Assessment of the Incidence and Risk Factors of Stress Urinary Incontinence in Women after Cervical Cancer Surgery: A Single-Centre Retrospective Study.

BACKGROUND: Stress urinary incontinence (SUI) is a common postoperative complication that significantly affects the quality of life in women who have undergone radical hysterectomy for cervical cancer. This study evaluates the incidence and risk factors associated with SUI in women after cervical cancer surgery. METHODS: This case-control study included women diagnosed with cervical cancer who underwent radical hysterectomy at our hospital between May 2020 and May 2023. Participants were divided into two groups based on the presence of postoperative SUI, namely the SUI group and the SUI-free group. Inclusion criteria required the absence of preoperative urinary incontinence and stable vital signs. Data were collected on demographic characteristics, tumour histology and staging, urodynamic parameters, and intraoperative and postoperative factors. RESULTS: Ninety-seven patients with cervical cancer who underwent radical hysterectomy were divided into two groups: The SUI group (n = 27) and the SUI-free group (n = 70), with an SUI incidence of 27.8% in the study population. Significant differences between the SUI and SUI-free groups were observed in menopausal status (p = 0.026), chronic constipation (p = 0.011), and tumour diameter (p < 0.001). Urodynamic assessments revealed a higher maximum urinary flow rate (Qmax) in the SUI group compared to the SUI-free group (21.36 ± 6.41 vs. 17.38 ± 5.18 mL/s; p = 0.002). Logistic regression analysis identified menopause (odds ratio (OR) = 7.700, 95% confidence interval (CI) = 1.256-47.192), chronic constipation (OR = 9.918, 95% CI = 1.387-70.911), Qmax (OR = 1.302, 95% CI = 1.061-1.598), and surgery duration (OR = 1.040, 95% CI = 1.001-1.081) as independent protective factors. CONCLUSIONS: SUI is a significant postoperative complication in women undergoing cervical cancer surgery. Menopause, chronic constipation, tumour diameter, Qmax, and surgery duration were independent risk factors.

Genetic support of causal association between lipid and glucose metabolism and stress urinary incontinence in women: a bidirectional Mendelian randomization and multivariable-adjusted study.

Background: Stress urinary incontinence (SUI) is a common condition characterized by urethral sphincter failure and urine leakage. Its prevalence in women is higher than in men, and estimates of crude prevalence rates vary widely due to factors such as research methodologies, study populations, and underreporting by patients. This variability hinders research and impacts patient diagnosis, treatment, and quality of life. The complex etiology of SUI is not fully understood, and previous studies have primarily focused on non-invasive indicators. While emerging observational research suggests a correlation between SUI in women and abnormalities in lipid and blood metabolism, the underlying biological mechanisms and causal relationships require further investigation. This study aims to explore the causalities between SUI in women and lipid and blood metabolism. Methods: Using bidirectional univariate Mendelian randomization (MR), we investigated the causal association between SUI liability in women (case/control = 5,924/399,509) from UK Biobank and lipid and glucose metabolism, indicated by total cholesterol (TC, N = 61,166), low-density lipoproteins (LDL, N = 58,381), high-density lipoproteins (HDL, N = 60,812), triglycerides (TG, N = 60,027), fasting glucose (FG, N = 19,745), and fasting insulin (FI, N = 38,238) from ENGAGE consortium. To account for potential confounding effects, multivariable MR (MVMR) analyses were performed, adjusting for body mass index (BMI) and separately among lipid and glucose metabolism. Results: We found that increased genetically proxied TC, LDL, and HDL levels were associated with an elevated risk of SUI in women (OR: 1.090-1.117, all P < 0.05), These associations were further supported by MVMR analyses with adjustment for BMI (OR: 1.087-1.114, all P < 0.05). Conversely, increased FG and FI were associated with reduced SUI reliability in women (OR: 0.731-0.815, all P < 0.05). When adjusting among lipid and glucose metabolism, only HDL and FI demonstrated causal effects. Reverse MR analyses provided no genetic evidence supporting the causal effect of SUI in women on lipid and blood metabolism (all P > 0.05). Conclusions: Our results reported that increased TC, LDL, and HDL are linked to higher SUI susceptibility in women, while higher FG and FI levels have a protective effect. In overweight/obese women with metabolic abnormalities, the positive associations between TC, LDL, and HDL levels and SUI indicate a higher risk.

