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Xiong Y, Wu G. Impact of Bariatric Surgery on Postpartum Urinary Incontinence in Women with Gestational Diabetes: A Retrospective Case-Control Analysis. Obes Surg 2025:10.1007/s11695-025-07899-1. [PMID: 40332739 DOI: 10.1007/s11695-025-07899-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2025] [Revised: 04/11/2025] [Accepted: 04/29/2025] [Indexed: 05/08/2025]
Abstract
BACKGROUND Prenatal obesity and gestational diabetes mellitus (GDM) are recognized contributors to the development of postpartum urinary incontinence (PPUI). Pregnant women with obesity and GDM are at an elevated risk, and while bariatric surgery (BS) has proven effective for sustained weight loss and may mitigate urinary incontinence, its influence on postpartum outcomes has not been thoroughly examined. This study evaluates the relationship between BS and PPUI outcomes-including symptom duration and subtype. METHODS In this retrospective case-control investigation, we analyzed pregnancies of women with a history of BS who later developed GDM. A control cohort without prior BS was established via 1:2 matching according to preoperative body mass index (BMI), maternal age, parity, and delivery year. This matching strategy ensured a robust comparative analysis between groups. RESULTS The no-BS control group experienced a significantly longer duration of PPUI (median: 18.2 weeks) compared to the BS group (median: 12.1 weeks; log-rank p < 0.001). Additionally, by 12 months postpartum, 82.6% of the BS group achieved symptom resolution versus 67.4% of controls (p = 0.03). Multivariate analysis further identified postoperative diarrhea as an independent predictor of extended PPUI duration (p = 0.002). CONCLUSIONS Our findings suggest that BS may contribute to improved PPUI outcomes by shortening the duration of urinary incontinence. However, complications such as postoperative diarrhea appear to adversely affect recovery, emphasizing the need for integrated perioperative and postpartum management in this high-risk group.
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Affiliation(s)
- Yajing Xiong
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guohua Wu
- The First Affiliated Hospital of Jinan University, Guangzhou, China.
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2
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Mohamed-Ahmed R, Robinson D. Up-and-coming pharmacotherapeutic options for treating patients with refractory overactive bladder. Expert Opin Pharmacother 2025; 26:325-334. [PMID: 39891374 DOI: 10.1080/14656566.2025.2458577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 01/22/2025] [Indexed: 02/03/2025]
Abstract
INTRODUCTION Overactive bladder (OAB) is a prevalent disorder with a significant impact on quality of life. The pathophysiology of OAB is multifactorial and the majority of patients will require treatment with multiple therapies across the course of their disease. First-line treatments include bladder retraining, fluid advice and pelvic floor muscle training. Following this, patients may be offered treatment with anticholinergic and β3 agonist medications. Anticholinergics are known to have high rates of discontinuation due to side effects and there are concerns regarding anticholinergic load and its impact on cognitive function in older adults. AREAS COVERED This paper aims to discuss the current and emerging treatment options available for patients who suffer from OAB. EXPERT OPINION The management of OAB in the clinical setting remains challenging. The goal of newer pharmacotherapies in OAB would be treatment that provides long-term symptomatic relief with minimal side effects and an improved quality of life. The future of OAB research is promising and should consider the implications of the gut-bladder axis, regenerative medicine, biomarkers and the role of digital health.
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Affiliation(s)
| | - Dudley Robinson
- Department of Urogynaecology, King's College Hospital, London, UK
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3
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Li Z, Lu X, Zhang K, Wu S, Yu W, Chen X, Zheng W. U-shaped association between serum 25-hydroxyvitamin D concentrations and urinary leakage among adult females aged 45 years and over in the United States: a cross-sectional study. BMC Womens Health 2024; 24:58. [PMID: 38263023 PMCID: PMC10804705 DOI: 10.1186/s12905-024-02906-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/13/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The relationship between serum vitamin D status and urinary leakage (UL) among middle-aged females needs to be further studied. The aim of this study was to evaluate the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with UL among American females ages 45 years and over. METHODS Seven cycles of the National Health and Nutrition Examination Survey (NHANES) with self-report UL data, were used. A total of 9525 women aged 45 years and older were enrolled in this study. Univariate and multivariate logistic regression models and the smooth curve fitting were utilized to analyze the association between clinical UL and serum 25-hydroxyvitamin D [25(OH)D] concentrations. RESULTS A non-linear relationship between serum 25(OH)D concentrations and clinical ULwas observed. When serum 25(OH)D concentration was higher than the inflection point 63.5 nmol/L, a positive correlation was observed between serum 25(OH)D concentrations and clinical UL ([OR]: 1.007, 95%CI: 1.005-1.009, P < 0.01). However, when serum 25(OH)D concentration was below the inflection point 63.5 nmol/L, a negative correlation was observed between serum 25(OH)D concentrations and clinical UL ([OR]: 0.993, 95%CI: 0.989-0.996, P < 0.01). CONCLUSIONS The association between serum vitamin D and the risk of UL exhibited a U-shaped pattern among US middle-aged females, with an inflection point occurring at a serum 25(OH)D concentration of 63.5 nmol/L.
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Affiliation(s)
- Zeyu Li
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Xinzhuo Lu
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Keshuai Zhang
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Shuangyan Wu
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Wei Yu
- School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China
| | - Xiaoling Chen
- Department of Intensive Care Unit, Fujian Medical University Union Hospital, Fuzhou, China.
| | - Wenzhong Zheng
- Department of Urology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 200001, Fujian Province, P.R. China.
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4
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Zhang Q, Zhang Z, He X, Liu Z, Shen L, Long C, Wei G, Liu X, Guo C. Vitamin D levels and the risk of overactive bladder: a systematic review and meta-analysis. Nutr Rev 2024; 82:166-175. [PMID: 37195440 DOI: 10.1093/nutrit/nuad049] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
CONTEXT Overactive bladder is treated mainly with behavioral and drug therapy, and symptoms of urinary frequency and incontinence are challenging to eliminate. There is thus a continuous unmet need for new drugs with a substitution effect mechanism. OBJECTIVE It not known whether vitamin D deficiency can lead to overactive bladder or urinary incontinence or whether vitamin D supplementation alleviates bladder symptoms. This comprehensive systematic review with meta-analysis was conducted to determine whether overactive bladder is associated with vitamin D deficiency. DATA SOURCES The PubMed and Cochrane Library databases were searched systematically up to July 3, 2022. DATA EXTRACTION Initially, 706 articles were identified in the literature search, of which 13 were included in the systematic review: 4 randomized controlled trials, 3 cohort studies, 3 cross-sectional studies, and 3 case-control studies. DATA ANALYSIS An increased risk of overactive bladder and urinary incontinence was observed with vitamin D deficiency (odds ratio [OR] = 4.46; 95%CI, 1.03-19.33; P = 0.046 and OR = 1.30; 95%CI, 1.01-1.66; P = 0.036, respectively). Vitamin D levels were relatively low in patients with overactive bladder or urinary incontinence (SMD = -0.33; 95%CI, -0.61 to -0.06, P = 0.019). On the basis of existing data, the risk of urinary incontinence was reduced by 66% after vitamin D supplementation (OR = 0.34; 95%CI, 0.18-0.66; P = 0.001). Egger test was conducted to assess publication bias, and the results were tested for robustness using a sensitivity analysis. CONCLUSIONS Vitamin D deficiency increases the risk of overactive bladder and urinary incontinence, and vitamin D supplementation reduces the risk of urinary incontinence. The development of new strategies to prevent or alleviate bladder symptoms is crucial. Vitamin D supplementation may be gaining recognition as an effective strategy for prevention or alleviation of bladder symptoms such as overactive bladder and incontinence. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022351443.
