Prevalence of urinary incontinence among women with diabetes in the Lolland-Falster Health Study, Denmark.

AIMS: To investigate the prevalence of urinary incontinence (UI) and UI subtypes (stress, urgency, and mixed UI) in women with or without diabetes mellitus; and to investigate the association between diabetes and UI (any and subtypes). METHODS: A cross-sectional study based on the Lolland-Falster, Denmark population-based health study. From 2016 to 2020, clinical measurement, questionnaires, and blood tests were collected. A total of 8563 women aged 18 or older were enrolled. Data analysis included 7906 women. UI was defined as any involuntary leakage of urine during the previous 4 weeks. Multiple logistic regression was used to adjust for confounders: age, body mass index, parity, physical activity, previous gestational diabetes, education, and smoking. RESULTS: UI prevalence was 50.3% in women with diabetes and 39.3% in women without diabetes. The unadjusted and adjusted odds ratio (OR) for UI in women with diabetes was OR 1.56 (95% confidence interval [CI], 1.27-1.92) and 1.11 (95% CI, 0.88-1.38), respectively. Mixed UI was associated with diabetes after controlling for confounders. A subgroup analysis found women using multiple antidiabetic medications had increased odds of UI, 2.75 (95% CI, 1.38-5.48), after controlling for confounders. CONCLUSION: The prevalence of UI in women with diabetes was higher than in women without diabetes. The odds of UI was 56% higher in women with diabetes compared with women without diabetes but the effect was attenuated when controlling for confounders and statistically significance was not achieved. For a subgroup using multiple antidiabetic medications, the risk of UI was higher than in women without diabetes.

Objective comparison of subtotal vs. total abdominal hysterectomy regarding pelvic organ prolapse and urinary incontinence: a randomized controlled trial with 14-year follow-up.

OBJECTIVE: To compare subtotal and total abdominal hysterectomy regarding objective assessment of pelvic organ prolapse, urinary incontinence and voiding function 14 years after hysterectomy for benign diseases. STUDY DESIGN: Long-term follow-up of a randomized clinical trial of subtotal vs. total abdominal hysterectomy with objective outcomes. All randomized women still alive and living in Denmark (n=304) were invited to answer a questionnaire and come for clinical examination consisting of 20-min pad weighing test, urinary flow, measurement of residual urine, POP-Q measurement for pelvic organ prolapse, 3 day voiding diary and also filled out the pelvic floor distress inventory (PFDI-20) questionnaire. RESULTS: We included 100/304 (32.9%) women (subtotal hysterectomy: 53, total hysterectomy: 47) in the clinical examinations. The study questionnaire was answered by 197 (64.8%) (subtotal: 97, total: 100), the PFDI-20 questionnaire was answered by 140 (46.1%) (subtotal: 68, total: 72). We found no difference between subtotal and total abdominal hysterectomy in the PFDI-20 scores or regarding objectively assessed urinary incontinence or pelvic organ prolapse. In the subtotal hysterectomy group, 31 (59.6%) women had objective stage 2 pelvic organ prolapse compared with 33 (70.2%) in the total hysterectomy group (P=0.27); however, only 6/31 and 9/33 had symptoms (P=0.45). There were more anterior pelvic organ prolapses in the total hysterectomy group (N=10) than in the subtotal hysterectomy group (N=4) (P=0.048). We found a higher mean maximum flow rate (Qmax) in the subtotal hysterectomy group (34.78ml/s) than in the total hysterectomy group (27.08ml/s) (P=0.042) as well as a higher mean functional capacity in the subtotal hysterectomy group (526ml) than in the total hysterectomy group (443ml) (P=0.0147) according to the voiding diary. CONCLUSION: Subtotal and total abdominal hysterectomy are comparable regarding long-term objective pelvic organ prolapse and urinary incontinence. The subtotal hysterectomy group had a higher Qmax and voided volume.