The point prevalence of stress incontinence among young adult Jordanian women based on activity levels.

BACKGROUND: Stress Urinary incontinence (SUI) is a common condition among women of all ages. The point prevalence of SUI among young adult Jordanian women is less explored. OBJECTIVES: To examine the point prevalence of SUI among this sample based on activity level, and whether the affected women have shared their complaints with healthcare providers and/or received education related to UI. METHODS: This was a cross-sectional survey-based study. Participants with diseases that affect the control of micturition were excluded. The International Consultation on Incontinence Questionnaire-UI Short-Form was used to calculate the point prevalence of UI. The Tegner activity scale was used to classify participants based on their physical activity levels. The participants reported whether they shared their complaints with a healthcare provider or received education about this health problem. RESULTS: Five hundred women (median age = 20 years, BMI = 22) participated (118 competitive athletes, 192 recreational, and 190 sedentary). The overall point prevalence of SUI was 14% (n = 61). A chi-square test of independence showed a significant difference in the point prevalence of SUI between women with different activity levels, χ2 (12) = 12.07, p < 0.01. The point prevalence of SUI among competitive athletes, recreational women, and sedentary women was 21%, 8%, and 11%, respectively. None of those with SUI have shared their complaints with healthcare providers or received education related to SUI. CONCLUSION: SUI is prevalent among young adult Jordanian women, with the highest prevalence observed in those engaged in competitive athletic activities. The affected women refrain from disclosing their SUI-related concerns to healthcare practitioners and lack sufficient knowledge about this health issue.

Prevalence and risk factors for overactive bladder symptoms in patients with artificial urinary sphincter.

To demonstrate the prevalence and risk factors for overactive bladder symptoms associated with artificial urinary sphincter implantation, we investigated the patients who underwent primary artificial urinary sphincter implantation with severe urinary stress incontinence. Forty-eight patients who completely answered the questionnaires of the overactive bladder symptom score before surgery were included. Patient characteristics, urinary status at pre and 1, 3, 6, and 12 months post-device activation, and predictive factors for overactive bladder symptoms were examined. Sixty percent of the patients had preoperative overactive bladder symptoms. Until 12 months after device activation, 35-40% of all patients had overactive bladder symptoms. The rate of persistent and de novo postoperative overactive bladder symptoms was 44.8% and 26.3%, respectively. Daily pad use was not different between patients w/wo overactive bladder symptoms. The only risk factor for postoperative overactive bladder symptoms was a max cystometoric capacity < 200 mL measured by a preoperative urodynamic study. Attention must be given to both persistent and de novo overactive bladder symptoms associated with artificial urinary sphincter implantation for patients with stress incontinence. Counsel should equally be provided for preoperative overactive bladder symptoms, especially in cases with a cystometric capacity < 200 mL.

Prevalence of stress urinary incontinence symptoms and their impact on the quality of life of Palestinian women: the first large cross-sectional study among the general population.

BACKGROUND: Little studies were conducted to assess the prevalence of stress urinary incontinence among Palestinian women. This study was conducted to determine the prevalence of stress urinary incontinence symptoms, their impact on the quality of life, and the risk factors that were associated with stress incontinence symptoms among Palestinian women. METHODS: This study was conducted in a cross-sectional design from 2023 to 2024. The data were collected through an interviewer-administered questionnaire. The questionnaire collected the demographic and health characteristics of the women. Additionally, the questionnaire also contained the PRAFAB questionnaire (PRAFAB-Q). Moreover, the questionnaire included the Assessment of Quality of Life (AQoL)-8D scale. RESULTS: Data were collected from 386 Palestinian women (response rate = 85.8%). The mean age of women in this study was 37.1 ± 14.7 years. In this study, 104 (26.9%) reported stress urinary incontinence symptoms. Of the women, 102 (26.4%) reported urinary leakage during coughing, 100 (25.9%) reported urinary leakage during sneezing, and 94 (24.4%) reported urinary leakage during laughing. The women who had a family history of stress incontinence were 2.5-fold (95% CI: 1.2-5.2) more likely to have stress incontinence symptoms compared to the women who did not have a family history of stress incontinence. Similarly, the women who were overweight/obese were 2.0-fold (95% CI: 1.1-3.7) more likely to have stress incontinence symptoms compared to the women who were underweight or had a normal weight. PRAFAB-Q scores were predicted by place of residence, family history of stress incontinence, and being recruited from a hospital. CONCLUSION: The study reported a high prevalence of stress urinary incontinence and identified the risk factors that were associated with stress incontinence symptoms among Palestinian women. The findings showed that the intensity of stress urinary incontinence symptoms was associated with deteriorated quality of life of the affected women. These findings could be used by urologists, gynecologists, obstetricians, and other healthcare providers caring for women to design ways to reduce the burden of stress urinary incontinence among Palestinian women and improve their quality of life.