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Affiliation(s)
- Qiang Zhang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhicheng Zhang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xueyu He
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhenmin Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Lianju Shen
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Chunlan Long
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Guanghui Wei
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xing Liu
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Pediatric Research Institute, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Program for Youth Innovation in Future Medicine, Chongqing Medical University, Chongqing, People's Republic of China
| | - Chunming Guo
- School of Life Sciences, Yunnan University, Kunming, China
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5
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Gul S, Aydogmus H, Keles C, Aydogmus S, Sengul M. The effect of vitamin D deficiency on urinary incontinence during third trimester pregnancy. Medicine (Baltimore) 2023; 102:e36044. [PMID: 37960799 PMCID: PMC10637412 DOI: 10.1097/md.0000000000036044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/19/2023] [Indexed: 11/15/2023] Open
Abstract
Urinary incontinence (UI) is a common problem which is associated with impaired quality of life. Vitamin D plays a crucial role for pelvic floor muscle function. The aim of this study was to investigate the effect of vitamin D deficiency on UI in pregnant women in the third trimester of pregnancy. All pregnant women at > 28 weeks of gestation who were followed in the gynecology and obstetrics outpatient clinic were screened. The patients were assessed for UI during routine follow-up. The Incontinence Severity Index was used to determine the severity of UI. A total of 210 patients were included as the study group and 40 patients were included as the control group. Both groups were compared based on the International Incontinence Severity Index scores. Of the patients, 40% had a history of UI and 84% had vitamin D deficiency. Pregnant women with vitamin D deficiency had statistically significant UI, compared to pregnant women in the control group. The severity of UI was also significantly higher in the patients with vitamin D deficiency. Urinary incontinence is significantly associated with vitamin D deficiency in pregnant women.
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Affiliation(s)
- Sezer Gul
- Izmir Katip Celebi University Atatürk Training and Research Hospital, Department of Obstetrics and Gynecology Izmir, Karabağlar/İzmir, Turkey
| | - Huseyin Aydogmus
- Izmir Katip Celebi University Atatürk Training and Research Hospital, Department of Obstetrics and Gynecology Izmir, Karabağlar/İzmir, Turkey
| | - Caglasu Keles
- Izmir Katip Celebi University Atatürk Training and Research Hospital, Department of Obstetrics and Gynecology Izmir, Karabağlar/İzmir, Turkey
| | - Serpil Aydogmus
- Izmir Katip Celebi University Faculty of Medicine, Department of Obstetrics and Gynecology Izmir, Karabağlar/İzmir, Turkey
| | - Mustafa Sengul
- Izmir Katip Celebi University Faculty of Medicine, Department of Obstetrics and Gynecology Izmir, Karabağlar/İzmir, Turkey
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6
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Liu L, Xu M, Zhou H, Hao X, Chen X, Liu X. Association of serum 25-hydroxyvitamin D with urinary incontinence in elderly men: evidence based on NHANES 2007-2014. Front Endocrinol (Lausanne) 2023; 14:1215666. [PMID: 37745700 PMCID: PMC10515204 DOI: 10.3389/fendo.2023.1215666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
Background The correlation between serum 25-hydroxyvitamin D (25(OH)D) and different sub-types of urinary incontinence in elderly men continues to be uncertain. Hence, we performed this research to evaluate whether serum 25(OH)D levels are correlated with urinary incontinence among elderly men. Methods The present study incorporated the male population aged 50 years and above from four cycles of the NHANES database spanning from 2007 to 2014, for the purpose of analysis. The assessment of urinary incontinence was carried out through a correlation questionnaire, while standardized liquid chromatography-tandem mass spectrometry (LC-MS/MS) was adopted to quantify serum 25(OH)D. A weighted multi-factorial logistic regression analysis was carried out to ascertain and investigate any potential correlation that may exist between serum 25(OH)D and urinary incontinence in senior males. Results Ultimately, a sum of 4663 elderly men were involved in our analysis. The outcomes of the univariable analysis illustrated that the group with vitamin D deficiency exhibited augmented odds of all three urinary incontinence types in comparison to the vitamin D-sufficient group. After accounting for age, race, and BMI, no appreciable variations in the outcomes were noticed. However, after accounting for all covariates, only SUI (OR = 1.677; 95% confidence interval (CI) = 1.074-2.618) and MUI (OR = 1.815; 95% confidence interval (CI) = 1.010-3.260) demonstrated statistical significance. Conclusion Decreased serum 25(OH)D levels were connected with stress urinary incontinence and mixed urinary incontinence in elderly men.
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Affiliation(s)
| | | | | | | | | | - Xiaoqiang Liu
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China
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Kurniadi A, Dewi AK, Sasotya RMS, Purwara BH, Kireina J. Effect of Vitamin D analog supplementation on levator ani strength and plasma Vitamin D receptor expression in uterine prolapse patients. Sci Rep 2023; 13:3616. [PMID: 36869168 PMCID: PMC9984360 DOI: 10.1038/s41598-023-30842-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/02/2023] [Indexed: 03/05/2023] Open
Abstract
Uterine prolapse is a pathological condition that can negatively impact women's quality of life. It is caused by weakening of the pelvic floor muscles. Function of levator ani muscle and other striated muscles is thought to be influenced by Vitamin D levels. Vitamin D exerts its biological effects by adhering to Vitamin D receptors (VDRs) present in striated muscles. We aim to analyze the effect of Vitamin D analog supplementation on levator ani muscle strength in uterine prolapse patients. This was a quasi-experimental study with a pre-post design on 24 postmenopausal women diagnosed with grade III and IV uterine prolapse. Vitamin D levels, VDR, levator ani muscle, and hand grip muscle strength were measured before and after three months of Vitamin D analog supplementation. We found that Vitamin D level, VDR serum level, levator ani muscle strength, and hand grip muscle strength all significantly increase (p < 0.001) following Vitamin D analog supplementation. The correlation coefficient between levator ani muscle and handgrip muscle strength was 0.616 and with p value of 0.001. To conclude, Vitamin D analog supplementation can significantly increase levator ani muscle strength in uterine prolapse patients. We propose that determining Vitamin D level in postmenopausal women and replenishing its deficiency with Vitamin D analog supplementation might aid in preventing POP progression.
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Affiliation(s)
- Andi Kurniadi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia.
| | - Asri Kurnia Dewi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia
| | - R M Sonny Sasotya
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia
| | - Benny Hasan Purwara
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia
| | - Jessica Kireina
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Jl. Pasteur 38, Bandung, 40161, West Java, Indonesia
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Chen KC, Chang ML, Lin CS, Rajneesh CP, Liao CH, You WC, Maa HC, Wu YN. Insight into SLC9A3 deficiency-mediated micturition dysfunction caused by electrolyte imbalance. Biomed Pharmacother 2023; 158:114155. [PMID: 36916397 DOI: 10.1016/j.biopha.2022.114155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/14/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Solute carrier family nine isoform 3 (SLC9A3) is an Na+/H+ exchanger that regulates Ca2+ homeostasis. SLC9A3 is largely involved in the transepithelial absorption of Na+/H+ and frequently functions in pair with a Cl-/HCO3- exchanger. OBJECTIVE To investigate the impact and pathophysiological mechanisms of long-term SLC9A3 deficiency on lower urinary tract symptoms (LUTS) in a mouse model MATERIALS AND METHODS: Slc9a3 knockout and wild-type mice (average >6 months) were used. The effects of SLC9A3 depletion on bladder and urethral functions and effectiveness of voiding were assessed using a cystometrogram (CMG). Histology, blood electrolytes, and gene expression were also analyzed. RESULTS The SLC9A3-deficient mice had smaller gross bladders than the wild-type mice. The CMG analysis revealed normal peak micturition pressure, higher threshold pressure, short intercontraction interval, less voided volume, and poor compliance in the SLC9A3-deficient mice, similar to clinical LUTS. Histological analysis revealed loose detrusor muscle and loss of transformability of the urothelium in the SLC9A3-deficient mice. Masson's trichrome analysis revealed severe collagen deposition in the detrusor muscle. Immunofluorescence staining also demonstrated a significant decrease in cytokeratins 5 and 20. Gene and protein expression analyses confirmed that SLC9A3 does not act directly on bladder tissue. Homeostasis was correlated with bladder dysfunction in the SLC9A3-deficient mice. DISCUSSION Fibrosis and collagen deposition in the bladder of the SLC9A3-deficient mice is due to bladder inflammation because of decreased blood flow and deregulated systemic homeostasis. Long-term SLC9A3 depletion causes progressive bladder dysfunction, similar to human LUTS. CONCLUSION Electrolyte imbalance causes SLC9A3 deficiency-mediated progressive micturition dysfunction.
