Effect of polyfluoroalkyl chemicals on the occurrence of urge urinary incontinence: a population-based study

Background:

The artificial fluorinated group of compounds polyfluoroalkyl chemicals (PFCs) has been applied extensively in daily life for decades, and is present in food, drinking water, and indoor dust. The nephrotoxicity of PFCs has been widely studied for its characteristics of being mainly excreted through passing urine and affecting urodynamics. This work aimed to investigate the relationship between PFCs and the occurrence of urge urinary incontinence (UUI) in the United States (US) population.

Methods:

There were 3157 eligible female participants retrieved from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2014. A logistic regression model was used to examine the relationship between UUI and eight kinds of PFCs. The dose–response relationship was investigated through restricted cubic spline analysis in this retrospective study.

Results:

Of the 3157 eligible female participants, 913 self-reported a history of UUI. Total PFCs, perfluorohexane sulfonic acid (PFHS), 2-(N-methyl-perfluorooctane sulfonamido) acetate (MPAH), and perfluorononanoic acid (PFNA) correlated positively with the occurrence of UUI after adjusting for age, race, education, vigorous recreational activities, hypertension, diabetes, body mass index (BMI), creatinine, and estimated glomerular filtration rate (eGFR). Based on the results of sub-group analysis, the increasing tertiles contained odds ratios [OR; 95% confidence intervals (CI)] of 1.25 (95% CI, 1.03–1.51, p = 0.026) and 1.56 (95% CI, 1.29–1.89, p < 0.001) for total PFCs compared with the lowest tertile. The OR for PFHS, MPAH, and PFNA were 1.75, 1.71, and 1.41 respectively, in the highest tertile.

Conclusion:

This study investigated the relationship between PFCs and UUI in female and found total PFCs, PFHS, MPAH, and PFNA were positively correlated with the risk of UUI. The results will contribute to developing individualized treatment for female patients suffering UUI.

Impact of smoking habit on overactive bladder symptoms and incontinence in women

Objective

To examine the correlation between smoking habit and lower urinary tract symptoms in women.

Methods

We first screened 10 000 female patients to examine their smoking habit. A total of 7004 samples were successfully collected for further analysis through a urinary continence survey. The ratio of current smoking to non‐smoking participants was set as 1:3 to allow thorough assessment of the impact of cigarette smoking on lower urinary tract symptoms.

Results

A total of 4756 complete responses were obtained for the Overactive Bladder Symptom Score and International Consultation on Incontinence Questionnaire‐Short Form questionnaire. The current smokers (2.54 ± 2.91, 2.48 ± 4.01) and ex‐smokers (2.27 ± 2.50, 2.25 ± 3.50) showed significantly higher Overactive Bladder Symptom Score and International Consultation on Incontinence Questionnaire‐Short Form scores than the non‐smokers (1.70 ± 2.05, 1.49 ± 2.73) (P < 0.0001, P < 0.0001 and P < 0.0001, P < 0.0001, respectively). The prevalence of urgency was affected by the smoking status. Younger participants (aged 20–39 years) showed a stronger influence of their smoking habit than older participants (aged ≥40 years). Urgency urinary incontinence was also affected by the smoking status.

Conclusions

The prevalence of urgency and urgency urinary incontinence is correlated with age and smoking habit, and both current and ex‐smokers show an increased prevalence of urgency and urgency urinary incontinence compared with non‐smokers, especially younger women.

[Imidafenacin for treatment of overactive bladder and urgent urinary incontinence: the results of open-label multicenter randomized controlled clinical trial]

INTRODUCTION

The analysis of the results of a multicenter, open, randomized comparative phase III clinical trial on the use of imidafenacin for treating patients with OAB was carried out. A clinical study was conducted according to GCP standards in 12 urological centers of the Russian Federation with the support of company AO "R-Pharm".

MATERIALS AND METHODS

A total of 296 patients (men and women) aged from 18 to 65 years with OAB and urgent urinary incontinence were included in the study. All patients were randomized into two groups. In Group 1 (n=148) patients received -cholinoblocker imidafenacin 1 tablet (0,1 mg) twice a day. Group 2 patients (n=148) were prescribed a comparison drug tolterodine 1 tablet (2 mg) twice a day, as well. The duration of treatment was 12 weeks.

RESULTS

The analysis of results showed a significant decrease in the OAB symptoms in both groups. In Group 1 a decrease of episodes of urge urinary incontinence was more pronounce compared to Group 2, as well as amount of day-time and night-time of episodes of urge urinary incontinence by the 2nd, 4th, 8th and 12th weeks of treatment in comparison with baseline scores. There were no differences between two groups in the severity of reducing average urinary frequency per day. Reducing the severity of urinary disturbances in patients of both groups was accompanied by an improvement in the quality of life. There was a significant and similar decrease in the average total score of both OAB Awareness Tool and EQ-5D questionnaires. Tolerability of treatment was satisfactory in both groups and there were no differences in the adverse events in Group 1 and 2.

CONCLUSION

Imidafenacin showed high clinical efficacy for treating patients with OAB, which is not inferior, and in some values, is superior in comparison to tolterodine. Both drugs had a similar safety and tolerability profile.