Abdominal obesity as assessed by anthropometric measures associates with urinary incontinence in females: findings from the National Health and Nutrition Examination Survey 2005-2018.

BACKGROUND: Urinary incontinence (UI) is significantly link to abdominal obesity. This study aimed to assess the association between anthropometric indices of abdominal obesity, including body roundness index (BRI), conicity index (CI), and waist-to-height ratio (WHtR), and UI risk in adult females. METHODS: We analyzed data from 10, 317 adult females in the National Health and Nutrition Examination Survey (NHANES) database (2005-2018). Weighted multivariable-adjusted regression analysis was conducted to determine the odds ratio (OR) and 95% confidence intervals (CI) for the association between BRI, CI, WHtR, and UI. Stratified analyses revealed the association based on the population type. Receiver operating characteristic curve (ROC) analyses were used to assess the predictive value of UI. RESULTS: All indices of abdominal obesity investigated were positively and independently associated with the prevalence and severity of three types of UI. After adjusting for all relevant confounding variables, a significantly positive association between BRI and the prevalence of UI were observed (OR quartile 4 vs. quartile 1: urge UI (UUI): 1.93, 95% CI 1.61-2.30; stress UI (SUI): 2.29, 95% CI 1.94-2.70; mixed UI (MUI): 2.26, 95% CI 1.82-2.82; all P < 0.0001, P for trend < 0.0001, respectively), as well as WHtR and CI, which particularly prominent for female in premenopausal. Moreover, a one-unit increment of BRI was significantly associated with an increased severity index of UUI (ß: 0.06, 95% CI 0.04-0.09, P < 0.0001), SUI (ß: 0.10, 95% CI 0.07-0.13, P < 0.0001) and MUI (ß: 0.07, 95% CI 0.04-0.10, P < 0.0001), which this trend was also observed in each subtype of UI for WHtR and CI. Furthermore, the ROC analysis demonstrated a higher diagnostic efficacy of BRI and WHtR compared with BMI in discriminating UI with an AUC of 0.600 for SUI, 0.617 for UUI, and 0.622 for MUI (all P < 0.05). CONCLUSIONS: An increased BRI, CI, and WHtR are significantly associated with higher prevalence and severity of UI in females.

Association between exposure to multiple metals and stress urinary incontinence in women: a mixture approach.

There is limited evidence linking exposure to heavy metals, especially mixed metals, to stress urinary incontinence (SUI). This study aimed to explore the relationship between multiple metals exposure and SUI in women. The data were derived from the National Health and Nutrition Examination Survey (NHANES), 2007-2020. In the study, a total of 13 metals were analyzed in blood and urine. In addition, 5155 adult women were included, of whom 2123 (41.2%) suffered from SUI. The logistic regression model and restricted cubic spline (RCS) were conducted to assess the association of single metal exposure with SUI risk. The Bayesian kernel machine regression (BKMR) and weighted quantile sum (WQS) were used to estimate the combined effect of multiple metals exposure on SUI. First, we observed that blood Pb, Hg and urinary Pb, Cd were positively related to SUI risk, whereas urinary W was inversely related by multivariate logistic regression (all p-FDR < 0.05). Additionally, a significant non-linear relationship between blood Hg and SUI risk was observed by RCS analysis. In the co-exposure models, WQS model showed that exposure to metal mixtures in blood [OR (95%CI) = 1.18 (1.06, 1.31)] and urine [OR (95%CI) = 1.18 (1.03, 1.34)] was positively associated with SUI risk, which was consistent with the results of BKMR model. A potential interaction was identified between Hg and Cd in urine. Hg and Cd were the main contributors to the combined effects. In summary, our study indicates that exposure to heavy metal mixtures may increase SUI risk in women.

Utility of opportunistic screening to assess the impact of urinary incontinence on quality of life and barriers to seeking treatment among women attending a tertiary healthcare centre in North India.

