Prevalence Of Urgency Urinary Incontinence Research Articles

U-shaped association between sleep duration and urgency urinary incontinence in women: a cross-sectional study.

To investigate the association between sleep duration and urgency urinary incontinence (UUI) among adult women. Cross-sectional data were retrieved from the 2005-2014 National Health and Nutrition Examination Survey. To explore the association between sleep duration and urgency urinary incontinence, multivariable logistic regression and restricted cubic spline (RCS) regression analysis was carried out. Among 9204 adult women, the weighted urinary incontinence prevalence was 31% for urgency urinary incontinence (UUI). The fully adjusted multivariable model revealed that participants with short (< 7h) or long (> 9h) sleep duration were more likely to report UUI compared to participants with normal (7-9h) sleep duration (OR 1.20, 95% CI 1.03-1.40, p = 0.02, OR 1.40, 95% CI 1.11-1.76, p = 0.005, respectively). Subgroup analysis showed no significant interaction. Furthermore, additional analysis demonstrated a U-shaped correlation between sleep duration and incident UUI. The non-linear association exists between sleep duration and urgency urinary incontinence. Compared with insufficient or excessive sleep, normal sleep duration is related to lower prevalence of urgency urinary incontinence. Future prospective longitudinal studies should be conducted to further investigate and determine the degree of the association between sleep time and urgent urinary incontinence.

The Epidemiology and Population-Based Studies of Women with Lower Urinary Tract Symptoms: A Systematic Review.

In this systematic review, we focused on epidemiology and population-based studies to identify recent realworld data of women with lower urinary tract symptoms. The PubMed, Scopus, and Cochrane databases were used for the literature search using the following keywords: epidemiology, population-based studies, women, female, lower urinary tract symptoms, and urinary incontinence. A total of 20 articles in the English language were found to be eligible for this review. The prevalence of LUTS in women was 11.8%-88.5%. The prevalence of storage symptoms was 23.6%-79%, voiding symptoms was 1.8%-51%, and post-micturition symptoms was 0.3%-46%. The prevalence of voiding and storage symptoms was 8.3%-26.6% and the prevalence of combined voiding, storage, and post-micturition symptoms was 6.6%-19.2%. Any incontinence was observed in 5.8%-45.8% of women. The majority of patients suffered from stress urinary incontinence with 1.9%-31.8%. The prevalence of urgency urinary incontinence and mixed-type urinary incontinence was 0.7%-24.4% and 2.1%-12%, respectively. Increased age, marital and work status, comorbidities, alcohol consumption, higher parity, vaginal delivery, instrumental delivery, prolonged labor, laceration, and postmenopausal status were found to be risk factors for lower urinary tract symptoms. The prevalence of lower urinary tract symptoms in women is increasing, especially with age. Since the worldwide prevalence of lower urinary tract symptoms remains unknown, multi-continental studies, especially in the developing world, with less heterogeneity and more standardized definitions, are needed to better evaluate real-world data in women with lower urinary tract symptoms.

Prevalence and trends in urinary incontinence among women in the United States, 2005–2018

