The female urethra: urethral function throughout a woman's lifetime

Ovarian Aging: The Silent Catalyst of Age-Related Disorders in Female Body

Age-related diseases have emerged as a global concern as the population ages. Consequently, understanding the underlying causes of aging and exploring potential anti-aging interventions is imperative. In females, the ovaries serve as the principal organs responsible for ovulation and the production of female hormones. The aging ovaries are related to infertility, menopause, and associated menopausal syndromes, with menopause representing the culmination of ovarian aging. Current evidence indicates that ovarian aging may contribute to dysfunction across multiple organ systems, including, but not limited to, cognitive impairment, osteoporosis, and cardiovascular disease. Nevertheless, due to the widespread distribution of sex hormone receptors throughout the body, ovarian aging affects not only these specific organs but also influences a broader spectrum of age-related diseases in women. Despite this, the impact of ovarian aging on overall age-related diseases has been largely neglected. This review provides a thorough summary of the impact of ovarian aging on age-related diseases, encompassing the nervous, circulatory, locomotor, urinary, digestive, respiratory, and endocrine systems. Additionally, we have outlined prospective therapeutic approaches for addressing both ovarian aging and age-related diseases, with the aim of mitigating their impacts and preserving women's fertility, physical health, and psychological well-being.

Pharmacological treatment of pregnancy complications in adults: An overview of phase IV clinical trials

The aim of this review was to provide a review of the pharmacological treatments for pregnancy complications in adults. This review analyzed medications used for pregnancy complications in phase IV clinical trials based on the ClinicalTrials.gov database. The search included completed trials only. As of September 1, 2023, a total of 29,654 phase IV clinical trials were identified, of which 298 were related to pregnancy complications. Of these, 24 clinical trials met the inclusion criteria for the current study. In the 24 included clinical trials, we found 9 trials for overactive bladder with 5005 participants in total, 236 of which had adverse effects from the drugs used. Six trials for preeclampsia were conducted on 663 participants, with only 1 adverse drug effect reported. Three trials each were conducted on urinary tract infections and gestational diabetes mellitus (115 and 656 participants, respectively) without any adverse drug effects reported. One trial each focused on anemia, dystocia, and placentation disorders (80, 1003, and 14 participants, respectively) without any adverse drug effects reported. The trials reported minimal adverse drug effects, suggesting potential effectiveness and safety in managing these complications. While the trials mentioned minimal adverse effects, close monitoring and individualized patient care are essential, as are evaluating the risk-benefit ratio and the specific circumstances of each patient.

Endocrine disruptors and bladder function: the role of phthalates in overactive bladder

Background

Phthalates, widely used as plasticizers, are pervasive environmental contaminants and endocrine disruptors. Their potential role in overactive bladder (OAB) pathogenesis is underexplored, necessitating further investigation into their impact on OAB using large-scale epidemiological data.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2011 to 2018. A weighted multivariable logistic regression model was employed to examine the relationship between urinary phthalate concentrations and OAB. Subgroup analyses were conducted to explore differences in associations across various subgroups. Restricted cubic spline (RCS) analysis was used to investigate the potential non-linear relationship between urinary phthalate concentrations and OAB. Additionally, Bayesian Kernel Machine Regression (BKMR) analysis was performed to explore the overall effects and interactions of phthalate mixtures.

Results

In the multivariable logistic regression model fully adjusted for confounding variables, higher concentrations of MBzP and MiBP were associated with an increased risk of OAB, particularly in the highest tertiles (MBzP: OR = 1.401, 95% CI: 1.108-1.771; MiBP: OR = 1.050, 95% CI: 1.045-1.056). Subgroup analysis found that subgroup characteristics did not have a significant moderating effect on the association between phthalates and OAB. RCS analysis revealed a linear relationship between both MBzP and MiBP and OAB. BKMR analysis confirmed a positive overall effect of phthalate mixtures on OAB risk, with MBzP identified as the major contributing factor.

Conclusion

In our study cohort, a positive correlation between urinary phthalate concentrations and OAB was observed, necessitating further research to validate and refine this conclusion.

An Overview of the Effect of Aging on the Female Urethra

Urethral function declines by roughly 15% per decade and profoundly contributes to the pathogenesis of urinary incontinence. Individuals with poor urethral function are more likely to fail surgical management for stress incontinence that focus on improving urethral support. The reduced number of intramuscular nerves and the morphologic changes in muscle and connective tissue collectively impact urethral function as women age. Imaging technologies like MRI and ultrasound have advanced our understanding of these changes. However, substantial knowledge gaps remain. Addressing these gaps can be crucial for developing better prevention and treatment strategies, ultimately enhancing the quality of life for aging women.

Discrimination and bladder health among women in the CARDIA cohort study: Life course and intersectionality perspectives

OBJECTIVE

This study examines whether discriminatory experiences are associated with lower urinary tract symptoms (LUTS) and their impact among 972 women in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study, which recruited participants from 4 cities in the United States.

METHOD

Exposure to discrimination was assessed 3 times (1992-93, 2000-01, 2010-11) and averaged across assessments. Participants separately reported whether they experienced discrimination on the basis of their gender, race or color, and socioeconomic position or social class. For each social identity, discrimination was assessed in 6-7 settings (e.g., when getting a job, medical care, or housing). At different time points, women who reported discriminatory experiences for a given social identity were asked how frequently the discrimination occurred and how stressful experience(s) were. Following the 2010-11 assessment, data on LUTS and their impact were collected. Women were classified into bladder health versus mild, moderate, or severe symptoms/impact clusters.

RESULTS

More Black than White women reported discriminatory experiences across all social identities and most settings. Perceived stress of discriminatory experiences did not differ between Black and White women. In analyses stratified by race and social identity, White women reported LUTS/impact with discriminatory experiences in more settings, more frequent discriminatory experiences across settings, and each additional social identity for which discrimination was experienced. Black women reported LUTS/impact with more frequent discriminatory experiences across settings. For Black women, greater perceived stress of both gender and race discrimination were associated with LUTS/impact. For White women, only greater perceived stress of race discrimination was associated with LUTS/impact.

CONCLUSIONS

This is one of the first studies to examine discrimination in relation to LUTS/impact. Additional research is needed to better understand differences in how discriminatory experiences based on potentially intersecting identities may be related to bladder health among women.