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Affiliation(s)
- Kuo-Chiang Chen
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; Department of Urology, Cathay General Hospital, Taipei City 106438, Taiwan
| | - Meng-Lin Chang
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; Department of Urology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243089, Taiwan
| | - Chun-Sian Lin
- Graduate Institute of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | | | - Chun-Hou Liao
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; Division of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City 231403, Taiwan
| | - Wen-Chen You
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Hung-Chune Maa
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; Department of Pathology, Cardinal Tien Hospital, New Taipei City 231403, Taiwan.
| | - Yi-No Wu
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan.
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9
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Shahraki SK, Emadi SF, Salarfard M, Chenari Z, Tadayyonfar F, Alikamali M. Effect of vitamin D supplementation on the severity of stress urinary incontinence in premenopausal women with vitamin D insufficiency: a randomized controlled clinical trial. BMC Womens Health 2022; 22:431. [PMCID: PMC9636788 DOI: 10.1186/s12905-022-02024-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
Background Urinary incontinence, especially stress urinary incontinence (SUI), is one of the problems experienced by premenopausal women. Given the role of vitamin D in enhancing muscle strength and function, this study explored the effect of vitamin D3 supplementation on SUI in premenopausal women. Methods A randomized controlled trial was performed with 60 premenopausal women referring to Kerman gynecological clinic in 2020 and 2021. Eligible women received a 5000-unit vitamin D supplement or placebo weekly for 3 months. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) was utilized to assess SUI severity before and after the intervention. The t-test, Chi-square test, and repeated measures ANOVA were carried out in SPSS software (version 22) to analyze the data. P-values smaller than 0.05 were considered significant. Results Before the intervention, there was no significant difference between the intervention and control groups in SUI severity (P = 0.652) and the impact of SUI severity on premenopausal women’s lives (P = 0.804). In contrast, after 8-12 weeks of vitamin D supplementation, these scores decreased significantly in the intervention group relative to the control group (P < 0.001). In addition, after vitamin D supplementation, the number of SUI and urinary leakage symptoms decreased in the intervention group (P < 0.001). Conclusion Vitamin D supplementation improves SUI in premenopausal women. Trial registration This trial was registered with the Iranian Registry of Clinical Trials; https://fa.irct.ir/trial/53474 (IRCT20190724044318N2) on 11/02/2021.
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Affiliation(s)
- Sedigheh Khodabandeh Shahraki
- grid.412105.30000 0001 2092 9755Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyedeh Fatemeh Emadi
- grid.411230.50000 0000 9296 6873Department of Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahla Salarfard
- grid.411583.a0000 0001 2198 6209PhD student in Reproductive Health, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Chenari
- grid.411230.50000 0000 9296 6873Department of Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Faezeh Tadayyonfar
- grid.412266.50000 0001 1781 3962Department of Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Alikamali
- grid.412105.30000 0001 2092 9755Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
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10
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da Silva SB. Vitamin D deficiency or insufficiency is associated with lower urinary tract symptoms. Int Braz J Urol 2022; 48:326-327. [PMID: 36165560 PMCID: PMC8932030 DOI: 10.1590/s1677-5538.ibju.2021.0645.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Sandra Barbosa da Silva
- Laboratório de Morfometria, Metabolismo e Doenças Cardiovasculares. Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, RJ, Brasil
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11
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Özçift B, Micoogullari U. The effect of vitamin D deficiency in children with overactive bladder related urinary incontinence. Int Braz J Urol 2022; 48:316-325. [PMID: 35170894 PMCID: PMC8932037 DOI: 10.1590/s1677-5538.ibju.2021.0645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/18/2021] [Indexed: 02/02/2023] Open
Abstract
Purpose: Overactive bladder (OAB) is a common syndrome associated with lower urinary tract symptoms (LUTS), especially urinary incontinence in children, which may affect the patient's quality of life (QoL). Vitamin D deficiency has been shown to be associated with OAB syndrome. This study evaluated the relationship between vitamin D status and OAB-related symptoms and QoL in children. Materials and Methods: The study included 52 pediatric patients with OAB-related urinary incontinence and 41 healthy children. LUTS were assessed using the Dysfunctional Voiding and Incontinence Symptoms Score (DVISS) questionnaire, and QoL was assessed using the Pediatric Incontinence Questionnaire (PINQ). Oral vitamin D supplementation was given to patients with OAB with vitamin D deficiency. Urinary symptoms and QoL were evaluated before and after vitamin D supplementation. Results: Vitamin D deficiency was more common in the OAB group (75%) than in the control group (36.6%). Logistic regression analysis revealed that vitamin D status (<20ng/mL) was a significant predictor of OAB. Both pre-treatment and post-treatment DVISS and PINQ scores showed a positive correlation. After vitamin D supplementation, 8 (23.5%) patients had a complete response and 19 (55.9%) patients had a partial response. Significant improvement in QoL was also achieved. Conclusions: Vitamin D deficiency is more common in children with urinary incontinence and OAB than in healthy children. Although vitamin D deficiency is not routinely evaluated for every patient, it should be evaluated in treatment-resistant OAB cases. Vitamin D supplementation may improve urinary symptoms and QoL in patients with OAB.
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Affiliation(s)
- Burak Özçift
- Health Sciences University, Izmir Dr. Behcet Uz Child Diseases and Surgery Training and Research Hospital - Pediatric Urology Izmir, Turkey
| | - Uygar Micoogullari
- Izmir Tepecik Training and Research Hospital - Urology Konak, Izmir,Turkey
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12
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Moreno-Artero E, Morice-Picard F, Bremond-Gignac D, Drumare-Bouvet I, Duncombe-Poulet C, Leclerc-Mercier S, Dufresne H, Kaplan J, Jouanne B, Arveiler B, Taieb A, Hadj-Rabia S. Management of albinism: French guidelines for diagnosis and care. J Eur Acad Dermatol Venereol 2021; 35:1449-1459. [PMID: 34042219 DOI: 10.1111/jdv.17275] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 03/22/2021] [Indexed: 12/12/2022]
Abstract
Albinism is a worldwide genetic disorder caused by mutations in at least 20 genes, identified to date, that affect melanin production or transport in the skin, hair and eyes. Patients present with variable degrees of diffuse muco-cutaneous and adnexal hypopigmentation, as well as ocular features including nystagmus, misrouting of optic nerves and foveal hypoplasia. Less often, albinism is associated with blood, immunological, pulmonary, digestive and/or neurological anomalies. Clinical and molecular characterizations are essential in preventing potential complications. Disease-causing mutations remain unknown for about 25% of patients with albinism. These guidelines have been developed for the diagnosis and management of syndromic and non-syndromic forms of albinism, based on a systematic review of the scientific literature. These guidelines comprise clinical and molecular characterization, diagnosis, therapeutic approach and management.
