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Sun D, He H, Luo B, Xie B. The association between weight-adjusted-waist index and stress urinary incontinence in female adults: a population-based study. Int Urol Nephrol 2024; 56:1851-1858. [PMID: 38289545 DOI: 10.1007/s11255-023-03928-z] [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: 11/02/2023] [Accepted: 12/24/2023] [Indexed: 05/14/2024]
Abstract
INTRODUCTION Obesity has a significant impact on female stress urinary incontinence. The weight-adjusted-waist index (WWI), a newly explored metric for measuring physical obesity and stress urine incontinence, has not been investigated. METHODS Cross-sectional data were obtained from the 2011 to 2018 National Health and Nutrition Examination Survey (NHANES) of participants with complete data for WWI and SUI. The independent connection between WWI and SUI was examined using weighted multivariable logistic regression analyses. Smoothed curve fitting was used to study their relationship. In addition, subgroup analyses were performed, and interaction tests were undertaken. RESULTS In 2,361 female participants over 20, WWI and SUI showed a positive association. Model 3 found that for each one-unit increase in WWI, SUI prevalence increased by 38% [1.38 (1.20, 1.59)]. The prevalence of SUI was 84% higher among participants in the highest quartile of WWI compared to those in the lowest quartile [1.84 (1.32, 2.57)]. Observed nonlinear positive correlation between WWI and SUI was revealed through smoothed curve fitting. In addition, we found that WWI was more strongly associated with SUI than traditional indicators of obesity, including BMI and weight. CONCLUSIONS Females with higher weight-adjusted waist index levels were more likely to develop stress urinary incontinence and have a stronger correlation than traditional indicators of obesity. According to our research, WWI may help detect women's stress urinary incontinence (SUI), and managing obesity through the WWI index may reduce SUI prevalence rates.
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Affiliation(s)
- Dakai Sun
- Department of Urology Surgery, The Second People's Hospital of Qujing, Yunnan, China
| | - Haoyang He
- Department of Urology Surgery, The Second People's Hospital of Qujing, Yunnan, China
| | - Baqiang Luo
- Department of Urology Surgery, The Second People's Hospital of Qujing, Yunnan, China
| | - Botao Xie
- Department of Urology Surgery, The Second People's Hospital of Qujing, Yunnan, China.
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Wang J, Ye H, Zhang C, Zhang A. Association of diarrhea or constipation with urinary incontinence in adults: A cross-sectional analysis of the National Health and Nutrition Examination Survey. Neurourol Urodyn 2024. [PMID: 38693849 DOI: 10.1002/nau.25480] [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: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 05/03/2024]
Abstract
AIMS This study aimed to investigate the association between diarrhea or constipation and urinary incontinence (UI) in adults. METHODS Data from the National Health and Nutrition Examination Survey for 2009-2010 was used to include 4686 adults aged 20 and over in the analysis. Stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) were used as outcome variables, with diarrhea and constipation as exposure factors. We first compared the baseline characteristics of those with and without SUI, as well as those with and without UUI. The impact of diarrhea or constipation on SUI and UUI was assessed using multivariate logistic regression models. To ensure the stability of the results, subgroup and stratified analyses were conducted. RESULTS The prevalence rates of UUI and SUI were 22.49% and 23.39%, respectively. Adjusted multivariate logistic regression analysis revealed that the risk of UUI was increased by either diarrhea (OR 1.66, 95% CI 1.36-2.04) or constipation (OR 1.42, 95% CI 1.11-1.83). The risk of SUI was also elevated by either diarrhea (OR 1.36, 95% CI 1.11-1.67) or constipation (OR 1.32, 95% CI 1.06-1.63). Subgroup analysis revealed no significant differences in the interaction tests between constipation or diarrhea and UI. CONCLUSIONS This study found that both constipation and diarrhea increase the risk of UUI and SUI.
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Affiliation(s)
- Junwei Wang
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Haibo Ye
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Cunming Zhang
- Department of Urology, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
| | - Aiwei Zhang
- Department of Ultrasound, Wenling Hospital Affiliated to Wenzhou Medical University (The First People's Hospital of Wenling), Taizhou, Zhejiang, China
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Xu M, Zhang X, Zhuo Y, Wu W, Liu Q, Qin S, Long Z, Ai K, Li Y, Zhang H. Health Qigong Mawangdui Guidance can improve pelvic floor muscle function and quality of life in females with stress urinary incontinence: A randomized controlled trial pilot study. Medicine (Baltimore) 2024; 103:e37671. [PMID: 38608094 PMCID: PMC11018200 DOI: 10.1097/md.0000000000037671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) is a great problem of public health, especially for women's quality of life. UI afflicts at least 21.6% of the global population, and more than half of the UI is related to female stress urinary incontinence (SUI). Mawangdui Guidance plays an important role in preventing diseases and maintaining health. METHODS Sixty female patients with SUI were randomly divided into a control group (n = 30) and an experimental group (n = 30). Patients in both groups were treated with basic rehabilitation therapy under the guidance of rehabilitation therapists who were trained in Mawangdui Guidance, based on the former, the experimental group was taught to exercise Mawangdui Guidance(including selected movements: "Qishi," "Longdeng," "Chishi," and "Yinyao"), while the control group performed Kegel exercise with a procedure of 20 min, six times per week for 6 weeks. The function was mainly evaluated by the 1 h pad-test, incontinence quality of life questionnaire (I-QOL), and international consultation on incontinence questionnaire urinary incontinence short form (ICI-Q-SF). In addition, evaluation of pelvic floor muscle function was also included in our assessment. RESULTS The leakage of urine in the 1 h pad-test was significantly decreased in both two groups after treatment (P < .05), and the urine leakage in the experimental group was significantly less than that in the control group (P < .05). The muscle strength of type I and II muscle fibers of the pelvic floor, intravaginal pressure, and I-QOL score in both two groups were increased after treatment; moreover, the experimental group was more significant than the control group (P <.05). The fatigue degree of type I and type II muscle fibers of the pelvic floor, and the ICI-Q-SF score in both groups were significantly improved after treatment (P < .05); however, there were no differences between these two groups. The total effective rate of the experimental group was 90.00%, and 76.67% in the control group (P <.05). CONCLUSION Mawangdui Guidance can effectively improve the function of pelvic floor muscle, improve the ability of urine storage and control, and alleviate the symptoms of female patients with SUI. However, the international research on Mawangdui Guidance is very limited, and more in-depth research is needed.