Women are disproportionately affected by urinary incontinence compared with men. Urinary incontinence results in physical and psychological adverse consequences and impaired quality of life and contributes to significant societal and economic burden. Previous studies reported high urinary incontinence burden in the United States. However, the current prevalence and recent trends in urinary incontinence and its subtypes among US women have not been described. In addition, correlates of urinary incontinence among US women have not been systematically evaluated in the contemporary population. The purpose of this study was to determine the prevalence and trends in urinary incontinence among adult women in the United States from 2005 to 2018. In addition, this study aimed to investigate the relationship of urinary incontinence subtypes with several sociodemographic, lifestyle, health-related, and gynecologic factors. We used data from the National Health and Nutrition Examination Survey, a nationally representative series of surveys that was designed to evaluate the health status of the US population. Data on urinary incontinence from 7 consecutive 2-year cycles (2005-2006 to 2017-2018) were used for this study. A total of 19,791 participants aged ≥20 years were included. Weighted prevalence estimates and 95% confidence intervals were calculated in each study cycle for stress, urgency, and mixed urinary incontinence. Multivariate-adjusted weighted logistic regression was used to investigate the temporal trends in urinary incontinence, in addition to determining the association between urinary incontinence subtypes with several participants' factors. In the 2017-2018 cycle, stress urinary incontinence was the most prevalent subtype (45.9%; 95% confidence interval, 42.1-49.7), followed by urgency urinary incontinence (31.1%; 95% confidence interval, 28.6-33.6) and mixed urinary incontinence (18.1%; 95% confidence interval, 15.7-20.5). The prevalence rates of urgency and mixed urinary incontinence were higher in women aged 60 years and older (urgency, 49.5% [95% confidence interval, 43.9-55.2]; mixed, 31.4% [95% confidence interval, 26.2-36.6]) than in those aged 40 to 59 years (urgency, 27.9% [95% confidence interval, 23.6-32.1]; mixed, 15.9% [95% confidence interval, 12.9-19.0]) and those aged 20 to 39 years (urgency, 17.6% [95% confidence interval, 13.8-21.5]; mixed, 8.3% [95% confidence interval, 5.4-11.3]). The overall prevalence of stress and mixed urinary incontinence was stable throughout 2005 to 2018 (both Ptrend=.3), with increases in mixed urinary incontinence among women aged 60 years and older (P=.001). The prevalence of urgency urinary incontinence significantly increased, particularly among women aged 60 years and older (both P=.002). Age, obesity, smoking, comorbidities, and postmenopausal hormone therapy were associated with higher prevalence of all types of urinary incontinence. Black women were less likely to report stress urinary incontinence but more likely to report urgency urinary incontinence. Although the estimated overall prevalence of stress and mixed urinary incontinence remained stable from 2005 to 2018, the prevalence of urgency and mixed urinary incontinence significantly increased among women aged 60 years and older. All subtypes of urinary incontinence were higher among women with obesity and comorbidities, those who used postmenopausal hormone therapy, and those who smoke.

Prevalence of Urinary Incontinence among a Nationally Representative Sample of Women, 2005-2016: Findings from the Urologic Diseases in America Project.

Urinary incontinence is frequently underreported and underdiagnosed in the clinical setting. We analyzed 12 years of data from a large, nationally representative sample of women in the United States to assess the prevalence, severity, and daily impact of urinary incontinence and its subtypes at the population level. We analyzed data from 15,003 women aged ≥20 years who participated in the 2005-2016 National Health and Nutrition Examination Survey. We estimated the prevalence of urinary incontinence in the prior year, overall and by subtype (stress, urgency or mixed). Among women with urinary incontinence, we additionally assessed symptom severity using the validated 4-level Incontinence Severity Index, as well as impact on daily activities. The 2005-2016 prevalence of any urinary incontinence was 53%; 16% of women had mixed urinary incontinence, 26% had stress only and 10% had urgency only. While urgency urinary incontinence and mixed urinary incontinence were highest among women aged ≥60 years, stress urinary incontinence was highest among women aged 40-59 years. NonHispanic Black women had higher prevalence of urgency urinary incontinence and lower prevalence of stress urinary incontinence compared to other racial/ethnic groups. Of women with urinary incontinence, 30% reported moderate or severe symptoms, which were more common among older than younger women. In addition, 24% of women with urinary incontinence reported that the condition affected their daily activities. Our study demonstrates a high prevalence of urinary incontinence among a nationally representative population of women in the United States, with many reporting that urinary incontinence affected their daily activities. Age and racial/ethnic trends varied by urinary incontinence subtype.

Racial differences in urinary incontinence prevalence and associated bother: the Multi-Ethnic Study of Atherosclerosis