INTRODUCTION: Urinary incontinence (UI) is a common but frequently neglected problem in females, significantly impacting their psychosocial health. The available estimates are an underestimation of a bigger problem. Thus, the study aimed to estimate the prevalence of UI, its associated risk factors, its impact on the Quality of life (QoL), and barriers to treatment-seeking behaviour in women attending tertiary healthcare centres. METHODS: We conducted a cross-sectional study using an opportunistic screening among women visiting a tertiary care hospital in Punjab recruited using multi-stage systematic random sampling. UI was classified as Stress (SUI), Urge (UUI), mixed (MUI), and No Incontinence (UI less than once a week or a month or no complaints) using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Bivariate analyses were done using the chi-square test to test the association between the dependent and independent variables. The predictors of UI were explored using univariable and multivariable binary logistic regression and depicted using Odds ratio with 95% confidence intervals. The impact of UI on Quality of Life (QoL) was assessed using the Incontinence Impact Questionnaire-Short Form (IIQ-7), and compared among the three UI types using One-Way ANOVA. Treatment barriers were explored using open-ended questions. RESULTS: Of the 601 women, 19.6% reported UI (stress UI: 10.1%, mixed UI: 6.0%, and urge UI: 3.5%). There were significant clinical-social factors that predicted different types of UI. The UI depicted a significant effect on QoL across all domains of the IIQ-7 (total mean score: 50.8 ± 21.9) compared to women with no incontinence (0.1 + 1.9). The score was highest in women with MUI, followed by SUI and UUI. About two-thirds of the affected women never consulted a doctor and considered it a non-serious condition or a normal ageing process. CONCLUSIONS: The present study found a high prevalence of UI through opportunistic screening across all the women's age groups with different conditions. Due to the associated stigma, clinicians should make every attempt to talk more about this, especially in women with medical conditions that can precipitate UI. Furthermore, the results call for generating more robust estimates through community-based screening studies.

Urinary phenols and parabens exposure in relation to urinary incontinence in the US population.

BACKGROUND: Our study aimed to investigate the impact of urinary concentrations of personal care products (PCPs)-related phenols (PNs) and parabens (PBs), including Triclosan (TCS), Bisphenol A (BPA), Benzophenone-3 (BP-3), Butylparaben (BPB), Ethylparaben (EPB), Methylparaben (MPB), and Propylparaben (PPB), on urinary incontinence (UI) occurrence. METHOD: We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2007 to 2016. Regression analysis was employed to investigate the relationship between exposure to PCPs-related substances, various levels of exposure, and UI within both the general population and the female demographic. Additionally, the Bayesian Kernel Machine Regression (BKMR) model was used to assess the effects of mixtures on UI. RESULTS: Our analysis comprised 7,690 participants who self-reported their diagnosis. Among them, 12.80% experienced stress urinary incontinence (SUI), 11.80% reported urge urinary incontinence (UUI), and 10.22% exhibited mixed urinary incontinence (MUI). In our fully adjusted multivariable models, BP-3 exposure exhibited a positive association with SUI (OR 1.07, 95% CI 1.02-1.14, p = 0.045). BPA exposure correlated with an increased risk of UUI (OR 1.21, 95% CI 1.01-1.44, p = 0.046) and MUI (OR 1.26, 95% CI 1.02-1.54, p = 0.029). TCS exposure displayed a negative correlation with the incidence of MUI (OR 0.87, 95% CI 0.79-0.97, p = 0.009). No significant links were observed between parabens and urinary incontinence. Notably, among the female population, our investigation revealed that BPA exposure heightened the risk of MUI (OR 1.28, 95% CI 1.01-1.63, p = 0.043). Participants in the highest tertile of BP-3 exposure demonstrated elevated likelihoods of SUI and MUI compared to those in the lowest tertile. In the BKMR analysis, negative trends were observed between the mixture and the risks of UUI and MUI when the mixture ranged from the 25th to the 40th and 35th to the 40th percentiles or above, respectively. Additionally, a positive trend was identified between the mixture and MUI when it was in the 40th to 55th percentile. CONCLUSION: In conclusion, our findings suggest that exposure to BPA, TCS, and BP-3 may contribute to the development of urinary incontinence.

Risk factors for postpartum stress urinary incontinence: a prospective study.