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Affiliation(s)
- Ming Xu
- College of Acupuncture-Moxibustion and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
| | - Xu Zhang
- College of Acupuncture-Moxibustion and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
| | - Yue Zhuo
- College of Acupuncture-Moxibustion and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
| | - Wanrong Wu
- College of Acupuncture-Moxibustion and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
- The First Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Qiong Liu
- College of Acupuncture-Moxibustion and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
| | - Shuang Qin
- College of Acupuncture-Moxibustion and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
| | - Zhuan Long
- College of Sports Art, Hunan University of Chinese Medicine, Changsha, China
| | - Kun Ai
- College of Acupuncture-Moxibustion and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
| | - Ya Li
- Changsha Central Hospital, Changsha, China
| | - Hong Zhang
- College of Acupuncture-Moxibustion and Rehabilitation, Hunan University of Chinese Medicine, Changsha, China
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Yavuz M, Etiler N. Addressing urinary incontinence by gender: a nationwide population-based study in Turkiye. BMC Urol 2023; 23:205. [PMID: 38071293 PMCID: PMC10710702 DOI: 10.1186/s12894-023-01388-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/06/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Urinary incontinence (UI), which usually occurs in women but affects both sexes, is a significant public health challenge. This study aims to comprehensively investigate the prevalence and determinants of UI in men and women, considering gender-specific factors. METHODS The study performed a secondary analysis on data obtained from 13,383 individuals surveyed in the 2019 Turkish Health Survey, providing a representation of the Turkish population. The dataset included sociodemographic and health-related variables like UI, body mass index (BMI), physical activity, smoking, and chronic diseases-statistical analysis employed chi-square tests and gender-stratified logistic regression models to identify UI-associated factors. RESULTS Our results showed that UI affected 8.8% of the population, with a striking gender disparity. Women had a notably higher prevalence at 11.2%, while men had a lower rate of 5.5%. Importantly, this gender gap narrowed with age. For example, in the 34-44 age group, the female/male ratio was 6.9, but it decreased to 1.4 in the 65-74 age group. Marital status and employment status played significant roles. Separated, divorced, or widowed individuals, particularly women, had the highest prevalence at 19.3%. Employment status influenced UI prevalence, with employed men having the lowest rate (2.1%), while retired women faced the highest rate (15.0%). Higher BMI, especially in obese individuals, significantly raised UI prevalence, reaching 7.9% for men and 15.8% for women. Physical inactivity, notably in women (17.0%), and prolonged sedentary hours (13.9%) were associated with higher UI rates. Former smokers, especially women (15.9%), had a notable impact on UI. Poor perceived health and chronic conditions like Chronic Obstructive Pulmonary Disease (COPD), hypertension, and diabetes were significantly associated with higher UI prevalence. Logistic regression analysis revealed that age, education, perceived health status, COPD, and diabetes were significant factors associated with UI in both sexes, while in women, BMI, physical activity, and smoking also played notable roles. CONCLUSIONS This extensive UI study has unveiled notable gender disparities and determinants. Notably, these disparities decrease with age, underlining UI's changing nature over time. Modifiable factors impact women more, while non-modifiable factors are linked to men. The study underscores the importance of tailoring healthcare strategies to address UI based on gender.
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Affiliation(s)
- Melike Yavuz
- Faculty of Medicine, Department of Public Health, Bahcesehir University, Istanbul, Türkiye.
| | - Nilay Etiler
- School of Public Health, University of Nevada Reno, NV, USA
- Faculty of Medicine, Department of Public Health, Istanbul Okan University, Istanbul, Türkiye
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Juhl C, Thimm MH, Glavind K. Impact on urinary incontinence after management of complications related to a retropubic midurethral sling. Int Urogynecol J 2023; 34:2767-2774. [PMID: 37470797 PMCID: PMC10682045 DOI: 10.1007/s00192-023-05600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/07/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The most common complications to midurethral sling (MUS) operations for stress urinary incontinence are postoperative urinary retention (POUR), vaginal MUS exposure, and urgency. They are well described but consensus regarding their management is missing. An evaluation of the treatment of POUR, exposure and urgency after the MUS procedure in our department was implemented. Incontinence status after treatment of complications was evaluated. METHODS A review of the medical records of women undergoing MUS procedures from 1 January 2017 to 31 December 2021 (n = 329). RESULTS A total of 279 women (85%) had no complications. Fifty women had one or more complications. Twenty-three women (7%) experienced POUR. Final treatment in 9 women was clean intermittent self-catheterization (CISC). All remained continent. Nine women had the MUS mobilized. This was successful in 8 women who remained continent. Six women had their MUS incised (one after unsuccessful mobilization). Four became incontinent again and 2 remained continent. Eight women had vaginal MUS exposure. Seven attempted recovering of the MUS. This was successful in 3 patients. The remaining had a partial MUS removal. Only 33% remained continent after removal. Ten patients developed de novo urge, but only 2 needed medication. CONCLUSIONS Mobilization of the MUS must be considered the optimal treatment for POUR when CISC fails. It is the most effective intervention with the best effect on POUR and the lowest risk of incontinence. Concerning vaginal exposure, a trial of recovering should be attempted as the risk of incontinence when undergoing a partial removal of the MUS is considerable.