Urinary incontinence is influenced by multiple factors, and the prevalence of urinary incontinence subtypes may differ by race and ethnicity. This study aimed to determine the prevalence of urinary incontinence subtypes and associated bother among women by race and ethnicity. This cross-sectional analysis used data from the Multi-Ethnic Study of Atherosclerosis, an observational cohort study of 4 racial and ethnic groups recruited from 6 communities from the United States. At the sixth follow-up examination, urinary symptoms were ascertained with the International Consultation on Incontinence Questionnaire. The prevalence rate ratios of stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence by race and ethnicity were calculated using generalized linear models for the binomial family while adjusting for covariates. The degree of bother was based on a scale of 0 (none) to 10 (greatest bother), and presence of any bother was defined as a score of ≥3. Among the 1749 female participants in the Multi-Ethnic Study of Atherosclerosis who completed the sixth follow-up examination, 1628 (93%) completed the questionnaire. Women who did not complete the questionnaire were older than those who completed the questionnaire (average age, 82.2 [standard deviation, 9.5] vs 73.7 [standard deviation, 8.4] years; P<.01) and more likely to use diuretics (29.8% vs 18.9%; P<.01). Among those who completed the questionnaire (n=1628), 39.4% were white, 12.5% were Chinese, 27.2% were black, and 20.9% were Hispanic. After adjusting for covariates, stress urinary incontinence (prevalence rate ratio, 0.47; 95% confidence interval, 0.25-0.86) and mixed urinary incontinence (prevalence rate ratio, 0.58; 95% confidence interval, 0.38-0.89) regardless of bother scores were significantly less prevalent among black vs white women, although no significant racial and ethnic differences in stress or mixed urinary incontinence prevalence were noted for Chinese or Hispanic women vs white women. No racial and ethnic differences in the prevalence of urgency urinary incontinence were noted after the adjustment for covariates. Most women with urinary incontinence reported bother scores of ≥3 regardless of race and ethnicity and urinary incontinence subtype, and bother scores did not differ significantly by race and ethnicity. Frequency of urinary incontinence subtypes may differ by race and ethnicity, but older women who report urinary incontinence are likely to have associated bother regardless of race and ethnicity.

Vitamin D intake and the 10-year risk of urgency urinary incontinence in women

Evidence indicates that higher serum 25-hydroxy vitamin D levels may be associated with decreased prevalence of urgency urinary incontinence (UI), but the impact of vitamin D consumption on development of urgency and mixed UI is unclear. The objective was to assess whether greater vitamin D intake was associated with decreased risk of incident urgency and mixed UI over 10 years using 2 large prospective cohorts of middle-aged and older women. We analyzed 38,101 women from the Nurses’ Health Study I (NHS I) and 35,190 women from NHS II who were free of UI at baseline. We followed incident UI, defined as new UI occurring at least monthly, separately by subtype (urgency, mixed, stress UI), from 2002-2012. We categorized vitamin D intake from supplements and diet. We estimated relative risk for developing UI according to vitamin D intake using Cox-proportional hazard models with adjustment for covariates. Median vitamin D intake was 580IU in the older women in NHS I (age range 56–71 at baseline) and 487IU in middle-aged women in NHS II (age range 40–57). Among women taking ≥1000IU of vitamin D, median intake in the older women was 1252IU and 1202IU in the middle-aged women. Among the older women, we found no relation of vitamin D intake to risk of developing UI, across all UI subtypes. In multivariable-adjusted analysis for middle-aged women, the relative risk of developing mixed UI among women taking >1000IU was 0.79 (0.63, 0.99) and for urgency UI was 0.88 (0.71, 1.07), versus <200IU. Risks of developing stress UI were not related to vitamin D intake categories. Overall, we did not find a relationship between vitamin D intake and UI incidence in middle-aged and older women; however, the reported intake was moderate.

Coital Incontinence in Women With Urinary Incontinence: An International Study

IntroductionCoital urinary incontinence (CUI) is not much explored during clinical history, and this could lead to an underestimation of the problem. AimTo evaluate the prevalence and clinical risk factors of CUI in women with urinary incontinence (UI), and to measure the impact of CUI on women’s sexuality and quality of life. MethodsThis was a multicenter international study, conducted in Italy, Greece, the United States, and Egypt. Inclusion criteria were: sexually active women with UI and in a stable relationship for at least 6 months. Exclusion criteria were: age <18 years and unstable relationship. The UI was classified as stress UI (SUI), urgency UI (UUI), and mixed UI (MUI). Women completed a questionnaire on demographics and medical history, in particular on UI and possible CUI and the timing of its occurrence, and the impact of CUI on quality and frequency of their sexual life. Main Outcome MeasuresTo evaluate the CUI and its impact on sexual life we used the open questions on CUI as well as the International Consultation on Incontinence questionnaire and Patient Perception of Bladder Condition questionnaire. ResultsIn this study 1,041 women (age 52.4 ± 10.7 years) were included. In all, 53.8% of women had CUI: 8% at penetration, 35% during intercourse, 9% at orgasm, and 48% during a combination of these. Women with CUI at penetration had a higher prevalence of SUI, women with CUI during intercourse had higher prevalence of MUI with predominant SUI, and women with CUI at orgasm had higher prevalence of UUI and MUI with predominant UUI component. Previous hysterectomy was a risk factor for CUI during any phase, while cesarean delivery was a protective factor. Previous failed anti-UI surgery was a risk factor for CUI during penetration and intercourse, and body mass index >25 kg/m2 was a risk factor for CUI at intercourse. According to International Consultation on Incontinence questionnaire scores, increased severity of UI positively correlated with CUI, and had a negative impact on the quality and frequency of sexual activity. Clinical ImplicationsThis study should encourage physicians to evaluate the CUI; in fact, it is an underestimated clinical problem, but with a negative impact on quality of life. Strengths & LimitationsThe strength of this study is the large number of women enrolled, while the limitation is its observational design. ConclusionCUI is a symptom that can affect sexual life and should be investigated during counseling in all patients who are referred to urogynecological centers.Illiano E, Mahfouz W, Giannitsas K, et al. Coital Incontinence in Women With Urinary Incontinence: An International Study. J Sex Med 2018;15:1456–1462.