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Affiliation(s)
- E Moreno-Artero
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France
| | - F Morice-Picard
- Pediatric Dermatology Unit, National Centre for Rare Skin Disorders, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France
| | - D Bremond-Gignac
- Department of Ophthalmology, Reference Centre for Rare Ocular Diseases (OPHTARA), Hôpital Necker-Enfants Malades, APHP5, Paris, France.,Université de Paris-Centre, Paris, France
| | - I Drumare-Bouvet
- Service d'exploration de la vision et neuro-ophtalmologie, CHRU de Lille, Lille, France
| | | | - S Leclerc-Mercier
- Department of Pathology, Hôpital Necker-Enfants Malades, APHP5, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université de Paris-Centre, Paris, France
| | - H Dufresne
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France.,Service Social Pédiatrique, Hôpital Necker-Enfants Malades, APHP5, Université de Paris-Centre, Paris, France
| | - J Kaplan
- Laboratory of Genetics in Ophthalmology, Imagine Institute, Paris, France
| | - B Jouanne
- French Association for Albinism (Genespoir), Rennes, France
| | - B Arveiler
- Molecular Genetics Laboratory, CHU de Bordeaux, Bordeaux, France.,INSERM U1211, Maladies Rares, Génétique et Métabolisme, Bordeaux, France
| | - A Taieb
- Pediatric Dermatology Unit, National Centre for Rare Skin Disorders, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Bordeaux, France
| | - S Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France.,Université de Paris-Centre, Paris, France
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13
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Castelán F, Cuevas-Romero E, Martínez-Gómez M. The Expression of Hormone Receptors as a Gateway toward Understanding Endocrine Actions in Female Pelvic Floor Muscles. Endocr Metab Immune Disord Drug Targets 2021; 20:305-320. [PMID: 32216732 DOI: 10.2174/1871530319666191009154751] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/06/2019] [Accepted: 07/19/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To provide an overview of the hormone actions and receptors expressed in the female pelvic floor muscles, relevant for understanding the pelvic floor disorders. METHODS We performed a literature review focused on the expression of hormone receptors mainly in the pelvic floor muscles of women and female rats and rabbits. RESULTS The impairment of the pelvic floor muscles can lead to the onset of pelvic floor dysfunctions, including stress urinary incontinence in women. Hormone milieu is associated with the structure and function alterations of pelvic floor muscles, a notion supported by the fact that these muscles express different hormone receptors. Nuclear receptors, such as steroid receptors, are up till now the most investigated. The present review accounts for the limited studies conducted to elucidate the expression of hormone receptors in pelvic floor muscles in females. CONCLUSION Hormone receptor expression is the cornerstone in some hormone-based therapies, which require further detailed studies on the distribution of receptors in particular pelvic floor muscles, as well as their association with muscle effectors, involved in the alterations relevant for understanding pelvic floor disorders.
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Affiliation(s)
- Francisco Castelán
- Department of Cellular Biology and Physiology, Biomedical Research Institute, National Autonomous University of Mexico, Mexico City, Mexico.,Tlaxcala Center for Behavioral Biology, Autonomous University of Tlaxcala, Tlaxcala, Mexico
| | - Estela Cuevas-Romero
- Tlaxcala Center for Behavioral Biology, Autonomous University of Tlaxcala, Tlaxcala, Mexico
| | - Margarita Martínez-Gómez
- Department of Cellular Biology and Physiology, Biomedical Research Institute, National Autonomous University of Mexico, Mexico City, Mexico.,Tlaxcala Center for Behavioral Biology, Autonomous University of Tlaxcala, Tlaxcala, Mexico
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The Relationship between Vitamin D Level and Lower Urinary Tract Symptoms in Women. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 54:405-410. [PMID: 33364878 PMCID: PMC7751233 DOI: 10.14744/semb.2020.01709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/22/2020] [Indexed: 11/20/2022]
Abstract
Objectives: In the literature, the effects of vitamin D on lower urinary tract symptoms (LUTS) have been investigated. Conflicting results have been reported in these studies conducted. LUTS is more common in women. In this study, we aimed to evaluate the relationship between vitamin D and LUTS in female patients using the uroflowmetric method. Methods: This retrospective cohort study included 186 female patients who were admitted with LUTS. Demographic characteristics, medical history, calcium (Ca) and vitamin D, including laboratory studies and uroflowmetry results, as maximum urine flow rate (Qmax), average urine flow rate (Qav) and voided volume (V) were recorded. Patients were divided into two groups according to age (18-50 and ≥51) and vitamin D levels (<20 and ≥20). Laboratory parameters and uroflowmetry results were compared between groups. Results: Mean age was 56.85±12.95 years. Mean vitamin D level was 21.19±13.93 ng/mL (2.5-83.5). Mean Qmax value was 35.41±12.63, whereas the mean Qav was 19.13±9.89, and the mean V was 446.60±165.08 mL. Vitamin D levels differed according to age groups (p=0.044). No significant difference was observed between groups according to Qmax, Qav and V values (p>0.05). No significant correlation was detected between vitamin D level and Qmax, Qav and V values. However, a negative correlation was detected between serum Ca level and V values (p=0.042) in the low vitamin D group. Conclusion: There was no direct relationship between vitamin D levels and LUTS in respect to uroflowmetry. However, we determined that Ca levels affect the uroflowmetry parameter in patients with low vitamin D levels. There is a need for further studies emphasizing serum Ca levels in addition to vitamin D levels in patients with LUTS.
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Seasonal Variation of Drug Prescription Rate for Overactive Bladder in Men Based on National Health Insurance Claims Data, 2012-2016. Int Neurourol J 2020; 24:278-285. [PMID: 33017898 PMCID: PMC7538287 DOI: 10.5213/inj.2040030.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/18/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose Overactive bladder (OAB) symptoms might be affected by weather, but only a few clinical studies have investigated this issue. We investigated seasonal variations in OAB-drug prescription rate (DPR) in men using nationwide claims data in Korea. Methods A total of 2,824,140 men aged over 18 years were included from the Health Insurance Review and Assessment service – National Patient Sample data between 2012 and 2016. Depending on the monthly average temperature, the seasons were divided into 3 groups, namely, hot (June, July, August, and September), intermediate (April, May, October, and November), and cold (January, February, March, and December) seasons. OAB-DPR was estimated using the claims data, and differences in its rate were examined among the 3 seasonal groups. Results The overall OAB-DPR was 1.97% (55,574 of 2,824,140). The OAB-DPR were 0.38%, 0.63%, 0.92%, 1.74%, 4.18%, 7.55%, and 9.69% in the age groups of under 30, 30s, 40s, 50s, 60s, 70s, and over 80 years, respectively; thus, the prescription rate increased with age (P<0.001), with a steeper increase after 60 years of age. OAB-DPR was 1.02% in the hot season, 1.19% in the intermediate season, and 1.27% in the cold season, with significant differences among the 3 seasonal groups (P<0.001). These seasonal variations persisted in the subgroup analysis in each age decade (P<0.001). Conclusions OAB-DPR varied with seasons and was significantly higher in the cold season than in the hot season, suggesting that cold weather may affect development and aggravation of OAB symptoms in men.