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Affiliation(s)
- Caroline Juhl
- Department of Gynecology and Obstetrics, Aalborg University Hospital, Reberbansgade 15, 9000, Aalborg, Denmark.
| | - Mette Holberg Thimm
- Department of Gynecology and Obstetrics, Aalborg University Hospital, Reberbansgade 15, 9000, Aalborg, Denmark
| | - Karin Glavind
- Department of Gynecology and Obstetrics, Aalborg University Hospital, Reberbansgade 15, 9000, Aalborg, Denmark
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Yuen MMA. Health Complications of Obesity: 224 Obesity-Associated Comorbidities from a Mechanistic Perspective. Gastroenterol Clin North Am 2023; 52:363-380. [PMID: 37197879 DOI: 10.1016/j.gtc.2023.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Obesity is associated with a wide range of comorbidities that transverse multiple specialties in clinical medicine. The development of these comorbidities is driven by various mechanistic changes including chronic inflammation and oxidative stress, increased growth-promoting adipokines, insulin resistance, endothelial dysfunction, direct loading and infiltrative effect of adiposity, heightened activities of the renin-angiotensin-aldosterone system and sympathetic nervous system, impaired immunity, altered sex hormones, altered brain structure, elevated cortisol levels, and increased uric acid production, among others. Some of the comorbidities might develop secondary to one or more other comorbidities. Considering the obesity-associated comorbidities in the context of the mechanistic changes is helpful in understanding these conditions and in guiding treatment and future research.
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Affiliation(s)
- Michele M A Yuen
- Department of Medicine, Obesity, Metabolism and Nutrition Institute, Massachusetts General Hospital; University of Hong Kong, 102 Pokfulam Road, Pok Fu Lam, Hong Kong.
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Zhou Y, Luo Y, Zhou Q, Xu J, Tian S, Liao B. Effect of gestational weight gain on postpartum pelvic floor function in twin primiparas: a single-center retrospective study in China. BMC Pregnancy Childbirth 2023; 23:273. [PMID: 37081492 PMCID: PMC10120153 DOI: 10.1186/s12884-023-05602-9] [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: 06/29/2022] [Accepted: 04/12/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The effect of gestational weight gain (GWG) as a controllable factor during pregnancy pelvic floor function has rarely been investigated, and studies on twin primiparas are even less frequent. The objective of the present study was to explore the effect of GWG on postpartum pelvic floor function in twin primiparas. METHODS We retrospectively analyzed the clinical data of 184 twin primiparas in the pelvic floor rehabilitation system of the First Affiliated Hospital of Chongqing Medical University from January 2020 to October 2021. Based on the GWG criteria recommended by the Institute of Medicine, the study subjects were classified into two groups: adequate GWG and excessive GWG. Univariate and multivariate logistic regression models were applied to explore the relationship between GWG and pelvic floor function. RESULTS Among the 184 twin primiparas, 20 (10.87%) had excessive GWG. The rates of abnormal vaginal dynamic pressure (95% vs. 74.39%), injured type I muscle fibers (80% vs. 45.73%), anterior vaginal wall prolapse (90% vs. 68.90%), and stress urinary incontinence (50% vs. 20.12%) of twin primiparas with excessive GWG were significantly higher than those with adequate GWG. There was no significant difference between the total score of the Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20) or the scores of the Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), the Colorectal-Anal Distress Inventory 8 (CRADI-8), and the Urinary Distress Inventory 6 (UDI-6) in the two groups (P > 0.05). After adjusting for potential confounding factors, the results showed that excessive GWG was positively associated with abnormal vaginal dynamic pressure (OR = 8.038, 95% CI: 1.001-64.514), injured type I muscle fibers (OR = 8.654, 95% CI: 2.462-30.416), anterior vaginal wall prolapse (OR = 4.705, 95% CI: 1.004-22.054), and stress urinary incontinence (OR = 4.424, 95% CI: 1.578-12.403). CONCLUSION Excessive GWG in twin primiparas was positively correlated with the prevalence of pelvic floor dysfunction but did not exacerbate pelvic floor symptoms in twin primiparas. Controlling GWG within a reasonable range is recommended for reducing the risk of PFDs in pregnant women with twins.
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Affiliation(s)
- Ying Zhou
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyilu Street, Yuzhong District, Chongqing, 400016, China
| | - Yetao Luo
- Department of Nosocomial Infection Control, The Second Affiliated Hospital of Army Medical University, No. 83 Xinqiaozheng Street, Shapingba District, Chongqing, 400037, China
| | - Qirong Zhou
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyilu Street, Yuzhong District, Chongqing, 400016, China
| | - Jiangyang Xu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyilu Street, Yuzhong District, Chongqing, 400016, China
| | - Shengyu Tian
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyilu Street, Yuzhong District, Chongqing, 400016, China
| | - Bizhen Liao
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyilu Street, Yuzhong District, Chongqing, 400016, China.
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Hjorth S, Axelsen SM, Gommesen D, Kjeldsen ACM, Taastrøm KA, Nohr EA. Body mass index, waist circumference, and urinary incontinence in midlife: A follow-up of mothers in the Danish National Birth Cohort. Neurourol Urodyn 2023. [PMID: 36942471 DOI: 10.1002/nau.25175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 02/15/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Obesity is a modifiable risk factor for urinary incontinence, yet few studies have investigated how waist circumference as compared to body mass index (BMI) influences the risk of urinary incontinence. OBJECTIVE To estimate how BMI and waist circumference associates with risk of urinary incontinence in midlife and determine which of the two is the strongest predictor of urinary incontinence. METHODS Cohort study among mothers in the Danish National Birth Cohort. Weight and waist circumference were self-reported 7 years after cohort entry. Symptoms of urinary incontinence in midlife were self-reported using the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and analyzed continuously and as presence or absence of any, stress (SUI), urgency (UUI), and mixed (MUI) urinary incontinence. Linear and log binomial regressions were used to calculate mean differences and risk ratios (RR) with 95% confidence intervals (CI). Restricted cubic splines were generated to explore nonlinear relationships. RESULTS Among 27 254 women at a mean age of 44.2 years, any urinary incontinence was reported by 32.1%, SUI by 20.9%, UUI by 2.4%, and MUI by 8.6%. For all outcomes, increases in risk were similar with higher BMI and waist circumference. The estimates of association were strongest for MUI (RR 1.10, 95% CI 1.08;1.12 and RR 1.12, 95% CI 1.10;1.14 for half a standard deviation increase in BMI and waist circumference, respectively). While increases in risk of the other outcomes were seen across the entire range of BMI and waist circumference, the risk of SUI rose until BMI 28 kg/m2 (waist circumference 95 cm), and then fell slightly. CONCLUSIONS Symptoms of urinary incontinence and prevalence of any urinary incontinence, SUI, UUI, and MUI increased with higher BMI and waist circumference. Self-reported BMI and waist circumference were equally predictive of urinary incontinence.