Impact of adenotonsillectomy on urinary storage symptoms in children with sleep-disordered breathing

ObjectiveTo prospectively evaluate the effectiveness of adenotonsillectomy on resolving urinary storage symptoms such as frequency, urgency, and urgency urinary incontinence (UUI) in indicated sleep disordered breathing (SDB) patients. MethodsWe prospectively analyzed changes in storage symptoms and SDB score before and after surgery in 102 children (74 males, 28 females, mean age 8.4 ± 2.8 years) who underwent adenotonsillectomy between July 2011 and Feb 2012. Before and 3 months after surgery, all children and their parents were requested to answer a self-reported SDB scale-questionnaire (22 questions, 0–22 points) and a urinary storage symptoms questionnaire. ResultsThe prevalence of urgency in the overall patients was 31.2%. After adenotonsillectomy, prevalence of frequency and, urgency in addition to SDB score were significantly decreased (p ≦ 0.001). The prevalence of UUI was also significantly lower (11.6%–7.4%, p < 0.001). Patients with urgency had a significantly higher SDB score than those without (11.4 ± 4.3 vs. 7.8 ± 4.0, p < 0.001). After treatment, there was no difference between these two groups. ConclusionAdenotonsillectomy markedly improved both SDB score and decreased the prevalence of voiding symptoms (frequency, urgency, and UUI). There was a strong correlation between preoperative SDB score and severity of urgency in children with SDB.

Vascular risk factors for male and female urgency urinary incontinence at age 68 years from a British birth cohort study

ObjectiveTo investigate the prevalence of urgency urinary incontinence (UUI) at age 68 years and the contribution of vascular risk factors to male and female UUI pathogenesis in addition to the associations with raised body mass index (BMI).Subjects and methodsIn all, 1 762 participants from the Medical Research Council (MRC) National Survey for Health and Development birth cohort who answered the International Consultation on Incontinence Questionnaire short form (ICIQ‐SF), at age 68 years, were included. Logistic regression was used to estimate associations between UUI and earlier life vascular risk factors including: lipid status, diabetes, hypertension, BMI, previous stroke or transient ischaemic attack (TIA) diagnosis; adjusting for smoking status, physical activity, co‐presentation of stress UI symptoms, educational attainment; and in women only, type of menopause, age at period cessation, and use of hormone replacement therapy (HRT).Results UUI was reported by 12% of men and 19% of women at age 68 years. Female sex, previous stroke or TIA diagnosis, increased BMI and hypertension (in men only) at age 60–64 years were independent risk factors for UUI. Female sex, increased BMI, and a previous diagnosis of stroke/TIA increased the relative risk of more severe UUI symptoms. Type and timing of menopause and HRT use did not alter the estimated associations between UUI and vascular risk factors in women.ConclusionMultifactorial mechanisms lead to UUI and vascular risk factors may contribute to the pathogenesis of bladder overactivity in addition to higher BMI. Severe UUI appears to be a distinct presentation with more specific contributory mechanisms than milder UUI.

