Prevalence and associated factors of urinary leakage among women participating in the 45 and Up Study

Concepcion, Kristine; Cheng, Yan; McGeechan, Kevin; Robertson, Sarah; Stewart, Mary; Bateson, Deborah; Estoesta, Jane; Chiarelli, Pauline

doi:10.1002/nau.23770

Cited by 6 publications

(9 citation statements)

References 34 publications

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“…Depression and anxiety are in cross-sectional studies associated with higher prevalence of urinary incontinence (UI) in women [ 1 – 4 ]. According to type, studies show an association to all three main types of UI, but strongest for urgency and mixed UI [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study

2020

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Background Anxiety and depression are in both cross-sectional and longitudinal studies associated with urinary incontinence (UI) in women, strongest for the urgency component of UI. The role of psychotropic drugs in this association, especially antidepressants, has been questioned, but not clarified. The present study aimed to explore the associations between UI and anxiety/depression and the possible impact of psychotropic drugs on these associations. Methods We conducted a cross-sectional, population-based study with questionnaire data from 21,803 women ≥20 years in the Norwegian Nord-Trøndelag Health Study merged with the Norwegian Prescription Database, which contains information on all dispensed prescriptions. We used multivariate logistic regression to investigate the association between UI (any UI, and by type and severity) and anxiety/depression (by different score on Hospital anxiety and depression scale), and the influence of psychotropic drugs on this association (by different volume of drug use). Results Compared with normal anxiety- and depression score, having moderate/severe anxiety or depression (HADS≥11) increased the prevalence of UI from 27.6 to 37.8% (OR 1.59 (1.40–1.81), p < 0.001) for anxiety and from 28.0 to 43.7% (OR 1.79 (1.46–2.21), p < 0.001) for depression. According to type of UI, mixed UI was most strongly associated with a high HADS-score with an odds ratio 1.84 (1.65–2.05) for anxiety and 1.85 (1.61–2.13) for depression. Compared to no UI, severe UI was associated with depression with odds ratios of 2.04 (1.74–2.40), compared with no UI. Psychotropic drug use did not influence the associations between UI and anxiety/depression. We found high prevalence of UI among users of various psychotropic drugs. After adjustments, only antidepressants were associated with UI, with OR 1.36 (1.08–1.71) for high defined daily dose of the drug. Anxiolytics were associated with less UI with OR 0.64 (0.45–0.91) after adjustments for anxiety. Conclusion This study showed that anxiety, depression and use of antidepressants are associated factors with UI, strongest for urgency and mixed type of UI, with increasing ORs by increasing severity of the conditions and increased daily dose of the medication. Use of antidepressants did not influence the associations between UI and anxiety/depression.

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Section: Introductionmentioning

confidence: 99%

Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study

2020

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“…The definition of urinary incontinence greatly impacted the prevalence of incontinence observed in the studies, with some studies considering any incontinence while others required that the patient had incontinence diagnosed by a physician in the last 6 months. The studies varied in their adjustment for potential confounders (such as increased body mass index, medication utilization, or psychological factors), however, the results of studies with more extensive covariate adjustment were consistent with the other studies. The study quality was mixed, with 4/12 rated as good, 3/12 rated as fair, and 5/12 rated as poor (Table , with further details in the online appendix).…”

Section: Resultsmentioning

confidence: 53%

“…We identified 12 studies that addressed the epidemiological link between low back pain and urinary symptoms; their general characteristics are summarized in Table . The studies were conducted in countries representative of several geographical areas including North America, Europe, Australia, and Asia.…”

Section: Resultsmentioning

confidence: 99%

“…We identified 12 studies that addressed the epidemiological link between low back pain and urinary symptoms; their general characteristics are summarized in Table 1. 5,6,[9][10][11][12][13][14][15][16][17][18] The studies were conducted in countries representative of several geographical areas including North America, Europe, Australia, and Asia. The majority (10/12) were cross-sectional in nature, and 7/12 involved secondary analysis of datasets that were not created specifically to assess the link between low back pain and urinary symptoms.…”

Section: Epidemiological Assessment Of Urinary Symptoms and Low Bacmentioning

confidence: 99%

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Is there a link between back pain and urinary symptoms?