PURPOSE: Postpartum stress urinary incontinence (SUI) is a common occurrence in women, and it has a profound effect on women's health and quality of life. This study aimed to investigate the risk factors for postpartum SUI and the relative importance of each factor, including pelvic floor ultrasound measurement data and clinical data. METHOD: Pregnant women who delivered in our hospital from March 2021 to January 2022 were selected as the study population. The clinical and anatomical Data from women with SUI and those without SUI were collected and analyzed. The clinical and anatomical risk factors associated with postpartum SUI were identified using univariate and multivariate analyses. RESULTS: A total of 255 participants were recruited. Logistic regression analysis indicated that age (OR:1.215, 95% CI:1.097-1.346, P < 0.001), vaginal delivery (OR:3.05, 95% CI:1.328-7.016, P < 0.009), parity (OR:3.059, 95% CI:1.506-6.216, P < 0.002), bladder neck descent (OR:4.159, 95% CI: 2.010-8.605, P < 0.001), the angle of the internal urethral orifice funnel (OR:1.133, 95% CI:1.091-1.176, P < 0.001) were important independent risk factors for postpartum SUI (all P < 0.05). The AUC was 0.883 (95% CI: 0.839-0.926) in the model. CONCLUSIONS: Age, vaginal delivery, parity, bladder neck descent and the angle of the internal urethral orifice funnel are independent risk factors for postpartum SUI. To prevent the occurrence of postpartum SUI, high-risk factors of postpartum SUI should be identified as early as possible during pregnancy and after delivery, and postpartum pelvic floor rehabilitation training should be promoted.

Incidence and risk factors of stress urinary incontinence after laparoscopic hysterectomy.

OBJECTIVE: To observe the long-term effects of total hysterectomy on urinary function, evaluate the effects of preoperative nutritional status, urinary occult infection, and surgical factors on the induction of postoperative stress urinary incontinence (SUI), and explore the incidence and risk factors of SUI. STUDY DESIGN: From January 2017 to December 2017, 164 patients with benign non-prolapsing diseases who underwent a laparoscopic total hysterectomy in the First People's Hospital of Taicang were selected as the analysis objects. The International Incontinence Standard Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Pelvic Floor Impact Questionnaire-short version 20 (PFDI-20) were used for telephone follow-up to subjectively assess the urinary function of patients, collect their medical records, and statistically analyze the number of postoperative SUI cases. Logistic multivariate analysis was used to analyze the influencing factors of postoperative female SUI, presented as adjusted odds ratios with 95% confidence intervals. RESULTS: Only 97 out of 164 patients completed the ICIQ-FLUTS and PFDI-20 questionnaires. Among these participants, 28 patients (28.86%) were diagnosed with SUI (study group), while 69 patients (71.13%) were classified as women without SUI (control group). The age, menopause, parity ≥ 2 times, Body mass index (BMI) ≥ 28 kg/m2, neonatal weight ≥ 4000 g, history of chronic cough, preoperative hemoglobin ≤ 100 g/L, preoperative urine bacteria ≥ 100u/L, preoperative uterine volume ≥ 90 cm3, intraoperative blood loss, and operation time of the study group were compared with those of the control group. The differences were statistically significant (P < 0.05). Further Logistic multivariate analysis showed that menopause, preoperative hemoglobin ≤ 100 g/L, preoperative urine bacteria ≥ 100u/L, uterine volume ≥ 90 cm3, history of chronic cough, BMI ≥ 28 kg/m2 were risk factors for postoperative SUI in patients undergoing hysterectomy (P < 0.05). CONCLUSIONS: Hysterectomy for benign non-prolapse diseases has a long-term potential impact on the urinary system of patients, and the risk of postoperative SUI increases. The main risk factors of SUI are parity, menopausal status, obesity, preoperative nutritional status, and occult infection of the urinary system.

Pelvic Floor Disorders Among Minority Women: Differences in Prevalence, Severity and Health-Related Social Needs.

OBJECTIVE: To characterize prevalence and severity of pelvic floor disorders (PFDs) in various health care settings and to examine unmet health-related social needs (HRSN) among minority women. MATERIALS AND METHODS: Minority women with PFDs were recruited from our academic urogynecology clinic, a general urology clinic at our institution's safety net hospital, and a community outreach mobile clinic. Questions from the Urinary Distress Index-6, Pelvic Organ Prolapse Distress Inventory-6, and Female Genitourinary Pain Index were used to identify patients with stress urinary incontinence, overactive bladder (OAB), and chronic pelvic pain syndrome (CPPS). RESULTS: Sixty-one (46.6%) women identified as Hispanic, 53 (40.4%) as Black, and 17 (12.9%) as Other. Overall, self-reported PFDs included stress urinary incontinence in 45%, OAB in 74.8%, and CPPS in 24.4% of women. Hispanic women were more likely to report OAB symptoms, compared to Black women (odds ratio (OR) 3.4 [1.2-10.2], P = .03) or Other women (OR = 5.1 [1.3-20.4], P = .02). Participants held a median of 5 unmet HRSN. Minority women facing issues with family and community support, transportation, and utilities were more likely to report CPPS symptoms, compared to those without psychosocial issues (support OR: 4.8 [1.7-13.7], P = .002; transportation OR: 2.0 [1.0-8.2], P = .05; utility OR: 7.0 [1.9-28.1], P = .005). CONCLUSION: Minority women with PFDs may have several unmet HRSNs which impact their ability to receive appropriate medical care. Our findings may assist in the development of effective strategies to improve health care outcomes for women dealing with PFDs.