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16
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Seasonal variations in overactive bladder drug prescription rates in women: a nationwide population-based study. World J Urol 2020; 39:877-882. [PMID: 32436073 DOI: 10.1007/s00345-020-03257-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Colder seasons can aggravate lower urinary tract symptoms, especially an overactive bladder (OAB). This aspect has been extensively studied in men and rarely in women. We investigated whether colder seasons influence OAB-drug prescription rates (OAB-DPRs) in women. METHODS Women aged > 18 years were selected from the Korean Health Insurance Review and Assessment Service-National Patient Sample data between 2012 and 2016. OAB-DPR was calculated according to age and seasonal groups. The prescription rates in summer (June, July, and August) and winter (January, February, and December) months were compared. Sub-analysis was performed according to age group. RESULTS In total, 3,061,343 adult women were included. The overall OAB-DPR was 3.75% (114,940/3,061,343). Overall OAB-DPRs in summer and winter were 1.41% (43,090/3,061,343) and 1.54% (47,038/3,061,343), respectively (p < 0.001). Seasonal variations in OAB-DPRs differed by age group (p < 0.001): OAB-DPRs were significantly lower in winter than in summer months in women aged < 50 years (odds ratio 0.942; 95% confidence interval 0.918-0.967; p < 0.001), but significantly higher in winter than in summer months in women aged ≥ 50 years (odds ratio 1.153; 95% confidence interval 1.135-1.171; p < 0.001). CONCLUSION In this study, a correlation was noted between OAB-DPR and seasons. OAB-DPRs were higher in the summer in women aged < 50 years and higher in the winter in women aged ≥ 50 years. Our findings suggest that female hormonal status may be involved in the contradictory effect of seasons on OAB symptoms.
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Allott BS, Dittmer KE, Kenyon AG, Elder PA. Preliminary investigation of the effect of treating sheep during pregnancy with a vitamin A, D, E formulation on the incidence of vaginal prolapse. N Z Vet J 2019; 68:193-197. [PMID: 31760874 DOI: 10.1080/00480169.2019.1696719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aim: To determine if vitamin D3 treatment reduced the incidence of vaginal prolapse in pregnant sheep on a North Canterbury sheep breeding property.Methods: Pregnant ewes from a single farm were allocated to three treatment groups in May 2018. At this time, the first group (EarlyVitADE; n = 512) received an I/M 1 mL dose of 500,000 IU/mL vitamin D3, 60,000 IU/mL vitamin A, and 25 mg/mL vitamin E. This was repeated in July 2018, when the second group (LateVitADE; n = 695) also received the same treatment. The third group (n = 737) were untreated controls. All cases of vaginal prolapse on the property were recorded from pregnancy diagnosis in June 2018 until ewes were set-stocked in August 2018. The planned start of lambing was 10 August 2018.Results: During the period of observation, vaginal prolapses were recorded in 3/699 (0.4%) 2-year-old ewes, and the odds of vaginal prolapse were not associated with treatment group in these ewes (p > 0.3). Amongst ewes aged ≥3 years, during the same period, there were 6/333 (1.8%), 6/443 (1.4%) and 25/469 (5.3%) cases in the EarlyVitADE, LateVitADE and control groups, respectively. Compared to control ewes, the odds of vaginal prolapse were reduced in both the EarlyVitADE (OR = 0.37; 95% CI = 0.15-0.92) and LateVitADE (OR = 0.25; 95% CI = 0.10-0.62) treatment groups.Conclusions and clinical relevance: In this preliminary study, administration of injectable vitamins A, D3, and E to pregnant ewes reduced the incidence of vaginal prolapse during the period from pregnancy diagnosis to set-stocking on one North Canterbury hill-country farm. Due to the restricted data collection period, this investigation should be replicated to better quantify the repeatability of the observed treatment effect over the complete lambing period.
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Affiliation(s)
- B S Allott
- North Canterbury Veterinary Clinics, Amberley, New Zealand
| | - K E Dittmer
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - A G Kenyon
- North Canterbury Veterinary Clinics, Amberley, New Zealand
| | - P A Elder
- Endolab, Canterbury Health Laboratories, Christchurch, New Zealand
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18
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Sharma JB, Kakkad V, Kumar S, Roy KK. Cross-sectional Study on Vitamin D Levels in Stress Urinary Incontinence in Women in a Tertiary Referral Center in India. Indian J Endocrinol Metab 2019; 23:623-627. [PMID: 32042698 PMCID: PMC6987784 DOI: 10.4103/ijem.ijem_531_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess the levels of vitamin D in patients with Stress Urinary Incontinence (SUI) in gynecology clinic of All India Institute of Medical Sciences, New Delhi. MATERIALS AND METHODS This is a cross sectional study on a total of 40 women presenting to gynecology outpatient department with stress urinary incontinence diagnosed by history and examination. The women were divided with moderate, severe and very severe SUI confirmed by incontinence severity index (ISI) and pad test. Vitamin D (serum 25 OH D) levels were measured in all cases by electrochemiluminenscene Immunoassay (ECLIA) using Roche Elecsys 2010 and levels of =30 ng/ml were taken as sufficient while levels between 20-30 ng/ml as insufficient and <20 ng/ml as deficient. Statistical analysis was performed using ANOVA test with P value of <0.05 taken as significant. RESULTS Mean age of patients was 41.6 years. Mean parity was 2.73 and mean duration of symptoms was 4.14 years. Vitamin D levels ranged between 6-38 ng/ml with mean being 17.15±8.1 ng/ml. Levels were deficient (<20 ng/ml) in 30 (75%) women, insufficient (20-30ng/ml) in 7 (17.5%) women and sufficient (>30ng/ml) in 3 (7.57%) women. There was no significant correlation between severely of SUI and levels of vitamin D with Vit D being 19.18±5.76 ng/ml in moderate SUI, 16.96±9.03 ng/ml in severe SUI and 13.60 ± 2.09 ng/ml in very severe SUI. CONCLUSION There was very high prevalence of vitamin D deficiency in SUI patients with 75% patients showing deficient levels and 17.5% showing insufficient levels in SUI patients. There is need to provide vitamin D supplementation in such women.
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Affiliation(s)
- Jai B. Sharma
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Vivek Kakkad
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - Sunesh Kumar
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
| | - K. K. Roy
- Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India
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Debruin DA, Andreacchio N, Hanson ED, Timpani CA, Rybalka E, Hayes A. The Effect of Vitamin D Supplementation on Skeletal Muscle in the mdx Mouse Model of Duchenne Muscular Dystrophy. Sports (Basel) 2019; 7:sports7050096. [PMID: 31035483 PMCID: PMC6572350 DOI: 10.3390/sports7050096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 12/29/2022] Open
Abstract
Vitamin D (VitD) has shown to be beneficial in reversing muscle weakness and atrophy associated with VitD deficiency. Duchenne muscular dystrophy is characterized by worsening muscle weakness and muscle atrophy, with VitD deficiency commonly observed. This study aimed to investigate the effect of VitD supplementation on dystrophic skeletal muscle. Eight-week old female control (C57BL/10; n = 29) and dystrophic (C57BL/mdx; n = 23) mice were randomly supplemented with one of three VitD enriched diets (1000, 8000 & 20,000 IU/kg chow). Following a four-week feeding period, the extensor digitorum longus (EDL) and soleus muscles contractile and fatigue properties were tested ex vivo, followed by histological analysis. As expected, mdx muscles displayed higher mass yet lower specific forces and a rightward shift in their force frequency relationship consistent with dystrophic pathology. There was a trend for mdx muscle mass to be larger following the 20,000 IU/kg diet, but this did not result in improved force production. Fiber area in the EDL was larger in mdx compared to controls, and there were higher amounts of damage in both muscles, with VitD supplementation having no effect. Four weeks of VitD supplementation did not appear to have any impact upon dystrophic skeletal muscle pathology at this age.
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Affiliation(s)
- Danielle A Debruin
- Institute of Sport and Health, Victoria University, Melbourne 3011, Australia.
- Australian Institute for Musculoskeletal Sciences (AIMSS), Melbourne 3021, Australia.
| | - Nicola Andreacchio
- Institute of Sport and Health, Victoria University, Melbourne 3011, Australia.
| | - Erik D Hanson
- Institute of Sport and Health, Victoria University, Melbourne 3011, Australia.
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Cara A Timpani
- Institute of Sport and Health, Victoria University, Melbourne 3011, Australia.