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Affiliation(s)
- Sarah Hjorth
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Susanne M Axelsen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte Gommesen
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Anne C M Kjeldsen
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Katja A Taastrøm
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Ellen A Nohr
- Department of Clinical Research, Research unit for Gynecology and Obstetrics, University of Southern Denmark, Odense, Denmark
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Markland AD, Shan L, Brady SS, Schreiner PJ, Sidney S, Van Den Eeden SK, Lewis CE. Characterizing the Spectrum of Bladder Health and Lower Urinary Tract Symptoms (LUTS) Among Women: Results From the CARDIA Study. Urology 2021; 158:88-94. [PMID: 34087312 PMCID: PMC9060156 DOI: 10.1016/j.urology.2021.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To operationalize a new definition for bladder health, we examined the distribution of lower urinary tract symptoms (LUTS) and impact, along with associated factors, among women in the Coronary Artery Risk Development in Young Adults (CARDIA) study. METHODS We performed cluster analyses using validated LUTS symptom burden and impact scales collected between 2005-2006 and 2010-2011. We performed multinomial logistic regression analyses to evaluate cardiovascular factors (metabolic syndrome, cardiovascular health behaviors, and inflammation) between clusters after adjusting for covariates (demographic, obstetric/gynecologic, co-morbidities). RESULTS Among CARDIA women (median age 51, range 42-59) with complete LUTS data (n = 1302), we identified and compared 4 cluster groups: women who reported no or very mild symptoms and no impact on well-being (bladder health, 44%, n = 569), versus women with LUTS and negative impact on well-being ranging from mild (31%, n = 407), moderate (20%, n = 259), to severe (5%, n = 67). With each 1-point lower BMI (kg/m2), odds of membership in mild (OR 0.97, CI 0.95-0.99), moderate (OR 0.95, CI 0.93-0.98), and severe (OR 0.90, CI 0.88-0.94) LUTS cluster groups versus the bladder health group were lower. Compared to women with metabolic syndrome, women without metabolic syndrome had lower odds of membership in mild (OR 0.67, CI 0.45-0.99), moderate (OR 0.51, CI 0.33-0.79), and severe (OR 0.48, CI 0.24-0.94) LUTS cluster groups versus the bladder health group. CONCLUSION Two out of 5 midlife women met our definition of bladder health. Bladder health and cardiovascular health among women may share common factors, including lower BMI and the absence of metabolic syndrome.
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Affiliation(s)
- Alayne D Markland
- Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, Birmingham, AL; University of Alabama at Birmingham, School of Medicine, Department of Medicine.
| | - Liang Shan
- University of Alabama at Birmingham, School of Medicine, Department of Medicine
| | - Sonya S Brady
- University of Minnesota, School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN
| | - Pamela J Schreiner
- University of Minnesota, School of Public Health, Division of Epidemiology & Community Health, Minneapolis, MN
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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10
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Suchithra BS, Dsilva F, Rajeev TP, Dsouza N. Mitigating Symptoms and Enhancing Quality of Life among Women with Stress Urinary Incontinence. Indian J Community Med 2021; 46:568-569. [PMID: 34759514 PMCID: PMC8575190 DOI: 10.4103/ijcm.ijcm_859_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 05/26/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- B S Suchithra
- Department of Community Health Nursing, Nitte Usha Institute of Nursing Sciences, Mangalore, Karnataka, India
| | - Fatima Dsilva
- Department of Medical Surgical Nursing, Nitte Usha Institute of Nursing Sciences, Mangalore, Karnataka, India
| | - T P Rajeev
- Department of Urology, Justice K.S Hegde Charitable Hospital, Mangalore, Karnataka, India
| | - Neevan Dsouza
- Department of Humanities, K.S Hegde Medical Academy, Mangalore, Karnataka, India
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Pipitone F, Sadeghi Z, DeLancey JO. Urethral function and failure: A review of current knowledge of urethral closure mechanisms, how they vary, and how they are affected by life events. Neurourol Urodyn 2021; 40:1869-1879. [PMID: 34488242 PMCID: PMC8556259 DOI: 10.1002/nau.24760] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/15/2021] [Accepted: 07/18/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION A critical appraisal of the literature regarding female urethral function and dysfunction is needed in light of recent evidence showing the urethra's role in causing stress and urge urinary incontinence. METHODS An evidence assessment was conducted using selected articles from the literature that contained mechanistic data on factors affecting urethral function and failure. RESULTS Maximal urethral closure pressure (MUCP) is 40% lower in stress urinary incontinence (SUI) than normal controls. Evidence from five women shows relatively equal contributions to MUCP from striated/smooth muscle, vascular-plexus, connective tissue. MUCP varies twofold in individuals of similar age and declines 15% per decade even in nulliparous women. Age explains 57% of the variance in MUCP. This parallels with striated/smooth muscle loss and reduced nerve density. Factors influencing pressure variation minute-to-minute and decade-to-decade are poorly understood. Connective tissue changes have not been investigated. MUCP in de novo SUI persisting 9-months postpartum is 25% less than in age and parity-matched controls. Longitudinal studies do not show significant changes in urethral function after vaginal birth suggesting that changes in urethral support from birth may unmask pre-existing sphincter weakness and precipitate SUI. Mechanisms of interaction between support injury, pre-existing urethral weakness, and neuropathy are unclear. CONCLUSION Urethral failure is the predominant cause of SUI and a contributing factor for UUI; potentially explaining why mixed symptoms predominate in epidemiological studies. Age-related striated muscle loss and differences between women of similar age are prominent features of poor urethral closure. Yet, connective tissue changes, vasculature function, and complex interactions among factors are poorly understood.
