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International Urogynecology Journal

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01-06-2014 | Original Article

Treatment status and risk factors for incidence and persistence of urinary incontinence in women

Authors: Nancy N. Maserejian, Vatche A. Minassian, Shan Chen, Susan A. Hall, John B. McKinlay, Sharon L. Tennstedt

Published in: International Urogynecology Journal | Issue 6/2014

Abstract

Introduction and hypothesis

The objective of this analysis was to describe urinary incontinence (UI) incidence and persistence over 5 years in association with treatment status, sociodemographic, medical, and lifestyle factors, in a racially/ethnically diverse population-based female sample.

Methods

The Boston Area Community Health Survey enrolled 3,201 women aged 30-79 years of black, Hispanic, and white race/ethnicity. Five-year follow-up was completed by 2,534 women (conditional response rate 83.4 %), allowing population-weighted estimates of UI incidence and persistence rates. Predictors of UI were determined using multivariate logistic regression models.

Results

Incidence of UI at least monthly was 14.1 % and weekly 8.9 %. Waist circumference at baseline and increasing waist circumference over 5-year follow-up were the most robust predictors of UI incidence in multivariate models (P ≤ 0.01). Among 475 women with UI at baseline, persistence was associated with depression symptoms [monthly UI, odds ratio (OR) = 2.39, 95 % confidence interval (CI) 1.14–5.02] and alcohol consumption (weekly UI, OR = 3.51, 95 % CI 1.11–11.1). Among women with weekly UI at baseline, 41.7 % continued to report weekly UI at follow-up, 14.1 % reported monthly UI, and 44.2 % had complete remission. Persistence of UI was not significantly higher (58.2 % vs. 48.0 %, chi-square P = 0.3) among untreated women. Surgical or drug treatment for UI had little impact on estimates for other risk factors or for overall population rates of persistence or remission.

Conclusions

Women with higher gains in waist circumference over time were more likely to develop UI, but waist circumference was not predictive of UI persistence. UI treatments did not affect associations for other risk factors. Additional research on the role of alcohol intake in UI persistence is warranted.

Minassian VA, Drutz HP, Al-Badr A (2003) Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet: Off Organ Int Fed Gynaecol Obstet 82:327–38CrossRef

Tennstedt SL, Chiu GR, Link CL, Litman HJ, Kusek J, McKinlay JB (2009) The effects of severity of urine leakage on quality of life in hispanic, white and black men and women: The Boston Area Community Health Survey. Urology 75:27–33. doi:10.1016/j.urology.2009.08.019 PubMedCentralPubMedCrossRef

Minassian VA, Devore E, Hagan K, Grodstein F (2013) Severity of urinary incontinence and effect on quality of life in women by incontinence type. Obstet Gynecol 121:1083–90. doi:10.1097/AOG.0b013e31828ca761 PubMedCentralPubMedCrossRef

Tennstedt SL, Link CL, Steers WD, McKinlay JB (2008) Prevalence of and risk factors for urine leakage in a racially and ethnically diverse population of adults: the Boston Area Community Health (BACH) Survey. Am J Epidemiol 167:390–9PubMedCrossRef

Waetjen LE, Liao S, Johnson WO, Sampselle CM, Sternfield B, Harlow SD, Gold EB (2007) Factors associated with prevalent and incident urinary incontinence in a cohort of midlife women: a longitudinal analysis of data: study of women’s health across the nation. Am J Epidemiol 165:309–18. doi:10.1093/aje/kwk018 PubMedCrossRef

Townsend MK, Curhan GC, Resnick NM, Grodstein F (2009) Postmenopausal hormone therapy and incident urinary incontinence in middle-aged women. Am J Obstet Gynecol 200(86):e1–5PubMed

Townsend MK, Danforth KN, Rosner B, Curhan GC, Resnick NM, Grodstein F (2008) Physical activity and incident urinary incontinence in middle-aged women. J Urol 179:1012–6, discussion 6-7PubMedCentralPubMedCrossRef

Devore EE, Minassian VA, Grodstein F (2013) Factors associated with persistent urinary incontinence. Am J Obstet Gynecol. doi:10.1016/j.ajog.2013.05.002 PubMed

McKinlay JB, Link CL (2007) Measuring the Urologic Iceberg: Design and Implementation of the Boston Area Community Health (BACH) Survey. Eur Urol 52:389–96PubMedCentralPubMedCrossRef

10.

Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29:4–20PubMed

11.

Kelley KE, Kelley TP, Kaufman DW, Mitchell AA (2003) The Slone Drug Dictionary: A research driven pharmacoepidemiology tool. Pharmacoepidemiol Drug Safety 12:168–9

12.

Raghunathan TE, Solenberger P, Van Hoewyk J. IVEware: Imputation and Variance Estimation Software User Guide. Survey Research Center, Institute for Social Research, University of Michigan. http://www.isr.umich.edu/src/smp/ive; 2002

13.

Harris SS, Link CL, Tennstedt SL, Kusek JW, McKinlay JB (2007) Care seeking and treatment for urinary incontinence in a diverse population. J Urol 177:680–4PubMedCrossRef

14.

Minassian VA, Yan X, Lichtenfeld MJ, Sun H, Stewart WF (2012) The iceberg of health care utilization in women with urinary incontinence. Int Urogynecol J 23:1087–93. doi:10.1007/s00192-012-1743-x PubMedCentralPubMedCrossRef

15.

Svenningsen R, Staff AC, Schiotz HA, Western K, Kulseng-Hanssen S (2013) Long-term follow-up of the retropubic tension-free vaginal tape procedure. Int Urogynecol J 24:1271–8. doi:10.1007/s00192-013-2058-2 PubMedCrossRef

16.

Townsend MK, Danforth KN, Rosner B, Curhan GC, Resnick NM, Grodstein F (2007) Body mass index, weight gain, and incident urinary incontinence in middle-aged women. Obstet Gynecol 110:346–53PubMedCrossRef

17.

Minassian VA, Stewart WF, Wood GC (2008) Urinary incontinence in women: variation in prevalence estimates and risk factors. Obstet Gynecol 111:324–31. doi:10.1097/01.AOG.0000267220.48987.17 PubMedCrossRef

18.

Thom DH, Brown JS, Schembri M, Ragins AI, Subak LL, Van Den Eeden SK (2010) Incidence of and risk factors for change in urinary incontinence status in a prospective cohort of middle-aged and older women: the reproductive risk of incontinence study in Kaiser. J Urol 184:1394–401. doi:10.1016/j.juro.2010.05.095 PubMedCentralPubMedCrossRef

19.

Ebbesen MH, Hunskaar S, Rortveit G, Hannestad YS (2013) Prevalence, incidence and remission of urinary incontinence in women: longitudinal data from the Norwegian HUNT study (EPINCONT). BMC Urol 13:27. doi:10.1186/1471-2490-13-27 PubMedCentralPubMedCrossRef

20.

Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, Richter HE, Myers D, Burgio KL, Gorin AA, Macer J, Kusek JW, Grady D (2009) Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med 360:481–90PubMedCentralPubMedCrossRef

21.

Maserejian NN, Kupelian V, Miyasato G, McVary KT, McKinlay JB (2012) Are physical activity, smoking and alcohol consumption associated with lower urinary tract symptoms in men or women? Results from a population based observational study. J Urol 188:490–5. doi:10.1016/j.juro.2012.03.128 PubMedCentralPubMedCrossRef

22.

Maserejian NN, Giovannucci EL, McVary KT, McGrother C, McKinlay JB (2010) Dietary macronutrient and energy intake and urinary incontinence in women. Am J Epidemiol 171:1116–25PubMedCentralPubMedCrossRef

23.

Maserejian NN, Giovannucci EL, McVary KT, McKinlay JB (2011) Intakes of vitamins and minerals in relation to urinary incontinence, voiding, and storage symptoms in women: a cross-sectional analysis from the Boston Area Community Health survey. Eur Urol 59:1039–47. doi:10.1016/j.eururo.2011.03.008 PubMedCentralPubMedCrossRef

24.

Sung VW, West DS, Hernandez AL, Wheeler TL 2nd, Myers DL, Subak LL (2009) Association between urinary incontinence and depressive symptoms in overweight and obese women. Am J Obstet Gynecol 200(557):e1–5

Title: Treatment status and risk factors for incidence and persistence of urinary incontinence in women
Authors: Nancy N. Maserejian
Vatche A. Minassian
Shan Chen
Susan A. Hall
John B. McKinlay
Sharon L. Tennstedt
Publication date: 01-06-2014
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 6/2014
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-013-2288-3

At a glance: The STEP trials

Springer Medicine

Treatment status and risk factors for incidence and persistence of urinary incontinence in women

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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