The Association Between Sarcopenia and Stress Urinary Incontinence Among Older Adults in India: A Cross-Sectional Study.

Background: Older adults in low- and middle-income countries (LMICs) often suffer from both sarcopenia and stress urinary incontinence (SUI), two conditions that can significantly impact their health. However, the relationship between these conditions has not been thoroughly explored. Methods: We conducted a cross-sectional study using data from older adults aged 50 years or older from the first wave of the Longitudinal Ageing Study in India (LASI). Participants with complete data on sarcopenia and SUI were included, excluding female participants who were still menstruating. Sarcopenia was defined as decreased grip strength and slow movement. SUI was assessed based on questionnaire responses about whether the participant had ever passed urine when sneezing, coughing, laughing, or lifting heavy objects. We analyzed the data using multiple logistic regression analysis, interaction tests, and stratified analysis. Results: Our results showed that sarcopenia was positively correlated with SUI in male participants after adjusting for adequate confounding factors (odds ratio [OR] = 1.37, 95% confidence interval [CI] [1.20, 1.56], p < 0.001). This correlation remained stable after adjusting for additional confounding factors (OR = 1.27, 95% CI [1.11, 1.45], p < 0.001). In female participants, a stable correlation between sarcopenia and SUI was also observed after adjusting for appropriate confounding factors (OR = 1.11, 95% CI [1.01, 1.23], p = 0.037). According to the results of interaction tests and stratified analysis, the positive correlation between sarcopenia and SUI is notably stronger among men who abstain from alcohol and women who haven't undergone hysterectomy. Conclusions: Sarcopenia and SUI were positively correlated in older Indian adults, regardless of gender. Drinking and a history of hysterectomy may be important influencing factors for both male and female older adults. Further large-scale clinical trials are necessary to confirm this association.

Development and external validation of clinical predictive model for stress urinary incontinence in Chinese women : a multicenter retrospective study.

BACKGROUND: Stress urinary incontinence (SUI), the prevalent form of urinary incontinence, significantly impairs women's quality of life. This study aims to create a visual nomogram to estimate the risk of SUI within one year postpartum for early intervention in high-risk Chinese women. METHODS: We recruited 1,531 postpartum women who gave birth at two hospitals in Kunshan City from 2021 to 2022. Delivery details were meticulously extracted from the hospitals' medical records system, while one-year postpartum follow-ups were conducted via phone surveys specifically designed to ascertain SUI status. Utilizing data from one hospital as the training set, logistic regression analysis was performed to pinpoint significant factors and subsequently construct the nomogram. To ensure robustness, an independent dataset sourced from the second hospital served as the external validation cohort. The model's performance was rigorously evaluated using calibration plots, ROC curves, AUC values, and DCA curves. RESULTS: The study population was 1,125 women. The SUI incidence within one year postpartum was 26% (293/1125). According to the regression analysis, height, pre-pregnancy BMI, method of induction, mode of delivery, perineal condition, neonatal weight, SUI during pregnancy, and SUI during the first pregnancy were incorporated into the nomogram. The AUC of the nomogram was 0.829 (95% CI 0.790-0.867), and the external validation set was 0.746 (95% CI 0.689-0.804). Subgroup analysis based on parity showed good discrimination. The calibration curve indicated concordance. The DCA curve showed a significant net benefit. CONCLUSION: Drawing from real-world data, we have successfully developed an SUI predictive model tailored for postpartum Chinese women. Upon successful external validation, this model holds immense potential as an effective screening tool for SUI, enabling timely interventions and ultimately may improve women's quality of life.