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Affiliation(s)
- Fernanda Pipitone
- Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI, USA
- Hospital das Clínicas da FMUSP, University of São Paulo, São Paulo, Brazil
| | - Zhina Sadeghi
- Division of Neurourology and Pelvic Reconstructive Surgery, Department of Urology University of Michigan, Ann Arbor, MI
| | - John O.L. DeLancey
- Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI, USA
- Department of Obstetrics and Gynecology, Michigan Medicine, Ann Arbor, MI, USA
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Suchithra BS, Rajeev TP, Dsilva F. Risk Factors of Urogenital Problems among Perimenopausal Women. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2021. [DOI: 10.1055/s-0041-1731913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Introduction Menopause is a natural event that results from cessation of the menstrual cycle. It usually occurs in midlife, marking the end of women’s reproductive life. Perimenopause refers to the time at which our body makes the natural transition to the menopause and may last for 4 to 8 years. A lot of urogenital problems start appearing after the age of 40 in women. The aim of the study is to identify the risk factors of the urogenital problems in perimenopausal women.
Materials and Methods An explorative survey design with a purposive sampling method was used to collect the data from 200 women and older than 40 years admitted to the tertiary care hospital and a community under Natekal Primary Health Center were selected for the study.
Results A total of 200 women were enrolled; 85 (42.5%) had urinary tract infections, 49 (24.5%) had urinary retention, 35 (17.5%) had vaginal dryness, 17 (8.5%) had urinary incontinence, 14 (7%) had a loss of libido. The majority, 76 (38%), had this problem for 1 to 2 years. There was association between selected demographic variables with risk factors like occupation (0.023; p < 0.05), number of children (0.023; p < 0.05), and mode of delivery (0.023; p < 0.05).
Conclusion The study result concludes that there was a significant association between urogenital problems and risk factors.
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Affiliation(s)
- B. S. Suchithra
- Department of Community Health Nursing, Nitte Usha Institute of Nursing Sciences, Nitte (deemed to be University), Mangaluru, Karnataka, India
| | - T. P. Rajeev
- Department of Urology, K.S. Hegde Charitable Hospital, Mangaluru, Karnataka, India
| | - Fatima Dsilva
- Faculty of Nursing Sciences, Nitte Usha Institute of Nursing Sciences, Nitte (deemed to be University), Mangaluru, Karnataka, India
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Doumouchtsis SK, Loganathan J, Pergialiotis V. The Role of Obesity on Urinary and Anal Incontinence in women: a review. BJOG 2021; 129:162-170. [PMID: 34312978 DOI: 10.1111/1471-0528.16848] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 11/30/2022]
Abstract
Obesity is increasing worldwide with significant healthcare implications. We searched PubMed/MEDLINE, Embase and Cochrane Library for articles registered until June 2020 to explore the relationship between obesity, urinary (UI) and anal incontinence (AI). Obesity is associated with low-grade, systemic inflammation and pro-inflammatory cytokine release, producing reactive oxygen species and oxidative stress (1). This alters collagen metabolism and, in combination with increased intraabdominal pressure, contributes to UI development. Whereas in AI, stool consistency may be a factor. Weight loss can reduce UI and should be a management focus, however effect on AI is less clear. Keywords: Obesity, Urinary incontinence, Anal incontinence.
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Affiliation(s)
- Stergios K Doumouchtsis
- Epsom and Saint, Helier University Hospitals NHS Trust, Obstetrics and Gynaecology, Surrey, UK
| | - Jemina Loganathan
- Epsom and Saint, Helier University Hospitals NHS Trust, Obstetrics and Gynaecology, Surrey, UK
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Moossdorff-Steinhauser HFA, Berghmans BCM, Spaanderman MEA, Bols EMJ. Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis. Int Urogynecol J 2021; 32:1633-1652. [PMID: 33439277 PMCID: PMC8295103 DOI: 10.1007/s00192-020-04636-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) is a common and embarrassing complaint for pregnant women. Reported prevalence and incidence figures show a large range, due to varying case definitions, recruited population and study methodology. Precise prevalence and incidence figures on (bothersome) UI are of relevance for health care providers, policy makers and researchers. Therefore, we conducted a systematic review and meta-analysis to investigate the prevalence and incidence of UI in pregnancy in the general population for relevant subgroups and assessed experienced bother. METHODS All observational studies published between January 1998 and October 2018 reporting on prevalence and/or incidence of UI during pregnancy were included. All women, regardless of weeks of gestation and type of UI presented in all settings, were of interest. A random-effects model was used. Subgroup analyses were conducted by parity, trimester and subtype of UI. RESULTS The mean (weighted) prevalence based on 44 included studies, containing a total of 88.305 women, was 41.0% (range of 9-75%). Stress urinary incontinence (63%) is the most prevalent type of UI; 26% of the women reported daily loss, whereas 40% reported loss on a monthly basis. Bother was experienced as mild to moderate. CONCLUSIONS UI is very prevalent and rising with the weeks of gestation in pregnancy. SUI is the most common type and in most cases it was a small amount. Bother for UI is heterogeneously assessed and experienced as mild to moderate by pregnant women.