- Australian Institute for Musculoskeletal Sciences (AIMSS), Melbourne 3021, Australia.
| | - Emma Rybalka
- Institute of Sport and Health, Victoria University, Melbourne 3011, Australia.
- Australian Institute for Musculoskeletal Sciences (AIMSS), Melbourne 3021, Australia.
| | - Alan Hayes
- Institute of Sport and Health, Victoria University, Melbourne 3011, Australia.
- Australian Institute for Musculoskeletal Sciences (AIMSS), Melbourne 3021, Australia.
- Melbourne Medical School, The University of Melbourne, Melbourne 3010, Australia.
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Ghanbari Z, Karamali M, Mirhosseini N, Akbari M, Tabrizi R, Lankarani KB, Eftekhar T, Pesikhani MD, Borzabadi S, Asemi Z. Vitamin D Status in Women with Pelvic Floor Disorders: A Meta-Analysis of Observational Studies. J Midlife Health 2019; 10:57-62. [PMID: 31391753 PMCID: PMC6643706 DOI: 10.4103/jmh.jmh_9_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The current evidence regarding the association between vitamin D status and pelvic floor disorder (PFD) are inconclusive. This meta-analysis was aimed to summarize existing data demonstrating the association between Vitamin D status and PFD using published observational studies. All national and international databases including Web of Science, PubMed, Google Scholar, and Scopus were searched up until January 30, 2018, and related published studies retrieved for meta-analysis. The effect sizes of Vitamin D status were presented as standardized mean difference (SMD) with 95% confidence interval (CI), using random-effect models and inverse variance method. The Cochran Q statistic and I 2 tests were used to evaluate the heterogeneity across included studies. Seven studies with 3219 women were included our meta-analysis. There was heterogeneity existing among included studies (I 2 = 96.4%, P < 0.001), so a random-effect model was used. The findings of this meta-analysis revealed that the mean serum Vitamin D levels in women with PFD were significantly lower than healthy women (SMD -0.60; 95% CI, -1.06, -0.13; P = 0.01). This meta-analysis demonstrates lower levels of serum Vitamin D in women with PFD rather than healthy women. Additional prospective studies regarding the association between Vitamin D status and PFD are required to confirm our findings.
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Affiliation(s)
- Zinat Ghanbari
- Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Maryam Karamali
- Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran
| | | | - Maryam Akbari
- Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Tabrizi
- Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran B. Lankarani
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Eftekhar
- Reproductive Health Research Center, Tehran University of Medical Science, Tehran, Iran
| | | | - Shokoofeh Borzabadi
- Biology Department, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
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Abdul‐Razzak KK, Alshogran OY, Altawalbeh SM, Al‐Ghalayini IF, Al‐Ghazo MA, Alazab RS, Halalsheh OM, Sahawneh FE. Overactive bladder and associated psychological symptoms: A possible link to vitamin D and calcium. Neurourol Urodyn 2019; 38:1160-1167. [DOI: 10.1002/nau.23975] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/11/2019] [Accepted: 02/26/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Khalid K. Abdul‐Razzak
- Department of Clinical PharmacyFaculty of PharmacyJordan University of Science and TechnologyIrbid Jordan
| | - Osama Y. Alshogran
- Department of Clinical PharmacyFaculty of PharmacyJordan University of Science and TechnologyIrbid Jordan
| | - Shoroq M. Altawalbeh
- Department of Clinical PharmacyFaculty of PharmacyJordan University of Science and TechnologyIrbid Jordan
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Protective Role of Nuclear Factor Erythroid-2-Related Factor 2 against Mechanical Trauma-Induced Apoptosis in a Vaginal Distension-Induced Stress Urinary Incontinence Mouse Model. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:2039856. [PMID: 30962861 PMCID: PMC6431382 DOI: 10.1155/2019/2039856] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 12/11/2018] [Accepted: 01/14/2019] [Indexed: 11/17/2022]
Abstract
Apoptosis and oxidative damage are involved in the pathogenesis and progression of stress urinary incontinence (SUI). Our previous results indicate that cell apoptosis and oxidative damage increase in a mouse model of mechanical injury-induced SUI and in fibroblasts treated with excessive mechanical strain. Nuclear factor erythroid-2-related factor 2 (Nrf2) is a well-characterized global antioxidant gene inducer that can reduce oxidative damage and apoptosis. Therefore, we predicted that Nrf2 may have a protective role in mechanical trauma-induced SUI. To test this hypothesis, a mouse model of vaginal distension- (VD-) induced SUI was established. Leak point pressure (LPP); levels of apoptosis, apoptosis-related proteins, and peroxidation products; and the activities of antioxidative proteins in the anterior vaginal wall were measured in wild-type (Nfe2l2+/+) C57BL/6 mice and Nrf2-knockout mice (Nfe2l2−/−). The results showed that Nrf2 knockout aggravated VD-induced reduction in LPP, increase in cell apoptosis and peroxidation product levels, decrease in antioxidative protein activities, and alterations in apoptosis-related protein levels in the vaginal walls of mice. To further confirm the role of Nrf2 in mechanical trauma-induced apoptosis and SUI, VD was performed on mice overexpressing Nrf2 via in vivo transfection of LV-Nfe2l2. The results showed that Nrf2 overexpression significantly alleviated VD-induced abnormalities in the anterior vaginal wall. Taken together, our data suggested that Nrf2 is a potential protective factor in mechanical trauma-induced apoptosis in a mouse model of SUI. Antioxidative therapy may be a promising treatment for mechanical trauma-related SUI.
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Ahn JH, Noh YH, Um KJ, Kim HS, Cho S. Vitamin D Status and Vitamin D Receptor Gene Polymorphisms Are Associated with Pelvic Floor Disorders in Women. J Menopausal Med 2018; 24:119-126. [PMID: 30202762 PMCID: PMC6127016 DOI: 10.6118/jmm.2018.24.2.119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/16/2018] [Accepted: 06/07/2018] [Indexed: 11/06/2022] Open
Abstract
Objectives To investigate if vitamin D receptor (VDR) gene polymorphisms and circulating vitamin D levels are associated with pelvic floor disorders (PFDs). Methods In this case-control study, 25-hydroxy-vitamin D (25[OH]D) serum levels were analyzed in 47 females with PFDs and 87 healthy females (controls), respectively. The VDR gene polymorphisms were determined by using polymerase chain reaction and performing digestions with 4 restriction enzymes i.e., ApaI, TaqI, FokI, and BsmI. Vitamin D levels of patients were divided into <20 ng/mL, 20 to 30 ng/mL, and ≥30 ng/mL categories. Results Our correlative analysis of VDR polymorphisms as a function of the presence of PFD showed that ApaI and BsmI polymorphisms were significantly associated with PFD in vitamin-D-deficiency and insufficiency groups (P < 0.05). Mean vitamin D levels did not differ between the PFD case (13.01 ± 0.84 ng/mL) and control (15.11 ± 1.04 ng/mL) groups (P > 0.05). However, there was a significant difference in the distribution of vitamin D levels between study group and controls using Pearson's χ2 test (<20 ng/mL, 20–30 ng/mL, and >30 ng/mL: 87.2%, 12.8%, and 0% in the study group and 75.9%, 16.1%, and 8.0% in controls, respectively, P < 0.05). Taken together, our observations suggest that vitamin D levels could be associated with PFDs and that 2 polymorphisms (i.e., ApaI and BsmI) in the VDR gene may contribute to an increased prevalence of PFDs in women with insufficient levels of vitamin D. Conclusions Examining vitamin D levels and performing a VDR genotype analysis may be helpful for assessing PFD risk.