Frailty and the Correlation Between Total Testosterone Levels and Urinary Incontinence Among Elderly Women.

INTRODUCTION AND HYPOTHESIS: The objective was to explore the correlation between total testosterone levels and stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) in older patients, emphasizing frailty. METHODS: This prospective cross-sectional study included 1,328 women over 60 years of age at an incontinence specialty clinic. Participants were assessed for UI, frailty, using the Japanese Frailty Scale, and total testosterone levels. Analysis of a logistic regression model was employed for age, body mass index (BMI), and vaginal deliveries adjustment, with association and multivariate analyses to evaluate the associations with SUI and UUI. RESULTS: The frailty and nonfrailty groups each consisted of 664 individuals. After age, BMI, and the number of vaginal deliveries adjustment, the analysis showed a negative association between total testosterone levels and both SUI (p < 0.001) and UUI (p < 0.001) in the frailty group. Multivariate analysis revealed that, in the nonfrailty group, factors such as low total testosterone levels (p = 0.0145), diabetes (p = 0.0052), and cerebral infarction (p = 0.0254) were related to SUI, whereas no significant factors were associated with UUI. In the frailty group, factors associated with SUI included low total testosterone levels (p < 0.0001), the number of vaginal deliveries (p < 0.0001), smoking (p = 0.0240), chronic lung disease (p < 0.0248), and hypertension (p < 0.0265). Factors associated with UUI were age (p < 0.0001), low total testosterone levels (p = 0.0025), diabetes (p < 0.0001), and the number of vaginal deliveries (p = 0.0152). CONCLUSIONS: The study highlights the significance of incorporating the assessment of frailty and testosterone levels in addressing UI among older women, particularly in the aged population, underscoring the need for tailored approaches in this demographic.

Curvilinear relationship was found between visceral adiposity index and stress urinary incontinence among US adult women: A cross-sectional study.

AIMS: The purpose of this study was to find out the relation between visceral adipose index (VAI) levels and stress urinary incontinence (SUI) in adult women. METHODS: From the National Health and Nutrition Examination Survey (NHANES) 2007-2020, females aged 20 or above were identified for this study. Visceral adiposity was determined using the VAI score, and the assessment of urinary incontinence was carried out through a correlation questionnaire. Logistic regression models and restricted cubic spline (RCS) regression were employed to analyze the relationship between VAI levels and SUI. RESULTS: Among the 6522 participants, 2672 (41.0%) were reported SUI. Multivariate logistic regression revealed significantly higher odds of SUI with increasing VAI levels (Q4 vs. Q1), adjusted odds ratio (aOR) = 1.53 (CI: 1.29-1.81, p < 0.001). RCS regression indicated a curvilinear relationship between VAI and SUI (p = 0.003). In threshold analysis, aOR for developing SUI was 1.18 (CI: 1.11-1.26, p < 0.001) for participants with VAI < 4.73, suggesting an 18% increased risk of SUI with each unit increase in VAI. No association between VAI and SUI was observed when VAI was ≥4.73. CONCLUSIONS: Our study has revealed a significant curvilinear relationship between VAI and SUI within a large and representative sample of women. Future research is necessary to evaluate the relationship between the two and explicate the underlying mechanisms of this relationship.

Risk Factors of Pelvic Floor Disorders Among Women in Rural Nepal: A Case-Control Study.

INTRODUCTION AND HYPOTHESIS: Risk factors for pelvic floor disorders (PFDs) are not well understood in lower resource settings. The objective of this study is to determine the risk factors associated with stress urinary incontinence (SUI), urge urinary incontinence (UUI), and pelvic organ prolapse (POP) among women of reproductive age in rural Nepal. METHODS: This is a case-control study nested within a community-based cross-sectional survey of parous women of reproductive age with PFDs in the Sarlahi District of Nepal. The presence of PFDs was confirmed by clinical assessment. Detailed sociodemographic information and histories were captured. RESULTS: We examined 406 women; the mean (SD, range) age was 32.7 (8.5, 16-49) years, mean BMI (SD) was 19.7 (3.3) kg/m2, and median (range) number of pregnancies was 4 (1-11). Two hundred and three women (50.0%) had either SUI or UUI, 85 (17.8%) had both SUI and UUI, and 71 (17.5%) had POP at or beyond the hymen. After controlling for other variables significant on bivariate analysis, age (adjusted odds ratio [aOR] 1.06 [95% CI 1.03-1.09]), illiteracy (aOR 2.24 [95% CI 1.04-4.80]), and presence of upper gastrointestinal issues (aOR 3.30, [95% CI 1.77-6.16]) were independently associated with SUI/UUI. Age (aOR 1.05 [95% CI 1.02-1.09]), bispinous diameter (aOR 2.88 ([95% CI 1.11-7.47]), and subpubic angle (aOR 2.78 [95% CI 1.55-5.03]) were independently associated with POP. CONCLUSION: Risk factors for PFDs in a homogenous community of parous women of reproductive age in rural Nepal are similar to those found in parous women in higher income countries.