Epidemiological Profile and Attitudes of Pregnant Women Toward Urinary Incontinence: A Single-Center Cross-Sectional Study.

OBJECTIVE: The objective was to highlight the epidemiological and clinical profile of urinary incontinence in pregnant women during the first trimester and to determine their knowledge and attitudes toward this condition in Kinshasa. METHODS: We carried out a descriptive cross-sectional study among 127 pregnant women who came for prenatal consultations in the first trimester from January to March 2022 at the LISANGA Medical Centre in Kinshasa. A questionnaire was developed containing the Urinary Symptom Profile (USP) scale. Kolmogorov-Smirnov normality tests were used to determine the normality of the distribution of the study variables. Inferential statistics were performed. The significance level was 0.05. RESULTS: The mean age was 29.7±5.5 years. Thirty-eight women (29.9%) were primigravida. The median age of pregnancy was 6 weeks of amenorrhoea. The prevalence of urinary incontinence was 73.2%, with 31.2% of urge urinary incontinence and 16.1% of stress incontinence. In 61.4% of cases, overactive bladder was associated with urinary incontinence. Among the incontinent pregnant women, 3.2% had consulted a doctor while accepting that this condition is a health problem, 13.4% knew they had a pelvic floor muscle, 4.7% had knowledge of its rehabilitation, and 8.7% had benefited from gymnastics during pregnancy. CONCLUSIONS: Urinary incontinence was frequent in the first trimester of pregnancy with a predominance of urgency. It was hardly discussed during prenatal consultations and pregnant women were not aware of the pelvic floor muscle, its rehabilitation, and of gymnastics during pregnancy.

[Prevalence of urinary incontinence in middle-aged and elderly adults in 10 areas in China].

Objective: To describe the population and area distribution differences in the prevalence of urinary incontinence in middle-aged and elderly adults in 10 areas in China. Methods: A total of 24 913 participants aged 45-95 years who completed the third resurvey of China Kadoorie Biobank during 2020-2021 were included. The prevalence of urinary incontinence was assessed by an interviewer-administered questionnaire, and urinary incontinence was classified as only stress urinary incontinence, only urgency urinary incontinence and mixed urinary incontinence. The prevalence of urinary incontinence and its subtypes were reported by sex, age and area, and the severity of urinary incontinence and treatment were described. Results: The average age of the participants was (65.4±9.1) years. According to the seventh national census data in 2020, the age-standardized prevalence rates of urinary incontinence was 25.4% in women and 7.0% in men. The age-standardized prevalence rates of only stress, only urgency and mixed incontinence were 1.7%, 4.2% and 1.2% in men and 13.5%, 5.8% and 6.1% in women, respectively. The prevalence rates of urinary incontinence and all subtypes in men and the prevalence of urinary incontinence and all subtypes except only stress urinary incontinence in women all increased with age (P<0.001). After adjusting for age, the prevalence of urinary incontinence in both men and women were higher in rural area than in urban area (P<0.001). The treatment rates in men and women with urinary incontinence were 15.4% and 8.5%, respectively. Conclusions: The prevalence of urinary incontinence was high in middle-aged and elderly adults in China, and the prevalence rate was higher in women than in men, but the treatment rate of urinary incontinence was low.

Prevalence and Quality of Life among Overweight and Obese Women with Different Severity and Types of Urinary Incontinence.

