The relationship between BMI and urinary incontinence subgroups: results from EpiLUTS.

To evaluate the relationship between body mass index (BMI) and urinary incontinence (UI) in adults ≥40 from the United States, United Kingdom, and Sweden. This was a secondary analysis of EpiLUTS-a population-representative, cross-sectional, Internet-based survey conducted to assess the prevalence and HRQL impact of urinary symptoms. UI was evaluated by the LUTS Tool and categorized by subgroups: no UI, urgency urinary incontinence (UUI), stress urinary incontinence (SUI), mixed urinary incontinence (MUI) (UUI + SUI), UUI + other UI (OI), SUI + OI, and OI. Descriptive statistics were used. Logistic regressions examined the relationship of BMI to UI controlling for demographics and comorbid conditions. Response rate was 59%; 10,070 men and 13,178 women were included. Significant differences in BMI were found across UI subgroups. Obesity rates were highest among those with MUI (men and women), SUI + OI (women), UUI and UUI + OI (men). Logistic regressions of each UI subgroup showed that BMI ≥ 30 (obese) was associated with UI in general and MUI (women) and UUI + OI (men). Among women, being obese increased the odds of having SUI and SUI + OI. Women with BMI 25-29.9 (overweight) were more likely to have UI in general and SUI with and without other incontinence (SUI, MUI, and SUI + OI). Being overweight was unrelated to any form of UI in men. Results were consistent with prior research showing BMI is associated with higher risk of UI. These findings indicate substantial differences in obesity by gender and UI subtype, suggesting different mechanisms for UI other than purely mechanical stress on the bladder.

Khullar V ，Sexton CC ，Thompson CL ，Milsom I ，Bitoun CE ，Coyne KS ... -  《-》

Urinary incontinence and its relationship to mental health and health-related quality of life in men and women in Sweden, the United Kingdom, and the United States.

Differences in health burden associated with urinary incontinence (UI) subtypes have been previously described, but the majority of studies are in women. Additional research is needed to examine the prevalence and burden of UI subtype including postmicturition incontinence, nocturnal enuresis, coital incontinence, and incontinence for unspecified reasons. Examine the burden of UI in men and women in Sweden, the United Kingdom, and the United States. Secondary analyses of the Epidemiology of Lower Urinary Tract Symptoms (EpiLUTS), a cross-sectional Internet survey, were performed. Participants who reported UI were categorized as (1) urgency urinary incontinence (UUI) only, (2) stress urinary incontinence (SUI) only, (3) mixed urinary incontinence (MUI), (4) UUI plus other incontinence (OI), (5) SUI plus OI, or (6) OI. Differences in health outcomes across UI groups were explored by gender using descriptive statistics and general linear models. Outcomes included treatment seeking for urinary symptoms, perception of bladder condition, depression, anxiety, and health-related quality of life (HRQL). Of 14 140 men and 15 860 women, 6479 men (45.8%) and 10 717 women (67.6%) reported UI. The most prevalent UI subgroups were OI in men and SUI in women. MUI and SUI plus OI had the greatest treatment seeking among men, whereas MUI and UUI plus OI had the greatest treatment seeking among women. Men with MUI had the highest rates of anxiety, followed by those with UUI plus OI and SUI plus OI, and OI with a similar trend observed for depression. Anxiety and depression were highest in SUI plus OI and MUI women. MUI and UUI plus OI men and women had significantly lower HRQL compared with other UI groups. UI is common in men and women aged >40. Individuals with UUI combined with SUI or OI bear a greater mental health burden and report poorer HRQL.

Coyne KS ，Kvasz M ，Ireland AM ，Milsom I ，Kopp ZS ，Chapple CR ... -  《-》

A comparison of the long-term consequences of vaginal delivery versus caesarean section on the prevalence, severity and bothersomeness of urinary incontinence subtypes: a national cohort study in primiparous women.

To study the effect of one vaginal delivery (VD) compared with one caesarean section (CS) on the prevalence, severity and bothersomeness of urinary incontinence (UI) subtypes--stress (SUI), urge (UUI) and mixed (MUI)--20 years after delivery. Registry-based national cohort study. Women who returned postal questionnaires (response rate 65.2%) in 2008. Primiparae with one birth in 1985-88 (n = 5236) and no further births. Medical Birth Register data were linked to a questionnaire. Analysis of variance and multivariate analysis were used to obtain adjusted prevalences and odds ratios (adjOR). Prevalence, risk factors, severity, bothersomeness of UI subtypes. The prevalence of SUI, UUI and MUI was 15.3, 6.1, 14.4%, respectively, and was higher for all subtypes after VD versus CS. Moderate to severe incontinence was more prevalent after VD (21.3%) compared with CS (13.5%; adjOR 1.68, 95% confidence interval [95% CI] 1.40-2.03). Bothersome incontinence differed between MUI (38.9%), UUI (27.1%) and SUI (18.0%). The prevalence of bothersome UI was higher after VD compared with CS (11.2 versus 6.3%; adjOR 1.85, 95% CI 1.42-2.39) and consulting a doctor for UI was reported more often after VD than CS. Bothersome MUI occurred in 40.0% of incontinent women after VD compared with 29.9% after CS (adjOR 1.65, 95% CI 1.07-2.54). Symptomatic pelvic organ prolapse was an important modifier of UI with regard to its prevalence, duration, type and bothersomeness. The prevalence of SUI, UUI and MUI was higher and moderate to severe UI and bothersome UI were reported more often after VD than CS 20 years after one delivery.

Gyhagen M ，Bullarbo M ，Nielsen TF ，Milsom I ... -  《-》

Remission and Transition of Female Urinary Incontinence and Its Subtypes and the Impact of Body Mass Index on This Progression: A Nationwide Population-Based 4-Year Longitudinal Study in China.

Pang H ，Xu T ，Li Z ，Gong J ，Liu Q ，Wang Y ，Wang J ，Xia Z ，Zhu L ... -  《-》

Comprehensive study of anxiety and depression in females with urinary incontinence.

Sarkar D ，Tandon M ，Pal DK 《-》