[Stress urinary incontinence in female athletes: a taboo topic]. / Incontinence urinaire d'effort chez les sportives : un tabou.

STRESS URINARY INCONTINENCE IN FEMALE ATHLETES: A TABOO TOPIC. Stress urinary incontinence (SUI) has a high prevalence (between 20% and 81%) in sportswomen, all the more so if they practice a sport at risk for the perineal function, including jumping, running, strong abdominal contraction in combat sports, and if their practice is intensive and/or repeated with a dose effect. Making sportswomen aware of the importance of an educational prevention program is key, as the impact on performance in top-level sportswomen is real. In leisure activities, or in sports without repeated impact, regular activity is protective against SUI. This review examines the mechanisms of SUI, its prevalence in different sports, and prevention in young sportswomen.

INCONTINENCE URINAIRE D'EFFORT CHEZ LES SPORTIVES : UN TABOU. L'incontinence urinaire d'effort (IUE) a une prévalence qui reste élevée (de 20 % à 81 %) chez la sportive, d'autant plus qu'elle pratique un sport à risque pour la fonction périnéale ­ incluant saut, course, forte contraction abdominale comme dans les sports de combat ­ et que la pratique est intensive et/ou répétée. La sensibilisation des sportives à un programme éducatif de prévention est importante car l'impact sur la performance chez les sportives de haut niveau est réel. Dans une pratique de loisir ou d'un sport sans impacts répétés, une activité régulière est protectrice de l'IUE.

Does Urodynamic Stress Incontinence Increase After the Menopause?: Results from 2,994 Urodynamic Studies in Australian Women.

INTRODUCTION AND HYPOTHESIS: Most studies attempting to estimate the age-related prevalence of urinary incontinence (UI) have used questionnaires. In the present study we analysed a consecutive series of urodynamic test results to determine the distribution of the different types of UI in pre- and post-menopausal women. We hypothesised that the prevalence of urodynamic stress incontinence (USI) would be significantly greater in pre-menopausal than in post-menopausal women. METHODS: All women from a large tertiary urogynaecology department, who underwent urodynamic tests during the years 2000-2015 were included. Patient history and test results were collected. A sample size of 1,475 was calculated, based on the hypothesis that the prevalence of USI will be 20% larger in the pre- versus the post-menopausal group. RESULTS: A total of 2,994 women with UI on urodynamics were available. There was a significant difference between pre- and post-menopausal status for each of the three diagnoses: USI 483 (59.3%) versus 912 (41.8%), detrusor overactivity (DO) 125 (15.4%) versus 399 (18.3%) and USI with concomitant DO 206 (25.3%) versus 869 (39.9%). A bimodal pattern of age was seen in women with USI, with a peak in the 46-50 and 61-65 age group, before decreasing with age. DO generally increased with age. USI with concomitant DO increased steadily after the menopause, becoming the predominant type after the age of 66. CONCLUSIONS: In this large cohort of women attending urodynamics, we have shown that USI is the predominant type of incontinence in pre-menopausal women; however, USI with concomitant DO increases after menopause, eventually predominating.

Factors associated with persistent sexual dysfunction and pain 12 months postpartum.