OBJECTIVE: Urinary incontinence (UI) is an involuntary leakage of urine and affects the social, physical, and psychological aspects of many individuals worldwide. The purpose of our study was to examine the prevalence, quality of life (QoL), severity, and different types of UI in overweight and obese women. METHODS: We conducted a cross-sectional study of 1,351 consecutive patients, who were recruited between June 2021 and May 2022. RESULTS: The mean age of the patients was 39.7 ± 14.2 years with less than a half in the 19-35-year age group (46.9%); 65% of the subjects were overweight or obese. The overall prevalence of UI was 61.2%. Overweight and obesity accounted to 70.2% of patients with mild to very severe UI. The risk estimates to have UI were 1.84 in overweight and 5.4 in obese group. The risk estimate for severe and very severe UI was 2.33 in overweight and 10.34 in obese group. When considering all subtypes, 67.9% of women with overweight and obesity had any of the subtypes, urge UI, stress UI, and mixed UI. Overweight and obesity were significantly associated with poor QoL in women with UI (p < 0.0001). Among 36.1% of all patients with poor QoL, 79.9% were overweight and obese. CONCLUSIONS: Overweight and obesity are important risk factors of UI affecting daily activity and QOL considerably. As the number of people with obesity is increasing, the prevalence of UI with increased severity is likely to increase in young to mid-aged women. Weight loss should be considered as first-line treatment for this patient population.

Impact of childbirth on pelvic floor dysfunction in women who have undergone previous pelvic floor reconstructive surgery: systematic review and meta-analysis.

INTRODUCTION AND HYPOTHESIS: The aim of the study was to perform a systematic review and meta-analysis of the impact of pregnancy and childbirth (vaginal delivery [VD]) or cesarean section (CS) on the recurrence of pelvic floor disorders in women who had previously undergone pelvic floor reconstructive surgery for pelvic organ prolapse (POP) or stress urinary incontinence (SUI), to facilitate future evidence-based counseling. METHODS: PubMed, Cochrane, Embase, BJOG, Scopus, etc. were screened, from 1990 to date. Inclusion criteria included cohort studies, case-control studies, case series, and case reports that reported on the primary outcome measure of the review. Exclusion criteria included studies on surgical procedures whose outcomes are unlikely to be impacted by pregnancy and childbirth or are obsolete. Meta-analysis was performed using Review Manager 5.3. RESULTS: Seven papers on midurethral slings (MUS; 181 women in both VD and CS groups respectively) and three papers on different hysteropexy techniques (47 and 29 women in the VD and CS groups respectively), were included in the meta-analysis. No difference was seen between the two groups regarding the recurrence of SUI in women who had previously undergone MUS surgery (OR: 1.18 [0.66, 2.09]; Z = 0.56; p = 0.58) or the recurrence of POP following hysteropexy using various apical suspension procedures (OR: 1.81 [0.04, 80.65]; Z = 0.31; p = 0.76). There are insufficient data to support meta-analyses for individual MUS sub-types or hysteropexy procedures. CONCLUSION: Current literature does not demonstrate a protective effect of CS in preventing recurrent SUI in women who had undergone MUS surgery for SUI. When hysteropexy is considered irrespective of the apical suspension procedure employed, the incidence of recurrent POP appears similar after CS and VD.

Unilateral levator avulsion increases the risk of de novo stress urinary incontinence after cystocele repair.

INTRODUCTION: Patients without concurrent baseline stress urinary incontinence (SUI) can develop de novo SUI after transvaginal mesh surgery (TVM) for cystocele repair. Surgeons should be aware of de novo SUI risk factors after TVM. METHODS: A total of 1124 women who were underwent TVM surgeries were recruited and assessed for eligibility from January 1, 2012 to April 30, 2021. All data related to patients and surgeries was collected, which included general conditions, clinical examination, surgery records, and follow-up results. Patients were divided into three groups according to follow-up results and data were compared with each group. The relative risk (RR) of de novo SUI with levator avulsion was also calculated. RESULTS: Three hundred thirty-six patients were included in this study. They were divided into no complication group (n = 249), de novo SUI group (n = 68), and other complications group (n = 19). It seemed elder or obese women had a higher risk of de novo SUI after TVM (p < 0.05). In de novo SUI group, incidence of levator avulsion before surgery were higher than the other two groups (p = 0.001). TVM can significantly change a prolapse to point Aa and Ba on POP-Q quantification system (p < 0.05). RR ratios of de novo SUI with unilateral avulsion group is 2.60 (95% confidence interval [CI] 1.39-4.87), and 2.58 (95%CI 0.82-8.15) for bilateral group. CONCLUSION: Unilateral levator avulsion, instead of bilateral levator avulsion, is a risk factor of de novo SUI after cystocele repair surgery.

