the final model showed good discrimination with a C-index of 0.789 and satisfactory calibration (p=0.828), both of which were supported by external validation. Decision curve analysis showed that the nomogram was clinically useful. The nomogram incorporating both the pelvic floor ultrasound parameters and clinical factors has been validated to show good discrimination and calibration, and could be an important tool for stress urinary incontinence risk prediction at an early stage of pregnancy.

Persistent stress urinary incontinence during pregnancy and one year after delivery; its prevalence, risk factors and impact on quality of life in Taiwanese women: An observational cohort study

ObjectiveThe study was to investigate the prevalence and risk factors of stress urinary incontinence (SUI) and its impact on the quality of life during pregnancy and 12 months after delivery. Materials and methods866 women delivering their newborns at a tertiary hospital were recruited. All women were asked to complete several questionnaires including demographic and obstetric data, Short Form 12 health survey (SF-12), Urogenital Distress Inventory Short Form (UDI-6), and Incontinence Impact Questionnaire Short Form (IIQ-7). All women were interviewed via telephone to answer the same questionnaires at 12 months postpartum. ResultsThere were 446 (51.5%) self-reported SUI women during pregnancy. Out of 560 women delivered vaginally, 70 (12.5%) had SUI at 12 months postpartum; in 306 women undergoing Cesarean delivery, 22 (7.2%) experienced SUI 12 months after delivery. Risk factors of SUI during pregnancy included body weight and body mass index at first visit. At 12 months postpartum, parity stood out as the risk factor of persistent SUI in vaginal delivery group, but no significant risk factor was found in Cesarean group. Women with SUI during pregnancy featured worse mental component summary (MCS) score of SF-12, compared to women without SUI. At 12 months postpartum, women with persistent SUI in vaginal delivery group had higher mean UDI-6 and IIQ-7 scores than those without SUI. ConclusionPersistent SUI is more prevalent in the vaginal delivery group than Cesarean group. Both SUI during pregnancy and after childbirth have negative impact on the quality of life in women undergoing vaginal delivery.

Risk factors for stress urinary incontinence after native-tissue vaginal repair of pelvic organ prolapse.

To identify risk factors for postoperative stress urinary incontinence (POSUI) after native-tissue prolapse repair without a concomitant anti-incontinence procedure. The present single-center retrospective study included women with genital prolapse who underwent high uterosacral ligament suspension without a concomitant anti-incontinence procedure during 2008-2013. Univariate and multivariate analyses were performed to identify risk factors for POSUI (identified through clinical interview and International Consultation on Incontinence Modular Questionnaire-Short Form [ICIQ-SF] self-administration) at 6months. In total, 87 (20.9%) of 417 women developed POSUI. Preoperative stress urinary incontinence (SUI) and urodynamically diagnosed SUI were significantly associated with POSUI; moreover, women with POSUI had a higher preoperative ICIQ-SF score, a lower opening detrusor pressure, and a lower detrusor pressure at maximum flow than did women without POSUI (P<0.05 for all comparisons). In the multivariate analysis, preoperative SUI (odds ratio 3.11), a detrusor pressure at maximum flow of less than 30cm H2 O (odds ratio 2.93), and urodynamically diagnosed SUI (odds ratio 2.26) were independent risk factors for POSUI. Preoperative urodynamic parameters, obtained before prolapse repair surgery, were associated with POSUI and could be useful in providing adequate counseling to facilitate decision making on whether to add a concomitant anti-incontinence procedure.