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Affiliation(s)
- Jae Hyung Ahn
- Department of Obstetrics and Gynecology, Seoul Medical Center, Seoul, Korea
| | - Yoo Hun Noh
- Department of Anatomy and Cell Biology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Kyung Joo Um
- Department of Obstetrics and Gynecology, Seoul Medical Center, Seoul, Korea
| | - Hyo Sun Kim
- Department of Obstetrics and Gynecology, Seoul Medical Center, Seoul, Korea
| | - Sook Cho
- Department of Obstetrics and Gynecology, Seoul Medical Center, Seoul, Korea
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Aydogmus H, Demirdal US. Vitamin D Deficiency and Lower Urinary Tract Symptoms in Women. Eur J Obstet Gynecol Reprod Biol 2018; 228:48-52. [PMID: 29908378 DOI: 10.1016/j.ejogrb.2018.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/31/2018] [Accepted: 06/04/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The association of vitamin D deficiency and pelvic floor dysfunction has been examined by numerous studies. Lower urinary tract symptoms (LUTS) associated with bladder filling and voiding functions are common in both sexes. A recent study reports a higher incidence of LTUS in men over 50 years old with vitamin D deficiency. The aim of the study is to investigate whether there is a difference in the Lower Urinary Tract Symptoms frequency between women with vitamin D deficiency and the control group or not. STUDY DESIGN In this case control study, a total of 150 women who had a measured vitamin D level within a month were divided into two groups, one with a serum vitamin D deficiency and the other with a normal vitamin D level. Both groups were evaluated in terms of menopausal status, numbers of pregnancy and delivery, pelvic examination findings, pelvic floor muscle strength, level of pelvic organ prolapse, LUTS scores, and the findings were recorded. Both groups were compared for the presence of lower urinary system symptoms. The BFLUTS validated for Turkish-speaking populations was used to assess lower urinary system symptoms. Statistical analyses were performed via IBM SPSS Statistics 23.0. The results were considered significant at p < 0.05 and a confidence interval of 95%. RESULTS Vitamin D deficiency was detected in 67.3% of the participants. No significant differences were found between the groups regarding variables that could affect lower urinary system symptoms such as menopausal status, presence of pelvic organ prolapse and neonatal weight (fetal macrosomia) The Pelvic Floor Muscle Strength was significantly lower in the group with vitamin D deficiency than the control group. BFLUTS scores of premenopausal women with vitamin D deficiency were found to be similar to the control group, likewise no significant differences in the BFLUTS scores were detected in postmenopausal women. CONCLUSION Although vitamin D deficiency causes a significant reduction in pelvic floor muscle strength, no significant correlation was found between lower urinary tract symptoms and vitamin D deficiency. There is a necessity of prospective randomized controlled trials to investigate the relationship between vitamin D deficiency and pelvic floor functions.
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Affiliation(s)
- H Aydogmus
- İzmir Katip Çelebi University Atatürk Research and Training Hospital, Department of Gynecology and Obstetrics, Turkey.
| | - U S Demirdal
- İzmir Katip Çelebi University School of Medicine, Department of Physical Medicine and Rehabilitation, Turkey.
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25
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Impact of coexisting overactive bladder in Medicare patients with osteoporosis. Arch Gerontol Geriatr 2018; 75:44-50. [DOI: 10.1016/j.archger.2017.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 11/22/2022]
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Mechanism of Mechanical Trauma-Induced Extracellular Matrix Remodeling of Fibroblasts in Association with Nrf2/ARE Signaling Suppression Mediating TGF- β1/Smad3 Signaling Inhibition. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:8524353. [PMID: 29109834 PMCID: PMC5646330 DOI: 10.1155/2017/8524353] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/29/2017] [Accepted: 08/09/2017] [Indexed: 11/30/2022]
Abstract
Stress urinary incontinence (SUI) is a common hygienic problem affecting the quality of women's life worldwide. In this research, we revealed the involvement and regulation of extracellular matrix (ECM) remodeling, oxidative damage, and TGF-β1 signaling in the pathological mechanisms of mechanical trauma-induced SUI. We found that excessive mechanical strain significantly increased apoptosis rate, decreased cell viability and ECM production, and broke the balance of MMPs/TIMPs compared with the nonstrain control (NC) group. The expression levels of TGFβ1, p-Smad3, Nrf2, GPx1, and CAT were downregulated, the production of ROS, 8-OHdG, 4-HNE, and MDA was increased, and the nuclear translocation of Smad2/3 was suppressed after 5333 μstrain's treatment. Both mTGF-β1 pretreatment and Nrf2 overexpression could reverse mechanical injury-induced TGFβ1/Smad3 signaling inhibition and ECM remodeling, whereas mTGF-β1 had no effect on Nrf2 expression. Nrf2 overexpression significantly alleviated mechanical injury-induced ROS accumulation and oxidative damage; in contrast, Nrf2 silencing exhibited opposite effects. Besides, vaginal distention- (VD-) induced in vivo SUI model was used to confirm the in vitro results; Nrf2 knockout aggravates mechanical trauma-induced LPP reduction, ECM remodeling, oxidative damage, and TGF-β1/Smad3 suppression in mice. Therefore, we deduce that mechanical injury-induced ECM remodeling might be associated with Nrf2/ARE signaling suppression mediating TGF-β1/Smad3 signaling inhibition. This might reflect a new molecular target for SUI researches.
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Tang J, Liu C, Min J, Hu M, Li Y, Hong L. Potential therapeutic role of punicalagin against mechanical-trauma-induced stress urinary incontinence via upregulation of Nrf2 and TGF-β1 signaling : Effect of punicalagin on mechanical trauma induced SUI. Int Urogynecol J 2017; 28:947-955. [PMID: 28168411 PMCID: PMC5437194 DOI: 10.1007/s00192-017-3283-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 01/19/2017] [Indexed: 12/30/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We investigated the effect of punicalagin (PUN; 2,3-hexahydroxydiphenoyl-gallagyl-D-glucose), on mechanical-trauma-induced stress urinary incontinence (SUI) in mouse and the mechanisms underlying any effects. METHODS Ninety virgin female C57BL/6 mice were randomized into six groups: five groups underwent vaginal distention (VD) for 1 h and leak-point pressure (LPP) was measured on the 1st, 3rd, 7th, 14th, and 28th day following (VD groups 1 d, 3 d, 7 d, 14 d, and 28 d). The sixth group was a noninstrumented control (NC) group. Then, 75 virgin female C57BL/6 mice were randomized into five groups: a VD group (that just underwent VD) and an NC group were orally administered saline every day for 7 days; and three VD + PUN groups that underwent VD and were orally administered PUN respectively at 2.5, 5, and 10 mg/kg every day for 7 days. LPP was tested on the day 7, then all mice were sacrificed and their urethras and anterior vaginal walls harvested for Masson staining, immunohistochemistry study, Western blot analysis, and quantitative polymerase chain reaction (qPCR). RESULTS LPPs after VD were significantly lower than the NC group, and the LPPs of mice on days 14 and 28 day after VD were significantly higher than on the days 1, 3, and 7. PUN significantly improved VD-induced drops in LPP and alleviated VD-induced decrease of collagen I, collagen III, α-smooth muscle actin (SMA), transforming growth factor (TGF)-β1, and p-Smad3, nuclear factor-erythroid 2 p45-related factor 2 (Nrf2), and glutathione peroxidase (GPx1) protein levels, and increase of 8-hydroxydeoxyguanosine (OHdG) in urethra and anterior vaginal wall. PUN also up-regulated the expression of manganese superoxide dismutase (MnSOD), whereas protein levels of Smad 2, p-Smad2, and Smad3 were not changed. CONCLUSIONS PUN exerts certain therapeutic effect on mechanical-trauma-induced SUI in mice, which might be through the activation of TGF-β1/Smad3 and Nrf2/antioxidant response element (ARE) signaling activation.