Urinary incontinence associates with poor work ability in middle-aged women: A Northern Finland Birth cohort 1966 study.

INTRODUCTION: Urinary incontinence is a common ailment in women and is likely to affect their work ability. We investigated the associations between the different subtypes of urinary incontinence and several dimensions of perceived work ability in middle-aged general population. MATERIAL AND METHODS: Cross-sectional survey at age 46 among participants of the Northern Finland Birth Cohort 1966 study (n = 3706, response rate 72%). Urinary incontinence symptoms and several items of Work Ability Index were collected by postal questionnaire. Work ability was dichotomized as good or poor work ability in general, in relation to physical job demands, to diseases and own 2-year prospect of work ability. The associations between urinary incontinence and work ability measures were assessed using logistic regression models, with further adjustments for biological, behavioral and work-related factors as well as general health. RESULTS: The odds ratio (OR), from lowest to highest, for poor work ability were 1.4-fold among women with stress urinary incontinence (OR 1.37, 95% confidence interval [CI] 1.09-1.72), 2.5-fold with mixed urinary incontinence (OR 2.51, 95% CI 1.68-3.74) and 3.3-fold with urgency urinary incontinence (OR 3.34, 95% CI 1.95-5.70). We note that our results reflect work ability in a Nordic society. CONCLUSIONS: Especially urgency and mixed types of urinary incontinence are associated with poor work ability among middle-aged women.

Development and internal validation of a risk prediction model for stress urinary incontinence throughout pregnancy: A multicenter retrospective longitudinal study in Indonesia.

BACKGROUND: This study aimed to develop a risk prediction model for stress urinary incontinence (SUI) throughout pregnancy in Indonesian women. METHODS: We conducted a multicenter retrospective longitudinal study involving pregnant women in Indonesia, who sought care at obstetrics clinics from January 2023 to March 2023, encompassing all stages of pregnancy. We collected data on their predictive factors and SUI outcome. SUI was diagnosed based on responses to the "leaks when you are physically active/exercising" criterion in the ICIQ-UI-SF questionnaire during our investigation of the participants. The models underwent internal validation using a bootstrapping method with 1000 resampling iterations to assess discrimination and calibration. RESULTS: A total of 660 eligible pregnant women were recruited from the two study centers, with an overall SUI prevalence of 39% (258/660). The final model incorporated three predictive factors: BMI during pregnancy, constipation, and previous delivery mode. The area under the curve (AUROC) was 0.787 (95% CI: 0.751-0.823). According to the max Youden index, the optimal cut-off point was 44.6%, with a sensitivity of 79.9% and specificity of 65.9%. A discrimination slope of 0.213 was found. CONCLUSION: The developed risk prediction model for SUI in pregnant women offers a valuable tool for early identification and intervention among high-risk SUI populations in Indonesian pregnant women throughout their pregnancies. These findings challenge the assumption that a high BMI and multiple previous deliveries are predictors of SUI in Indonesian women. Further research is recommended to validate the model in diverse populations and settings.

Possible association of urinary incontinence with post-COVID-19: a report of three cases.

INTRODUCTION: The disorder denominated urinary incontinence (UI) has been diagnosed amongst 25-45% of women worldwide. Muscle weakness is one of the more notable symptoms, which is exhibited in the acute form of coronavirus disease 2019 (COVID-19) that compromises the respiratory musculature. Accordingly, this report aims to delineate three cases in women with UI possibly associated with post-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. CASE REPORTS: Three elderly Brazilian women expressed UI symptomology post-COVID-19 recovery. In the investigation reports, there was no documented acute impairment or hospitalization post-COVID-19. Nevertheless, some form of UI derived from muscle weakness was detected and treated by physiotherapy in these patients. The patient 1 (P1) was classified as mixed urinary incontinence (MUI) based on the presented symptomology during the filling phase and urinary leakage on exertion. Intravaginal probing suggested neural integrity. The P2 and P3 were classified as stress urinary incontinence (SUI), related to increased abdominal pressure. In all the three cases, there were benefits from physical therapy treatment. CONCLUSIONS: This case report is relevant in improving our understanding and lead to future research about the possibility of clinical variations as UI after infection by SARS COV 2 contributing to greater awareness in the diagnostic workup and allowing for earlier treatment and management. It is concluded that the surveillance of the distinct symptomologies associated with the SARS-CoV-2 infection is fundamental, because there is no adequate corroboratory evidence in the scientific literature, for the cases of pelvic floor muscles weakness that causes UI.

