Epidemiology and Natural History of Urinary Incontinence

Hunskaar, Steinar; Arnold, E. P.; Burgio, Kathryn L.; Diokno, Ananias C.; Herzog, A. Regula; Mallett, Veronica

doi:10.1007/s001920070021

Cited by 495 publications

(485 citation statements)

References 77 publications

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“…The clinical diagnosis shifted many women with mixed incontinence to the group of genuine stress incontinence while the percentage of urge was slightly affected. The results from our epidemiological survey are in agreement with other comparable studies 1 .…”

Section: Methodssupporting

confidence: 93%

Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study

Hannestad¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

140

165

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Objective To examine whether modifiable lifestyle factors such as smoking, obesity, physical activity and intake of alcohol or caffeinated drinks were associated with urinary incontinence in women. Design Cross sectional population-based study.Setting The Norwegian Epidemiology of Incontinence in the County of Nord-Trøndelag (EPINCONT) Study is part of a large survey performed in a county in Norway during 1995 -1997. Population Women 20 years (n ¼ 34,755, 75% of the invited) attended the first part of the survey and received the questionnaire. There were 27,936 (80% of source population) women who completed the incontinence part of the questionnaire. Methods Questionnaire covering several health topics including urinary incontinence was received at a screening station. Logistic regression analysis was used to adjust for confounding and to establish associations with the different outcomes under investigation: any incontinence, severe incontinence and stress, urge and mixed subtypes. Main outcome measures Effect measure were odds ratios with corresponding 95% confidence intervals.Results Former and current smoking was associated with incontinence, but only for those who smoked more than 20 cigarettes per day. Severe incontinence was weakly associated with smoking regardless of number of cigarettes. The association between increasing body mass index and incontinence was strong and present for all subtypes. Increasing levels of low intensity physical activity had a weak and negative association with incontinence. Tea drinkers were at slightly higher risk for all types of incontinence. We found no important effects of high intensity physical activity, intake of alcohol or coffee. Conclusions Several potentially modifiable lifestyle factors are associated with urinary incontinence. Highest odds ratios were found for body mass index, heavy smoking and tea drinking.

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Section: Methodssupporting

confidence: 93%

Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study

Hannestad¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

140

165

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“…Studies analysing older populations (> 60 years) reveal an increased prevalence of UUI [17][18][19][20] with a higher prevalence rate among HT users [21].…”

Section: Commentsmentioning

confidence: 99%

Serum estradiol does not differentiate stress, mixed and urge incontinent women around menopause. A report from the Women's Health in the Lund Area (WHILA) study

Hamer

Källén

Lidfeldt

et al. 2011

European Journal of Obstetrics & Gynecology and Reproductiv

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Serum estradiol does not differentiate stress, mixed and urge incontinent women around menopause. A report from the Women's Health in the Lund Area (WHILA) study.Andrada, Maria; Källén, Karin; Lidfeldt, Jonas; Samsioe, Göran; Teleman, Pia General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. To outline serum estradiol levels in perimenopausal women with stress, mixed or urge incontinence. We believe the majority of urgency symptoms in perimenopausal women to be caused by a pelvic floor dysfunction and a hypermobility of the bladder neck. If this is the case, there would be no difference in estradiol levels between the groups. Study design:Setting: university hospital. In the observational Women´s Health In the Lund Area study, a subset of 400/2221 women reporting urinary incontinence completed a detailed questionnaire regarding lower urinary tract symptoms and had their serum steroid hormone levels measured.Statistical analyses were made by Chi-square test, nonparametrical tests, ANOVA, multi-and univariate logistic regression analysis. Results:Stress incontinence was reported by 196, mixed incontinence by 153 and urge incontinence by 43 women. Serum estradiol did not differ significantly between stress incontinent (median 49.5 pmo/l, range 2.63-875.4), urge incontinent ( median 31.6 pmol/l, range 2.63-460.7) or mixed incontinent women ( median 35.5 pmol/l, range 2.63-787.9, p = 0.62). Logistic regression analysis correcting for age, parity, hormonal status, smoking, hysterectomy and BMI also failed to show any difference in estradiol levels between the groups (p=0.41-0.58). Conclusion:No significant differences in serum estradiol levels between stress, mixed or urge incontinent perimenopausal women could be demonstrated . 4Keywords:Female urinary incontinence; mixed urinary incontinence; serum estradiol; stress urinary incontinence; urge urinary incontinence.5

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“…1 The incidence in this group is unknown; however 10 ± 20% of females in the general population are known to be a ected. 2 The neuropathic group have additional and unique problems compared to the general population with stress incontinence. Speci®cally, neuropathic patients may have detrusor hyperre¯exia combined with a weak external urethral sphincter in an upper motor neurone injury, or they may have an acontractile bladder with a weak urethral sphincter in a lower motor neurone injury.…”

Section: Introductionmentioning

confidence: 99%

Experience of tension-free vaginal tape for the treatment of stress incontinence in females with neuropathic bladders

Hamid

Khastgir

Arya³

et al. 2003

Spinal Cord

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Study design: Retrospective. Objective: To evaluate the safety and e cacy of the tension-free vaginal tape (TVT) for the treatment of stress incontinence in females with neuropathic bladders. Setting: London Spinal Injuries Unit, Stanmore & Institute of Urology, London, UK. Methods: Twelve women (mean age 53.3 years; range 41 ± 80 years) with neuropathic bladder dysfunction and stress urinary incontinence were treated with tension-free vaginal tape (TVT) between November 1997 and December 2000. The group consisted of women with: (i) traumatic spinal cord injuries (n=3); (ii) post lumbar spinal surgery (n=6); (iii) spinal stenosis (n=3). Four of the 12 patients had previously failed surgery for stress incontinence. All patients underwent pre-and post-TVT evaluation with video-urodynamic studies. Results: Mean follow-up was 27.1 months (range 17 ± 54 months). Three patients were voiding spontaneously (stress voiding) before surgery and continued to do so post-operatively. The remaining 9 were performing clean intermittent self-catheterisation before the insertion of TVT and continued to do so after the surgery. At follow up 10 patients (83.3%) were dry. The procedure failed in one patient and the other complained of mild leakage, but she reported a decrease in the number of pads used. One patient developed detrusor hyperre¯exia on postoperative video-urodynamics but there was no evidence of stress incontinence. One patient had a bladder perforation on insertion of TVT, managed successfully with extended use of a urethral catheter post-operatively. Three patients developed post-operative urinary tract infection successfully treated with oral antibiotics. Conclusions: Tension-free vaginal tape insertion is minimally invasive, safe and e ective for the treatment of stress incontinence in females with bladder neuropathy with intrinsic sphincter de®ciency. Previous surgery for incontinence did not a ect post-operative complications or outcome.

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Epidemiology and Natural History of Urinary Incontinence

Cited by 495 publications

References 77 publications

Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study

Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study

Serum estradiol does not differentiate stress, mixed and urge incontinent women around menopause. A report from the Women's Health in the Lund Area (WHILA) study

Experience of tension-free vaginal tape for the treatment of stress incontinence in females with neuropathic bladders

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