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Affiliation(s)
- Jianming Tang
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, #238 Liberation Road, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Cheng Liu
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, #238 Liberation Road, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Jie Min
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, #238 Liberation Road, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Ming Hu
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, #238 Liberation Road, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Yang Li
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, #238 Liberation Road, Wuhan, 430060, Hubei Province, People's Republic of China
| | - Li Hong
- Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, #238 Liberation Road, Wuhan, 430060, Hubei Province, People's Republic of China.
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Abstract
INTRODUCTION Role of Vitamin D is very well known for the functioning of many body organs. However, its role in the postmenopausal women in relation to various genitourinary disorders has been recognized recently. The main objective of this study was to evaluate role of Vitamin D in vaginal health, prolapse, bladder and bowel function, and bacterial vaginosis (BV). MATERIALS AND METHODS This was a randomized controlled study in which 200 geriatric female patients of 65-78 years of age divided into two groups comprising study and control group with 100 participants in each. Detailed obstetrical, gynecological, and clinical history was elicited. Detailed examination regarding the prolapse, urinary and bowel functions, and bacterial infections was done followed by follow-up of 3 and 6 months each. Chi-square and independent t-test used for data analysis. RESULTS Mean modified vaginal health index (MVHI) among patients with pelvic floor diseases was statistically significant with P = 0.0472. There was a visible increasing trend in Vitamin D deficiency with increase in time since menopause (P = 0.1193). Patients with pelvic floor disease had mean Vitamin D statistically significant with P = 0.0462. With increase in Vitamin D levels, MVHI was found to be better. The association of mean Vitamin D levels among patients with urinary incontinence as compared to controls was significant with P = 0.0460. Association of mean Vitamin D levels in patients with fecal incontinence and BV as compared to controls was not statistically significant with P = 0.6304 and 0.79, respectively. Low Vitamin D levels were associated with high mean parathyroid hormone (PTH) levels statistically significant with P = 0.034. MVHI was found to increase significantly with Vitamin D supplementation at 3 and 6 months' follow-up. There was increase in Vitamin D and calcium levels and fall in serum PTH levels at 3 and 6 months. CONCLUSIONS Vitamin D levels were associated with a decreased risk of pelvic floor disorders, improved MVHI in women in geriatric age group.
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Affiliation(s)
- Harmanpreet Kaur
- Department of Obstetrics and Gynecology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Ripan Bala
- Department of Obstetrics and Gynecology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Madhu Nagpal
- Department of Obstetrics and Gynecology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
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Navaneethan PR, Kekre A, Jacob KS, Varghese L. Vitamin D deficiency in postmenopausal women with pelvic floor disorders. J Midlife Health 2015; 6:66-9. [PMID: 26167056 PMCID: PMC4481742 DOI: 10.4103/0976-7800.158948] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The aim of this study is to evaluate the association of vitamin D deficiency and pelvic floor disorders (PFD) including pelvic organ prolapse (POP) and stress urinary incontinence in postmenopausal women. MATERIALS AND METHODS This is a prospective case control study on 120 women with or without symptoms of PFD. Relevant history and clinical examination were conducted. Serum 25-hydroxy vitamin D levels were measured in all women. Chi square and student t test were used to test significance of association. Logistic regression was used to adjust for age. Odds ratios and 95% confidence intervals were calculated. RESULTS Of the 120 postmenopausal women included, 51 had PFD on clinical examination. Of the 51 cases, 28 women had POP and 14 women had stress incontinence (SUI) while nine women had both POP and SUI. The study showed that vitamin D levels were significantly lower in women with PFD than those without PFD. Menopausal status of more than 5 years was also significantly associated with PFD. CONCLUSION Findings suggest association of vitamin D deficiency and PFD in postmenopausal women. In addition, postmenopausal women have a high prevalence of vitamin D deficiency indicating a need to evaluate vitamin D levels in these women.
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Affiliation(s)
- Preethi Raja Navaneethan
- Department of Obstetrics and Gynecology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Aruna Kekre
- Department of Obstetrics and Gynecology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | | | - Lilly Varghese
- Department of Obstetrics and Gynecology, Christian Medical College Hospital, Vellore, Tamil Nadu, India
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Aydogmus S, Kelekci S, Aydogmus H, Demir M, Yilmaz B, Sutcu R. Association of antepartum vitamin D levels with postpartum pelvic floor muscle strength and symptoms. Int Urogynecol J 2015; 26:1179-84. [PMID: 25792352 DOI: 10.1007/s00192-015-2671-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 02/24/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Vitamin D affects skeletal muscle strength and functions via various mechanisms. Strength and/or functional dysfunctions of the pelvic floor muscles may be associated with the distortion of pelvic floor functions. We hypothesized that vitamin D deficiency may contribute to pelvic floor dysfunction (PFD) by affecting pelvic floor muscle strength (PFMS). The aim of this study was to assess the effect of vitamin D deficiency during pregnancy on postpartum PFMS. METHODS This cross-sectional study was conducted in a university hospital. One hundred and eighty pregnant women were admitted to our hospital in their third trimester and compared with 156 healthy nulliparous women. Venous blood samples for examining vitamin D levels were taken from each participant and stored at -80 °C. At 8-10 weeks postpartum, patients were invited to the hospital, asked about their PFD symptoms, and PFMS was measured using a perineometer. RESULTS There was no statistical significance among groups regarding mean age, maternal age, and weight at delivery. Postpartum PFMS and duration in vitamin D-deficient women were significantly lower than those without the deficiency. Vitamin D-deficient vaginal delivery cases (group I) had a postpartum PFMS average of 21.96 ± 7.91 cm-H₂O, nonvitamin D-deficient normal delivery cases (group III) had a PFMS of 29.66 ± 10.3 cm-H₂O (p = 0.001). In the cesarean delivery groups, vitamin D-deficient (group II) and nonvitamin D-deficient (group IV) cases had PFMS values of 32.23 ± 9.66 and 35.53 ± 15.58 cm-H₂O respectively (p = 0.258). CONCLUSIONS Lower vitamin D levels in the third trimester correlates with decreased PFMS.
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Affiliation(s)
- S Aydogmus
- Department of Gynaecology and Obstetrics, İzmir Katip Çelebi University School of Medicine, İzmir, Turkey,
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Aydogmus S, Kelekci S, Aydogmus H, Eriş S, Desdicioğlu R, Yilmaz B, Sağlam G. High prevalence of vitamin D deficiency among pregnant women in a Turkish population and impact on perinatal outcomes. J Matern Fetal Neonatal Med 2014; 28:1828-32. [PMID: 25260128 DOI: 10.3109/14767058.2014.969235] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Maternal vitamin D deficiency is a major public health problem. The aim of this study is to investigate the influence of vitamin D deficiency on perinatal results in primigravida. METHODS One-hundred fifty-two healthy nullipar women were included in the study. Pregnant women with serum vitamin D levels <15ng/ml were defined as Group I and ≥15 ng/dl were defined as Group II; data were evaluated retrospectively. Type of delivery, gestational age at birth, birth weight, intensive care of the newborn, peri-and postpartum complications were recorded. Statistical analyses were performed with SPSS for Windows (version 16.0 ). Categorical variables were assessed using chi-squared test. The numeric variables were analyzed using Student's t-test and one-way ANOVA. RESULTS 44.6% of pregnant women were found to have vitamin D deficiency. The mean serum vitamin D levels for Groups I and II were 10.8 ± 3.8 and 23.8 ± 13.3 ng/ml, respectively. SGA deliveries were detected in 16.66% and 4.87% of the primigravidas with and without vitamin D deficiency, respectively. CONCLUSIONS This study has shown that maternal vitamin D deficiency is related with an increased risk of SGA delivery. Further studies are needed to explain the relationship with vitamin D deficiency and poor perinatal outcomes.
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Affiliation(s)
- Serpil Aydogmus
- a Department of Obstetrics and Gynecology Izmi , School of Medicine
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