Associations between visceral adipose index and stress urinary incontinence among US adult women: a cross-sectional study.

OBJECTIVE: Visceral adipose index (VAI) is a novel parameter for the evaluation of visceral obesity. The present study aimed to investigate the association between VAI levels and stress urinary incontinence (SUI) in a nationally representative population. MATERIALS AND METHODS: The National Health and Nutrition Examination Survey (NHANES) women population aged > 20 years were analyzed from 2001 to 2018. SUI was determined by self-reported questions. VAI was calculated using physical examination data and laboratory tests. Survey-weighted logistic regression models were used to analyze the correlation between SUI and VAI. RESULTS: The final analysis included 9709 women. Among them, 4032 (41.53%) were any SUI, 1130 (11.64%) were at least weekly SUI, and 506 (5.21%) were at least daily SUI. In multivariate analysis, the odds ratio (OR) for overall SUI increased slightly after full adjustment (OR 1.06, 95% CI 1.03-1.10, P = 0.001). Similar results were observed in weekly (OR 1.04, 95% CI 1.00-1.08, P = 0.0327) and daily (OR 1.04, 95% CI 1.00-1.09, P = 0.0702) SUI. The analysis of VAI categorized showed an increased OR of any, weekly, and daily SUI in the highest compared to the lowest tertile (OR 1.44, 95% CI 1.26-1.65, P < 0.0001 for trend, OR 1.38, 95% CI 1.07-1.78, P = 0.0153 for trend, OR 1.33, 95% CI 0.94-1.87, P = 0.094 for trend). CONCLUSION: This study revealed a significant association between SUI and VAI among US adult women. VAI is an easily applicable index for the evaluation of visceral fat dysfunction, which might be useful for the calculation of SUI risk.

Prevalence and sociodemographic correlates of urinary incontinence in Japanese women: A web-based cross-sectional study.

BACKGROUND: Epidemiological studies on urinary incontinence that used a validated international standard questionnaire are limited in Japan, and few studies have examined the sociodemographic and behavioral correlates of urinary incontinence. OBJECTIVE: The aim of this study was to estimate the prevalence of urinary incontinence according to the Japanese version of the International Consultation on Incontinence Questionnaire-Short Form, and its sociodemographic and behavioral correlates among Japanese women. DESIGN: A web-based cross-sectional study. METHODS: A randomly sampled cross-sectional Internet survey was conducted in Japan among 3030 women aged 20-64 years. The International Consultation on Incontinence Questionnaire-Short Form score, sociodemographic, body mass index, medical and childbirth history, practice of pelvic floor muscle training, and medical care use were obtained. Descriptive statistics, the chi-square test, and forced-entry logistic regression analysis were used in data analysis. RESULTS: Participants' average age was 43.4 years, and the response rate was 32.9%. The prevalence of urinary incontinence was 25.5%, and it increased with age. Stress urinary incontinence was the most common subtype (57.4%), followed by urge urinary incontinence (20.3%) and mixed urinary incontinence (16.7%). Less than 5% of those with urinary incontinence had experience with pelvic floor muscle training and medical care use. Middle-aged and older (p < 0.001), overweight and obesity (p < 0.001), vaginal delivery status (p < 0.001), low back pain (p = 0.008), and previous pelvic floor muscle training engagement (p < 0.001) were significantly associated with urinary incontinence. CONCLUSION: Increasing population awareness of urinary incontinence from an early age and developing effective interventions for the identified at-risk groups, such as the middle-aged and older, those with overweight and obesity, and those with previous pregnancies, are urgently needed.

Association between grip strength and stress urinary incontinence of NHANES 2011-2014.

