The Association Between Constipation and Lower Urinary Tract Symptoms in Parous Middle-Aged Women: A Prospective Cohort Study.

Objective: To examine the prospective association between constipation and risk of developing lower urinary tract symptoms (LUTS) in parous middle-aged women. Materials and Methods: The study uses data from 3,729 women from the Avon Longitudinal Study of Parents and Children who provided self-reports of medication intake for constipation at two time points (Baseline): 2001-2003 and 2003-2005. Women with LUTS at baseline were excluded. After 10 years of follow-up, women provided self-reports of LUTS using an adapted version of the International Consultation on Incontinence Questionnaire on Female LUTS. LUTS were categorized according to International Continence Society definitions as stress urinary incontinence (UI), urgency UI, mixed UI, nocturia, increased daytime frequency, urgency, hesitancy, and intermittency. LUTS were considered present if symptoms were reported to occur at least "sometimes" for all subtypes, except for increased daytime frequency (≥9 times) and nocturia (≥2 times nightly). Results: At follow-up, the prevalence of any LUTS was 40%. Women (mean age 43.3 years, standard deviation 0.5), who took medication for constipation at either time point had increased risks of urgency (adjusted relative risks [RRs] = 1.35; 95% confidence interval [CI] 1.04-1.95) and hesitancy (adjusted RR = 1.72; 95% CI 1.04-3.01) compared with women who reported not using medication for constipation at either time point. The risk of urgency (adjusted RR = 1.94; 95% CI 1.15-3.29) and hesitancy (adjusted RR = 1.78; 95% CI 1.03-4.19) was greater for women who reported taking medication for constipation at both time points. There was no evidence that constipation was associated with stress UI, urgency UI, mixed UI, nocturia, increased daytime frequency, and intermittency. Conclusion: Constipation is prospectively associated with an increased risk of urgency and hesitancy among parous middle-aged women. If further research finds evidence that this association is causal, this implies that women should seek treatment to alleviate constipation to reduce their consequent risk of developing these LUTS.

A Prospective Study of the Association between Physical Activity and Lower Urinary Tract Symptoms in Parous Middle-Aged Women: Results from the Avon Longitudinal Study of Parents and Children.

PURPOSE: We examined prospective associations between physical activity and a range of lower urinary tract symptoms in parous middle-aged women. MATERIALS AND METHODS: We used prospectively collected data on women participating in the ALSPAC (Avon Longitudinal Study of Parents and Children). Physical activity levels were self-reported at a mean ± SD age of 37.2 ± 4.6 years and translated into MET hours per week. A total of 4,126 and 2,770 women reported symptoms of lower urinary tract symptoms, including stress, urgency and mixed incontinence, at 3 and 11.5 years of followup, respectively. RESULTS: The prevalence of any lower urinary tract symptoms at 3 and 11.5 years of followup was 15% and 23% at a mean age of 40.5 and 49.3 years, respectively. At 3 years of followup women in the highest category of physical activity (43.2 MET hours or more per week) had lower odds of stress incontinence (aOR 0.51, 95% CI 0.32-0.80) than women in the lowest category (0 MET hours per week). At 11.5 years of followup women in the highest category of physical activity had lower odds of stress incontinence (aOR 0.56, 95% CI 0.39-0.82), urgency incontinence (aOR 0.34, 95% CI 0.20-0.67) and mixed incontinence (aOR 0.34, 95% CI 0.19-0.63) compared to women in the lowest physical activity category. CONCLUSIONS: Greater physical activity is associated with reduced odds of lower urinary tract symptoms, especially stress incontinence, among middle-aged parous women. Further research is necessary to examine the impact of different types of physical activity on lower urinary tract symptoms.