Welk

Baverstock

2020

Neurourology and Urodynamics

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Aims: To identify epidemiological studies of mechanical low back pain and urinary dysfunction, and to identify potential evidence supporting a mechanism for this relationship.Methods: A systematic online search was conducted of EmBASE, Medline, CINAHL, and PEDro databases. We excluded studies where an obvious link between low back pain and urinary dysfunction exists (such as cauda equina syndrome). Two reviewers used inclusion/exclusion criteria to screen the articles. Data were extracted and summarised with a narrative review, and study quality was assessed.Results: We included 22/930 studies. Twelve studies addressed the epidemiological link between low back pain and urinary symptoms. The studies all found a statistically significant association between the diagnosis of urinary incontinence or urinary symptoms and low back pain, (aOR's 1.1 to 3.1).Results were consistent when stratified by sex, age, and when adjusted for confounders. The study quality was good in 4/12. Eight studies reported on an assessment/intervention related to pelvic floor function, urinary symptoms and low back pain. Pelvic floor dysfunction was common in women with low back pain, however randomized studies and pre-post studies reported mixed results for pelvic floor physiotherapy improving low back pain. The study quality was good in 3/8. Conclusions:Low back pain and urinary incontinence are associated in large epidemiological studies, and the presence of one condition seems to predispose the development of the other. There is limited evidence to suggest pelvic floor interventions are useful for low back pain in this patient population, therefore the mechanism for this relationship is still unclear. K E Y W O R D Slow back pain, overactive bladder, stress incontinence, urge incontinence, urinary incontinence

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“…Up to 25% of women experience daily chronic pelvic pain (defined as pelvic pain lasting longer than 6 months) . Up to 30% of women at 5 years postpartum, 45% of women over the age of 45, and 58% of female athletes who play high impact sports report stress or urge incontinence symptoms due to non‐neurogenic pelvic floor dysfunction. The female athlete triad (bone density abnormalities, menstrual dysfunction, and abnormal nutrition status) is present in 40% of high school female athletes, 69% of female endurance athletes, and 77% of female ballet dancers .…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal Women's Health Education in Physiatry: A Mismatch in Residency Education and Clinical Practice

Bennis

Rho

2019

PM&R

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Background Musculoskeletal Women's Health (MSK WH) is a niche subspecialty within physical medicine & rehabilitation (PM&R). Women make up 50.7% of the population of the United States but are burdened with higher rates of musculoskeletal disease compared to men. MSK WH topics are not included in PM&R or Primary Care Accreditation Council for Graduate Medical Education (ACGME) program requirements. Given the comprehensive training provided in PM&R, physiatrists are ideal candidates to diagnose, treat, and provide education on MSK WH conditions. Objective To identify the prevalence of formalized MSK WH education and of WH physiatrists at ACGME‐accredited PM&R residency programs. Design Cross‐sectional survey design. Setting Computer‐based survey. Participants ACGME‐accredited residency programs (N = 86; as of February 2017). Methods A single, multiple choice, computer‐generated Research Electronic Data Capture (REDCap) survey with branching logic was sent to all ACGME‐accredited PM&R residency programs (N = 86). Outcomes The primary outcome was to assess the prevalence of women's health curricula at ACGME‐accredited PM&R residency programs in the United States. The secondary outcome was to assess the prevalence of WH physiatrists at these programs. Results Eighty‐six ACGME‐accredited PM&R residency programs were contacted with 55 completed responses (64% response rate). Only six programs (11%) reported the presence of a formal WH curriculum at their residency program. In contrast, 25 programs (45%) reported having WH physiatrists at their institutions, and 36 programs (65%) reported that general physiatrists were providing WH‐related care. Conclusions The study findings identify a mismatch between the prevalence of MSK WH residency education (11% of programs) and the prevalence of physiatrists providing MSK WH care (66% of programs). Physiatrists are ideally suited to manage MSK WH care. Based on the findings of this cross‐sectional study, residency programs and governing bodies should evaluate these trends and consider the addition of topics pertinent to women's musculoskeletal health into PM&R graduate medical education. Level of Evidence III.

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Prevalence and associated factors of urinary leakage among women participating in the 45 and Up Study

Abstract: Findings from this analysis estimate that approximately one in two women aged 45 years and older will most likely experience urinary leakage. The associated factors could serve as screening indicators for urinary leakage.

Cited by 6 publications

References 34 publications

Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study

Urinary incontinence associated with anxiety and depression: the impact of psychotropic drugs in a cross-sectional study from the Norwegian HUNT study

Is there a link between back pain and urinary symptoms?

Musculoskeletal Women's Health Education in Physiatry: A Mismatch in Residency Education and Clinical Practice

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