OBJECTIVES: To investigate the association between grip strength (GS) and relative grip strength (rGS) with the prevalence and severity risk of SUI. METHODS: Female patients were retrieved from the NHANES 2011-2014. GS was measured using a digital hand dynamometer, rGS was defined as grip strength divided by BMI. Samples were classified into four groups based on quartiles of GS and rGS distribution (Q1-Q4)。Logistic regression models were established to detect the relationship between GS or rGS and SUI. The potential bias of baseline variables between SUI and non-SUI groups was controlled by performing the propensity score matching (PSM). RESULTS: A total of 4263 samples were included, with 3085 (85%) people in non-SUI group and 1178 (27.6%) people in SUI group. GS and rGS levels of people without SUI were higher than that of SUI patients. Monthly SUI patients' GS and rGS levels were higher than weekly SUI patients' level. Logistic regression analysis showed that risks of prevalence and severity of SUI decreased with increasing levels of GS and rGS. rGS was found to have a stronger association with SUI than GS [prevalence: GS: Q4 vs. Q1: aOR = 0.633, 95%CI = 0.508-0.789, p < 0.001; rGS: Q4 vs. Q1: aOR = 0.365, 95%CI = 0.290-0.459, p < 0.001; severity: GS: Q4 vs. Q1: aOR = 0.727, 95%CI = 0.600-0.881, p = 0.001; rGS: Q4 vs. Q1: aOR = 0.371, 95%CI = 0.282-0.488, p < 0.001]. The results of PSM confirmed that GS and rGS were correlated with SUI. CONCLUSIONS: Lower levels of GS and rGS are associated with an increased prevalence and severity risk of SUI.

Association of epidural analgesia during labor and early postpartum urinary incontinence among women delivered vaginally: a propensity score matched retrospective cohort study.

BACKGROUND: Although epidural analgesia is considered the gold standard for pain relief during labor and is safe for maternity and fetus, the association between the epidural analgesia and pelvic floor disorders remains unclear. Thus we estimate the association between epidural analgesia and early postpartum urinary incontinence (UI). METHODS: A propensity score-matched retrospective cohort study was conducted at a university-affiliated hospital in Shanghai, China. Primiparous women with term, singleton, and vaginal delivery between December 2020 and February 2022 were included. UI was self-reported by maternity at 42 to 60 days postpartum and was classified by International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Using logistic regression models, the associations between epidural analgesia and early postpartum UI were assessed. RESULTS: Among 5190 participants, 3709 (71.5%) choose epidural anesthesia during labor. Analysis of the propensity-matched cohort (including 1447 maternal pairs) showed epidural anesthesia during labor was independently associated with UI in early postpartum period (aOR 1.50, 95% CI 1.24-1.81). This association was mainly contributed to stress UI (aOR 1.38, 95% CI 1.12-1.71) rather than urge UI (aOR 1.45, 95% CI 0.99-2.15) and mixed UI (aOR 1.52, 95% CI 0.95-2.45). Furthermore, we observed that the association between epidural anesthesia and UI was more pronounced among older women (≥ 35 y) and women with macrosomia (infant weight ≥ 4000 g), compared with their counterparts (both P for interaction < 0.01). After further analysis excluding the women with UI during pregnancy, the results remained largely consistent with the main analysis. CONCLUSIONS: The findings support that epidural anesthesia was associated with SUI in the early postpartum period.

Association Between Sleep Duration and Urinary Incontinence in Female Adults: A Cross-sectional Study in National Health and Nutrition Examination Survey 2007-2018.

OBJECTIVE: To elaborate on the effect of sleep duration on urinary incontinence (UI), we investigated the association between sleep duration with the risk of UI from the National Health and Nutrition Examination Survey (NHANES) dataset. METHODS: A cross-sectional survey of female participants aged 20years old and above were enrolled from the year 2007-2018. We performed weighted multivariable logistic regression models to assess the association between sleep duration and UI. RESULTS: A total of 6838 female participants were included. Compared with sleep duration less than 6 hours, other sleep duration was found to be not significantly correlated with total UI, stress urinary incontinence, and mixed urinary incontinence in all three models Compared to sleep duration less than 6 hours, multivariate regression demonstrated that moderate sleep (6-8 hours) indicated a lower urgent urinary incontinence (UUI, odds ratio=0.764, 95% confidence interval=0.620-0.944, P = .013). Inadequate sleep (<6 hours) indicated a higher UUI (odds ratio=1.308, 95% confidence interval=1.060-1.614, P = .013) compared to moderate sleep duration (6-8 hours). The association might be modified by the family income-to-poverty ratio. CONCLUSION: Inadequate sleep (<6 hours) was associated with a higher incidence of UUI. A moderate sleep duration (6-8 hours) was related to a lower rate of UUI. Further studies are warranted for clinical prevention and treatment guidance.