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Affiliation(s)
| | - Bary C M Berghmans
- Pelvic care Unit Maastricht, CAPHRI, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | | | - Esther M J Bols
- Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
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Dicpinigaitis PV. Prevalence of stress urinary incontinence in women presenting for evaluation of chronic cough. ERJ Open Res 2021; 7:00012-2021. [PMID: 33644221 PMCID: PMC7897843 DOI: 10.1183/23120541.00012-2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 11/17/2022] Open
Abstract
Cough is among the most common symptoms for which individuals seek medical attention. The majority of women seeking evaluation of chronic cough report the presence of cough-induced stress urinary incontinence. https://bit.ly/3iAr9rh.
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Gleicher S, Byler T, Ginzburg N. Association Between Stress Urinary Incontinence and the Components of Metabolic Syndrome Among Females 20-59 Years. Urology 2020; 145:100-105. [PMID: 32735979 DOI: 10.1016/j.urology.2020.07.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/04/2020] [Accepted: 07/09/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To assess the relationship between stress urinary incontinence (SUI) and metabolic syndrome among a population-based cohort of women 20-59 years. METHODS National Health and Nutrition Examination Survey database was used between the years of 2013 and 2016 and included women aged 20-59 years. SUI was defined as "Urinary leakage with physical activity." Metabolic syndrome was defined as >2 risk factors: fasting blood glucose (FBG) >99 mg/dL, triglyceride >149 mg/dL, high-density lipoprotein <50 mg/dL, waistline >88 cm, and blood pressure >130/85. We generated weighted estimated prevalence and ran multivariable logistic regression models. RESULTS Among 3430 female subjects, the estimated prevalence of SUI was 38.7% (95% confidence interval [CI] 36.7-40.7%) and metabolic syndrome was 10.2% (95% CI 8.9-11.6). Higher rates of SUI were seen with large waistlines, elevated FBG, and elevated triglycerides. Among women with metabolic syndrome, 56.1% (95% CI 39.7-49.0%) had SUI. Among all women, metabolic syndrome and elevated FBG significantly increase the risk of SUI (odds ratio [OR] 1.53 [95% CI 1.02-2.28] and OR 1.86 [95% CI 1.14-3.03], respectively). In women 20-39 years, a large waistline significantly increased the risk of SUI (OR 1.72 [95% CI 1.00-2.99]). CONCLUSION Among females 20-59 years in the United States, 38.7% report SUI and 10% have metabolic syndrome. Metabolic syndrome and an elevated FBG significantly increase the risk of SUI among all women. A large waistline increases the risk of SUI in women aged 20-39 years. Weight loss and adequate control of metabolic syndrome should be considered key strategies in the management of SUI.
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Affiliation(s)
| | - Timothy Byler
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY
| | - Natasha Ginzburg
- Department of Urology, SUNY Upstate Medical University, Syracuse, NY.
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17
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Scarabelot KS, da Silva Pereira F, Pelegrini A, Tuon T, Virtuoso JF. Anthropometric indicators as predictors of pelvic floor muscle distress in young women. Neurourol Urodyn 2020; 39:1949-1957. [PMID: 32628314 DOI: 10.1002/nau.24406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/14/2020] [Indexed: 11/06/2022]
Abstract
AIM To identify anthropometric indicators that could predict pelvic floor muscle distress (PFMD) in young women. METHOD A cross-sectional study was conducted, whose sample consisted of 54 women aged between 18 and 35 years. The Pelvic Floor Distress Inventory was used to assess the PFMD. The anthropometric indicators evaluated were body mass index (BMI) being measured the weight and height, body fat percentage (skinfolds), waist circumference (WC), waist-to-hip ratio (WHR), and relative fat mass (RFM), which is calculated from height and WC. Descriptive and inferential statistics (Spearman correlation, simple linear regression, and receiver operating characteristic curve) were used, with a significance level of 5%. RESULTS The PFMD and the anthropometric indicators BMI (r = .43), body fat percentage (r = .42), WC (r = .46), WHR (r = .49), and RFM (r = .48) showed a positive and moderate correlation (P < .01). In all, 24%, 23%, 20%, and 18% of the PFMD can be credited to RFM, WC, WHR, and body fat percentage, respectively. The cut-off point for RFM was 38.44 for the symptom of pressure in the lower abdomen and 36.24 for symptom of stress urinary incontinence and incomplete emptying of the bladder. CONCLUSION Anthropometric indicators of body fat percentage, WC, WHR, and RFM can be predictors of PFMD in young women minimally symptomatic.
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Affiliation(s)
- Karoline S Scarabelot
- Programa de Pós-Graduação em Ciências do Movimento Humano, UDESC, CEFID, Florianópolis, Santa Catarina, Brazil
| | - Franciele da Silva Pereira
- Programa de Pós-Graduação em Ciências do Movimento Humano, UDESC, CEFID, Florianópolis, Santa Catarina, Brazil
| | - Andreia Pelegrini
- Programa de Pós-Graduação em Ciências do Movimento Humano, UDESC, CEFID, Florianópolis, Santa Catarina, Brazil
| | - Talita Tuon
- Programa de Pós-Graduação em Ciências da Reabilitação, UFSC, Centro Araranguá, Santa Catarina, Brazil
| | - Janeisa F Virtuoso
- Programa de Pós-Graduação em Ciências da Reabilitação, UFSC, Centro Araranguá, Santa Catarina, Brazil
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Irwin RS, Dudiki N, French CL. Life-Threatening and Non-Life-Threatening Complications Associated With Coughing: A Scoping Review. Chest 2020; 158:2058-2073. [PMID: 32565267 DOI: 10.1016/j.chest.2020.06.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND This is an update of the section on complications that are associated with coughing in the 2006 CHEST cough guidelines that addresses two aims: (1) to systematically identify and thematically categorize the diverse complications of cough by providing a guide for future studies and (2) to identify gaps in the literature for future research. RESEARCH QUESTION What are the potential complications that are associated with the act of coughing that have been reported in infants, children, adolescents, and adults? STUDY DESIGN AND METHODS A scoping review was performed with the use of PubMed and SCOPUS databases that were searched from their beginning until September 6, 2019. RESULTS Two hundred forty-seven publications met our inclusion criteria. To these, we added 38 articles from the 2006 complications paper that were not identified in the literature search plus the paper itself for a final total of 286 publications that formed the basis of this review. Since 2006, three new categories of complications have been reported: ear, nose and throat; disease transmission; and laboratory testing. Multiple additional complications that fall outside of these three categories have also been identified and included in the following categories: cardiovascular, constitutional symptoms, dermatologic, GI, genitourinary, musculoskeletal, neurologic, ophthalmologic, psychosocial/quality of life, and respiratory. Not previously highlighted is that some of the complications led to serious morbidity that included death, especially in patients with comorbid conditions, and potentially resulted in harm to others when cough resulted in a motor vehicle accident. INTERPRETATION Our work identified a large number of cough complications that we thematically categorized primarily by organ system so that future studies of each system or each complication can be conducted. The gap in the literature that future studies should address is to identify the frequency of the complications and the strength of their association with cough. Only then will one be able to describe the findings in a manner that allows specific recommendations for avoiding these complications. In the meantime, patients with cough should be evaluated and treated according to evidence-based guidelines to mitigate or prevent the myriad of potential complications that are associated with coughing.