OBJECTIVE: Identify factors associated with persistent sexual dysfunction and pain 12-months postpartum in an underserved population. METHODS: Extending Maternal Care After Pregnancy (eMCAP) is a program addressing health needs/disparities of patients at risk for worse perinatal outcomes. Participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Urinary Distress Index (UDI-6) 12-months postpartum. The PISQ-12 was dichotomized with scores < 32.5 indicating sexual dysfunction. Urinary incontinence (UI) was defined as at-least-somewhat bothersome (vs. none or not-at-all bothersome) urgency urinary incontinence (UUI) or stress urinary incontinence (SUI). Screening for anxiety and depression was completed using Generalized Anxiety Disorder-7 (GAD-7) and Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariable logistic regression analyses were performed for sexual dysfunction vs. normal-function, and pain vs. no-pain, using demographic, peri/postpartum, and social-determinant-of-health variables as correlating factors. RESULTS: 328 sexually active patients provided data. On bivariate analysis, sexual dysfunction (n = 31, 9.5%) vs. normal function (n = 297, 90.5%) groups showed no differences in age, BMI, parity, mode of delivery, episiotomy/laceration types, or breastfeeding. Sexual dysfunction was significantly associatedwith both UUI and SUI: 12 (39%) vs. 46 (15%) had UUI, p = 0.001, and 20 (65%) vs. 97 (33%) had SUI, P < 0.001; the dysfunction group also had higher GAD-7 and EPDS scores and greater overall stress levels. On multivariable analysis, SUI and stress remained significantly associated: OR (95% CI) 2.45 (1.02-6.03) and 1.81 (1.32-2.49), respectively. Comparing pain (n = 45, 13.7%) vs. no-pain (n = 283, 86.2%), dyspareunia patients endorsed greater stress levels. CONCLUSION: The interplay between sexual health, incontinence, and mental health deserves further study, and all three should be routinely addressed in postpartum care.

The association between triglyceride -glucose index and stress urinary incontinence in adult American women: A population-based study.

PURPOSE: This investigation seeks to determine the triglyceride glucose (TyG) index's link to stress urinary incontinence (SUI) in American females of adult age. METHODS: The investigation relied on data acquired via the National Health and Nutrition Examination Survey (NHANES) conducted over the period from 2011 to 2018. The independent relationship between TyG index and SUI was tested using multivariate logistic regression analysis. We applied a smooth curve fitting approach to analyze the interrelation of them. In addition, subgroup analysis was conducted and interaction experiments were conducted. RESULTS: Among 4459 female participants aged 20 and above, TyG index and SUI demonstrated a favorable correlation. Model 3 indicated that with every single-unit rise in the TyG index, the incidence of SUI increases by 18% [1.18 (1.01, 1.38)]. In contrast to individuals in the lowest tertile, subjects within the highest tertile of the TyG index exhibited a 68% increase in SUI incidence [1.68 (95% CI: 1.26, 2.23), 0.0004]. By using smooth curve fitting, a nonlinear positive evidence of an interconnection of the TyG index to SUI was identified. CONCLUSIONS: Women exhibiting increased TyG index levels are at a heightened risk of SUI. TyG index displays a stronger correlation than that observed with BMI. According to our findings, the TyG index is viewed as a potential tool for identifying SUI in women, and monitoring the value of TyG index may be helpful for predicting the occurrence of SUI.

The prevalence of overt, occult, and no-demonstrated stress urinary incontinence and their clinical and urodynamic findings in women with advanced-stage cystoceles.

OBJECTIVES: To elucidate the prevalence of overt, occult and no demonstrated (ND) stress urinary incontinence (SUI) in women with advanced-stage cystoceles. STUDY DESIGN: Between November 2011 and January 2017, all women with ≥stage 2 cystoceles were retrospectively enrolled. Overt SUI was diagnosed before the prolapse reduction test, and occult SUI was diagnosed when urine leakage was noted after a reduction test with vaginal gauze. Otherwise, a diagnosis of ND-SUI was made. MAIN OUTCOME MEASURES: The prevalence, clinical and urodynamic findings of overt SUI, occult SUI, and ND-SUI. RESULTS: In 480 enrolled women, 62% had overt SUI, 17% had occult SUI, and 21% had ND-SUI. The occult SUI group had the most advanced prolapse. The pad weight results after prolapse reduction (37.3 ± 44.3 vs. 13.4 ± 21.9, p < 0.05), the bladder capacity (243 ± 54 vs. 273 ± 48, p < 0.001), and questionnaires regarding life quality were significantly different between the overt SUI and the occult SUI groups. Bladder oversensitivity (BO) was the most common urodynamic diagnosis (389/480, 81%), especially in overt SUI, while urodynamic stress incontinence (56/480, 12%) and detrusor overactivity (60/480, 13%) were uncommon. The cutoff value of stage 3 uterine prolapse was the strongest predictor for predicting occult SUI (sensitivity = 30.3%, specificity = 78.5%; area = 0.60, 95% CI: 0.52-0.68). CONCLUSION: SUI occurs in a ratio of 3:1:1 among cases with overt, occult, and no demonstrable symptoms. BO is the most common urodynamic diagnosis. Pad test with prolapse reduction remains an important tool, especially for coexistent stage 3 uterine prolapse.

