Incidence and remission of stress, urge, and mixed urinary incontinence in midlife and older women: A longitudinal cohort study.

To analyze factors related to the incidence and remission of stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI) among women at midlife. A total of 2115 women participants in a prospective longitudinal survey (GAZEL cohort) were included. In 2000 and 2008, a specific questionnaire about urinary incontinence (UI) symptoms was sent to all participants. Incidence, remission, and risk factors associated with each type of UI were considered. Within our population followed up for 8 years, we observed an overall incidence rate of UI of 21.9% (95% CI, 19.6-24.2%) and a remission rate of 33.3% (30.1-36.5%). For the different UI types, the incidence and remission rates were respectively 14.9% (12.9-24.2%) and 37.9% (37.8-42.0%) for SUI, 3.2% (2.2-4.2%) and 25.5% (3.5-37.5%) for UUI, 3.1% (2.1-4.1%) and 24.6% (19.3-29.9%) for MUI. Educational level, increase in body mass index (BMI), BMI and depression at inclusion were associated with SUI incidence. The history of surgery for UI was associated with the incidence of UUI and MUI. Surgery for SUI was significantly associated with remission, while pelvic floor rehabilitation and vaginal delivery were significantly associated with a lower SUI remission. Vaginal delivery was also negatively associated with MUI remission. The influence of the standard risk factors seems to differ in each type of UI.

Legendre G ，Fritel X ，Panjo H ，Zins M ，Ringa V ... -  《-》

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 ... -  《-》

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 in nulliparous women before and during pregnancy: prevalence, incidence, type, and risk factors.

Daly D ，Clarke M ，Begley C 《-》