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Affiliation(s)
- Richard S Irwin
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA.
| | - Natasha Dudiki
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Cynthia L French
- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA
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- Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA
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Elshatanoufy S, Matthews A, Yousif M, Jamil M, Gutta S, Gill H, Galvin SL, Luck AM. Effect of Morbid Obesity on Midurethral Sling Efficacy for the Management of Stress Urinary Incontinence. Female Pelvic Med Reconstr Surg 2020; 25:448-452. [PMID: 29734200 DOI: 10.1097/spv.0000000000000594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The aim of our study was to assess midurethral sling (MUS) failure rate in the morbidly obese (body mass index [BMI] ≥40 kg/m) population as compared with normal-weight individuals. Our secondary objective was to assess the difference in complication rates. METHODS This is a retrospective cohort study. We included all patients who underwent a synthetic MUS procedure from January 1, 2008, to December 31, 2015, in our health system. Failure was defined as reported stress urinary incontinence symptoms or treatment for stress urinary incontinence. Variables collected were BMI; smoking status; comorbidities; perioperative (≤24 hours), short-term (≤30 days), and long-term (>30 days) complications; and follow-up time. Statistics include analysis of variance, χ test, logistic regression, Kaplan-Meier method, and Cox regression. RESULTS There were 431 patients included in our analysis. Forty-nine patients were in class 3 with a BMI mean of 44.9 ± 5.07 kg/m. Median follow-up time was 52 months (range, 6-119 months). Class 3 obesity (BMI ≥40 kg/m) was the only group that had an increased risk of failure when compared with the normal-weight group (P = 0.03; odds ratio, 2.47; 95% confidence interval, 1.09-5.59). Obesity was not a significant predictor of perioperative, short-term, or long-term postoperative complications (P = 0.19, P = 0.28, and P = 0.089, respectively) after controlling for other comorbidities. CONCLUSIONS Patients in the class 3 obesity group who are treated with an MUS are 2 times as likely to fail when compared with those in the normal-weight category on long-term follow-up with similar low complication rates.
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Affiliation(s)
- Solafa Elshatanoufy
- From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Henry Ford Health System
- Wayne State University
| | | | - Mairy Yousif
- Department of Obstetrics and Gynecology, Henry Ford Health System
| | | | - Sravanthi Gutta
- Department of Obstetrics and Gynecology, Henry Ford Health System
- Wayne State University, Detroit, MI
| | - Harmanjit Gill
- Department of Obstetrics and Gynecology, Henry Ford Health System
- Wayne State University, Detroit, MI
| | - Shelley L Galvin
- Division of Research, Grants and Library Services, Mountain Area Health Education Center.,Department of Obstetrics and Gynecology, UNC School of Medicine, Asheville, NC
| | - Ali M Luck
- From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Henry Ford Health System
- Wayne State University
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Yi YA, Keith CG, Graziano CE, Davenport MT, Bergeson RL, Christine BS, Morey AF. Strong correlation between standing cough test and 24-hour pad weights in the evaluation of male stress urinary incontinence. Neurourol Urodyn 2019; 39:319-323. [PMID: 31692080 DOI: 10.1002/nau.24200] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 10/21/2019] [Indexed: 11/08/2022]
Abstract
AIMS We sought to compare in-office physical exam findings via standing cough test (SCT) versus 24-hour pad weights among men seeking treatment for postprostatectomy stress urinary incontinence (SUI). METHODS A retrospective review of a single surgeon database of incontinence procedures was performed. Documentation of SUI severity (grades 0-4) was completed by SCT preoperatively utilizing the Male Stress Incontinence Grading Scale (MSIGS). All patients had pads per day (PPD) and 24-hour pad weights obtained. We determined the Spearman's correlation coefficient between these variables. RESULTS We identified 104 men who underwent anti-incontinence surgery (AdVance Sling or artificial urinary sphincter [AUS]). In the sling group (65 patients), nearly all (97%) had minimal incontinence with SCT (MSIGS = 0-2). In the AUS group (39 patients), most patients (69%) had an MSIGS 3 or 4 with SCT. Spearman's coefficient between quantification of SCT and pad weight for the overall group was ρ = .68 (P < .0001) demonstrating a strong positive correlation. PPD was also strongly correlated with pad weight (ρ = .55, P < .0001). As seen previously, SCT and PPD were correlated (ρ = .47, P < .0001). In a multivariable model predicting pad weight, the effect of SCT was greater than PPD (β = 83 [54-111], P < .0001 vs 45 [2169], P = .0004). CONCLUSIONS SCT findings strongly correlate to 24-hour pad weights in the evaluation of male SUI. The SCT shows promise as a rapid, reliable, noninvasive measure of SUI severity before anti-incontinence surgery.