Predictive factors of post-HoLEP incontinence: differences between stress and urgency urinary incontinence.

INTRODUCTION: The analysis of post-HoLEP urinary incontinence (UI) has traditionally focused on stress UI. Our aim is to evaluate the factors associated with stress and urgency UI in the first month after the surgery. METHODS: Data were obtained from patients who underwent HoLEP by the same experienced surgeon. UI was evaluated at one month and at 6 months after the surgery. Three groups were defined: continent patients, patients with pure urgency UI and patients with stress or mixed UI. Preoperative, intraoperative, urodynamic and clinical variables were analyzed and compared between the three groups. RESULTS: In total, 235 subjects were included. One month after the surgery, 156 (66.5%) were continent (group 1), 49 (20.8%) reported pure urgency UI (group 2), and 30 (12.7%) reported some level of stress UI (group 3). In Group 2, the factors associated with urgency UI in the univariate analysis were age, presurgical urgency UI, having diabetes or hypertension. In Group 3, age, prostatic volume, preoperative PSA, time of enucleation, weight of the resection in grams, having an IDC or being diabetic were significant in the univariate analysis. In the multivariate analysis, age predicts both types of UI, while prostatic volume and having an IDC predict stress or mixed UI. CONCLUSION: In the first month post-HoLEP, age is a predictive factor of urgency UI and stress UI. In addition, prostatic volume and the presence of an indwelling urinary catheter are predictive factors of stress UI.

Household air pollution and urinary incontinence symptoms among older adults in LASI: a large-scale population-based study.

BACKGROUND: The effects of household air pollution on urinary incontinence (UI) symptoms and stress urinary incontinence (SUI) symptoms have not been studied. This study seeks to investigate the correlation between household air pollution and UI/SUI symptoms among middle-aged and elderly adults in India. METHODS: We employed data derived from individuals aged 45 years and older who participated in the inaugural wave (2017-2018) of the Longitudinal Aging Study in India (LASI). The assessment of household air pollution exposure and the occurrence of UI/SUI symptoms relied on self-reported data. The analytical approach adopted was cross-sectional in nature and encompassed a cohort of 64,398 participants. To explore relationships, we utilized multivariate logistic regression analysis, incorporating subgroup analysis and interaction tests. RESULTS: 1,671 (2.59%) participants reported UI symptoms and 4,862 (7.55%) participants reported SUI symptoms. Also, the prevalence of UI/SUI symptoms is much higher among middle-aged and elderly adults who use solid polluting fuels (UI: 51.23% vs. 48.77%; SUI: 54.50% vs. 45.50%). The results revealed a noteworthy correlation between household air pollution and the probability of experiencing UI/SUI symptoms, persisting even after adjusting for all conceivable confounding variables (UI: OR = 1.552, 95% CI: 1.377-1.749, p < 0.00001; SUI: OR: 1.459, 95% CI: 1.357-1.568, p < 0.00001). Moreover, significant interaction effects were discerned for age, education level, tobacco consumption, alcohol consumption, and physical activity (p for interaction < 0.05). CONCLUSIONS: The results of our study indicate that the utilization of solid fuels in the home increases the likelihood of developing urinary incontinence and stress urinary incontinence. As a result, we argue that there is an immediate need to reform the composition of cooking fuel and raise public awareness about the adverse effects of air pollution in the home.