The prevalence of lower urinary tract symptoms (LUTS) and overactive bladder (OAB) by racial/ethnic group and age: Results from OAB‐POLL

To estimate the prevalence of LUTS and OAB in a large, ethnically diverse US study. This cross-sectional, population-representative survey was conducted via the Internet in the US among 10,000 men and women aged 18-70 (2,000 African-Americans [AA], 2,000 Hispanics, 6,000 whites). The LUTS tool assessed how often participants experienced LUTS during the past 4 weeks on a five-point Likert scale. OAB was defined by the presence of urinary urgency ≥ "sometimes" or ≥ "often," and/or the presence of urgency urinary incontinence (UUI). Descriptive statistics were used to evaluate group differences. Logistic regression analyses were conducted to examine the impact of racial/ethnic group on OAB. Response rate, 56.7%. Prevalent LUTS included terminal dribble and nocturia across gender, post-micturition leaking (men), and stress incontinence (women). Prevalence of OAB ≥ "sometimes" and ≥ "often" were 17% and 8% in men and 30% and 20% in women--with significantly higher rates among AA men and women. A similar trend was found for UUI among men (AA, 10%; Hispanic and whites, 6%), while AA and white women had higher prevalence of UUI (19%) as compared to Hispanic women (16%). In logistic regression analyses, AA and Hispanic men and women were significantly more likely than whites to have OAB despite having lower prevalence of self-reported comorbid conditions and risk factors. LUTS and OAB are highly prevalent in both men and women and increase with advancing age. Further, racial/ethnic group is a robust predictor of OAB in men and women.

A cross-sectional study on urgency urinary incontinence among adult women in Beijing

Objective To investigate prevalence and risk factors of urgency urinary incontinence (UUI) among adult women in Beijing.Methods Multiple-stage stratified sampling was used to recruit women equal to and more than 20 years old from 48 communities ( villages and neighborhoods ) in six districts of Beijing,by household interview with a standardized questionnaire to collect information of demographic characteristics,delivery history,health conditions and UUI related clinical data.Data analysis was performed by SPSS software version 16.0.Results Totally,3058 adult women completed the survey,with an overall prevalence of UUI of 1.7 % (52/3058).Distribution of age,cultural background,family income,number of pregnancy,number of abortion,delivery history,history of chronic diseases,general surgery,pelvic surgery,abdominal pain and abdominal distension were found significantly different between UUI participants and non-UUI ones with univariate analysis ( all P ＜ 0.05 ).Results of multivariate logistic regress analysis showed that number of pregnancy ( OR = 1.29,95% CI = 1.06-1.58 ),history of chronic diseases ( OR = 2.53,95% CI = 1.38-4.62 ) and history of abdominal pain ( OR = 2.32,95%CI= 1.10 -4.91 ) all significantly associated with UUI.Conclusions UUI associates with complicated factors and its prevention and intervention at communities is necessary targeting at related factors. Key words: Urinary incontinence,urge; Female; Cross-sectional studies

The prevalence of urinary and fecal incontinence in Canadian secondary school teenage girls: questionnaire study and review of the literature.

The purpose of this study was to examine the prevalence of pelvic floor dysfunction and incontinence in the Canadian nulligravid secondary school female teenage population. During the University of Toronto day in 1996, female visitors to the Obstetrics and Gynecology Department booth were asked to complete anonymous pelvic floor and continence questionnaires, which were thoroughly explained to them and completed during their visit. Out of the 332 completed forms, 69% were completed by nulligravid teenagers in secondary school. These students formed our study population. The prevalence of urgency urinary incontinence (UUI) symptoms was 17% and of stress urinary incontinence (SUI) symptoms was 15%. In all candidates these reported symptoms were mild, occurring less than once a week. Occasional minor fecal incontinence (involuntary loss of flatus or fecal staining) was 38%; of these, 92% reported loss of flatus. Major fecal incontinence with loose bowel movements was reported by 3% of the study population. Two girls (1%) reported nocturnal enuresis. Weight directly correlated with SUI symptoms and fecal incontinence, but not with UUI. Fecal incontinence correlated with SUI symptoms (P = 0.0152), but not with UUI. Ten per cent of the study population were sexually active, but sexual activity did not correlate with incontinence problems. Voiding habits were markedly variable: 30% were infrequent voiders (three times or fewer per day). Nocturia was reported by 3%. We concluded that in nulligravid teenage female students minor fecal incontinence appears to be the most common incontinence type; urge incontinence was slightly more common than SUI. Unlike UUI, SUI symptoms were more prevalent with fecal incontinence, which were affected by weight. There appears to be a problem with a high prevalence of poor voiding habits.