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Affiliation(s)
- Yooni A Yi
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas
| | | | | | | | - Rachel L Bergeson
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas
| | | | - Allen F Morey
- Department of Urology, UT Southwestern Medical Center, Dallas, Texas
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Chow JS. Stress urinary incontinence: An undertreated problem which deserves attention. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2019. [DOI: 10.1016/j.cobme.2019.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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SCARABELOT KS, ANTUNES MMU, PELEGRINI A, VIRTUOSO JF. Pelvic, anorectal and urinary symptoms according to the nutritional status of adult women: A cross-sectional study. REV NUTR 2019. [DOI: 10.1590/1678-9865201932e180257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT To review the occurrence of pelvic, anorectal and urinary symptoms according to the nutritional status of adultwomen. Methods This is a cross-sectional study with 54 women, aged 18 to 35 years, divided into normal weight (<25kg/m2), overweight (25kg/m2 to 29.99kg/m2) and obesity (≥30kg/m2) according to the body mass index. The presence of pelvic floor muscle dysfunction symptoms was assessed by the Pelvic Floor Distress Inventory and the impact of these symptoms by the Pelvic Floor Impact Questionnaire. Descriptive and inferential statistics were used, with a significance level of 5%. Results Pelvic Floor Distress Inventory total score was 22.95 (SD=26.11) in the eutrophic group and 59.67 (SD=47.80) in the obesity group (p=0.01). Considering the scales, urinary symptoms were higher in obese women than in the eutrophic group (p=0.01). In the assessment of patients with each symptom, a difference (p<0.01) was observed in incomplete bowel emptying, in which the highest frequency occurred in overweight women (47.4%) compared to eutrophic and obese women (both 26.3%). Urinary incontinence symptoms (18.2% in eutrophic women, 27.3% overweight and 54.5% obese), stress urinary incontinence (8.3% eutrophic, 41.7% overweight and 50.0%, obese) and difficulty in emptying the bladder (0.0% eutrophic, 33.3% overweight and 66.7% obese) exhibited higher frequencies (p=0.03; p<0,01 and p=0.02, respectively) in obese women. Conclusion Symptoms of pelvic floor muscles dysfunction, especially urinary tract muscles, occur more frequently in obese adult women when compared to eutrophic women.
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Urinary Incontinence and Surgery for Obesity and Weight-Related Diseases: Are There Predictors of Improvement? Obes Surg 2018; 29:109-113. [PMID: 30178155 DOI: 10.1007/s11695-018-3482-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE The aim of this study was to evaluate changes in urinary incontinence (UI) before and after surgery for obesity in female patients and to identify factors related to the remission of symptoms. MATERIALS AND METHODS This was a prospective cohort study with female patients over 18 years old who underwent surgery for obesity and weight-related diseases between June 2016 and September 2017. Urinary symptoms and quality of life related to UI were assessed based on a structured interview and the results of the validated questionnaires. RESULTS Two hundred twenty-one patients were assessed pre-operatively, and 118 (53.3%) reported UI. Eighty-eight patients (74.6%) completed the pre- and postoperative questionnaires. After 6 to 12 months, patients were revaluated, and 50 (56.8%) were considered to be in remission of urinary symptoms. Women who had only a cesarean birth had a 117% increase in the probability of achieving remission of UI compared with women who had both vaginal and cesarean deliveries, and patients with an additional point in the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score at the beginning had a 4% lower probability of having remission of symptoms. CONCLUSIONS Improvement in UI may be an important outcome of surgery for obesity and weight-related diseases. In this study, previous cesarean section was only associated with the highest rate of remission of symptoms, and patients with higher scores in the ICIQ-UI-SF had a lower probability of remission.
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Pomian A, Majkusiak W, Lisik W, Tomasik P, Horosz E, Zwierzchowska A, Kociszewski J, Barcz E. Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders? Obes Surg 2017; 28:1653-1658. [PMID: 29256106 PMCID: PMC5973994 DOI: 10.1007/s11695-017-3067-x] [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] [Indexed: 11/24/2022]
Abstract
Introduction Obesity is one of the well-documented risk factors of pelvic floor disorders (PFDs). The PFDs include urinary and fecal incontinence (UI, FI) and pelvic organ prolapse (POP). Surgery-induced weight loss improves different kinds of incontinence as well as POP symptoms. However, there is a lack of evidence how bariatric surgery influences pelvic floor anatomy and function in women without previous PFDs and whether it may be concerned as PFD prophylaxis tool. Materials and Methods The present analysis is a prospective, non-randomized case-control study from January 2014 to September 2017. Participants underwent pelvic floor ultrasound examination with bladder neck position estimation at rest, during levator ani tension, and at Valsalva maneuver before surgery and 12–18 months after. Pelvic organ prolapse quantification (POPQ) > 2 stage and PFD complaints were the exclusion criteria. Results Fifty-nine patients underwent bariatric surgery (57 sleeve gastrectomy and 2 gastric bypass). Mean BMI decreased from 43.8 ± 5.9 to 29 ± 4.6 kg/m2 after surgery (p < 0.001). Statistically significant higher position of the bladder neck at rest, during tension, and at Valsalva maneuver (p < 0.05) was shown after surgery. We did not demonstrate differences in bladder neck mobility and bladder neck elevation at tension after weight loss. Conclusions Bariatric surgery is associated with a betterment of bladder neck position at rest, tension, and Valsalva maneuver in women without PFDs. We postulate that bariatric surgery may be a tool for PFD prevention. It does not improve levator ani function and does not limit bladder neck mobility, which implicates that it has no influence on preexisting pelvic dysfunction.
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Affiliation(s)
- Andrzej Pomian
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | - Wojciech Majkusiak
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | - Wojciech Lisik
- Department of General and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Tomasik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | - Edyta Horosz
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | - Aneta Zwierzchowska
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | | | - Ewa Barcz
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland.
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