Association Between Added Sugar Intake and Urinary Incontinence in Females: A Cross-sectional Population-based Study.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is a widespread issue in women that severely impacts quality of life. The addition of sugar is associated with multiple adverse effects on health. This study examined the potential association between added sugar intake and UI. METHODS: Adult females from the National Health and Nutrition Examination Survey database (2005-2018) were included in this study. The primary outcomes were the prevalence of stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI). Weighted logistic regression, stratified logistic regression, restricted cubic spline regression, and sensitivity analyses were utilized to determine whether added sugar was associated with UI after multivariate adjustment. RESULTS: A total of 14,927 participants met the inclusion criteria. The results revealed a heightened prevalence of SUI, UUI, and MUI in the fourth quartile of added sugar energy percentage (OR = 1.304, 95% confidence interval [CI] = 1.105-1.539; OR = 1.464, 95% CI = 1.248-1.717; OR = 1.657, 95% CI = 1.329-2.065 respectively). The effect was more pronounced in young women and the subgroup analyses did not reveal any noteworthy interaction effects. According to the sensitivity analyses, the results for SUI and the MUI were consistent with those of the primary analyses. CONCLUSIONS: The excessive intake of added sugar among women may increase their risk of SUI and MUI. Our study highlights the negative effects of added sugar on female genitourinary health and highlights the need for universal access to healthy diets.

Prevalence of stress urinary incontinence and urge urinary incontinence in multiples sclerosis patients: a systematic review and meta-analysis.

Urinary incontinence (UI), encompassing stress urinary incontinence (SUI) and urge urinary incontinence (UUI), is a prevalent and debilitating condition in patients with multiple sclerosis (MS), profoundly impacting their quality of life. This systematic review and meta-analysis aimed to elucidate the worldwide prevalence rates of SUI and UUI among MS patients. This study was conducted by examining observational studies published between 2000 and 2023. An exhaustive literature search was conducted across databases such as PubMed, MEDLINE, Web of Science, Scopus, ProQuest, and Google Scholar. The Meta-prop method facilitated pooled prevalence estimation of UUI and SUI, while Egger tests assessed publication bias. In total, 27 studies with 15,052 participants were included in the meta-analysis. The findings revealed a high random effect pooled prevalence of UUI at 41.02% (95% Confidence Interval [CI]: 30.57-51.89; I2 = 99%, p < 0.001) and SUI at 25.67% (95% CI: 19.30-32.58%; I2 = 94.9%, P < 0.001). Additionally, the pooled prevalence of mixed urinary incontinence (MUI) was reported at 18.81% (95% CI: 7.55-33.48; I2:95.44%, p < 0.001). The high heterogeneity observed suggests variable prevalence across populations and highlights the intricate nature of UI in MS. These findings underscore the critical need for dedicated supportive, therapeutic, and rehabilitative interventions to manage this common complaint in MS patients effectively.

Associated factors of stress, urgency, and mixed urinary incontinence in a geriatric outpatient assessment of older women with hip fracture.

PURPOSE: Urinary incontinence (UI) is known to be common among older female hip fracture patients. Little is known about different subtypes of UI among these patients. Our aim was to identify factors associated with subtypes of UI in a cross-sectional design. METHODS: 1,675 female patients aged ≥ 65 and treated for their first hip fracture in Seinäjoki Central Hospital, Finland, during 2007-2019, were included in a prospective cohort study. Of these, 1,106 underwent comprehensive geriatric assessment (CGA), including questions on continence, at our geriatric outpatient clinic 6 month post-fracture. A multivariable-adjusted multinomial logistic regression model was used to examine factors associated with UI subtypes. RESULTS: Of the 779 patients included, 360 (46%) were continent and 419 (54%) had UI 6-month post-fracture. Of the women with UI, 117 (28%) had stress UI, 183 (44%) had urgency UI and 119 (28%) had mixed UI, respectively. Mean age of the patients was 82 ± 6,91. In multivariable analysis, depressive mood and poor mobility and functional ability were independently associated with stress UI. Fecal incontinence (FI) and Body Mass Index (BMI) over 28 were independently associated with urgency UI. Mixed UI shared the aforementioned factors with stress and urgency UI and was independently associated with constipation. CONCLUSIONS: Mixed UI was associated with most factors, of which depressive mood and impaired mobility and poor functional ability were shared with stress UI, and FI and higher BMI with urgency UI. CGA is key in assessing UI in older hip fracture patients, regardless of subtype.