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1.
Urology ; 163: 16-21, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34536408

RESUMO

OBJECTIVE: To characterize the racial/ethnic representation in the studies used in the American Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction stress urinary incontinence guideline. METHODS: Cited studies were reviewed using inclusion and exclusion criteria. The inclusion criteria focused on United States literature to allow for demographic comparison with census data. To compare the racial representation in a study to the diversity in the surrounding city, we calculated the differences between county census data and the study race reported data and performed regression analyses. RESULTS: Eighty-seven cited studies were reviewed, of which 33 were excluded and 52 studies were further evaluated. Seventeen studies were US studies, nine of which reported race. Eighty percent of the women included in the 9 studies were non-Hispanic white women. A diverse geographic region did not correlate with increased study enrollment of non-White patients. CONCLUSION: The majority of cited studies used to develop the stress urinary incontinence management guidelines did not report the race/ethnicity of participants. Among those studies that did, Asian, Black, and Hispanic women were included at lower rates than non-Hispanic white women, identifying an area of opportunity to improve research recruitment and promote health equity. Non-Hispanic women were consistently overrepresented while other women were either under-represented or completely excluded.


Assuntos
Etnicidade , Participação do Paciente , Grupos Raciais , Incontinência Urinária por Estresse , Feminino , Humanos , Participação do Paciente/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Sociedades Médicas , Estados Unidos , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/terapia , Urodinâmica
2.
Am J Obstet Gynecol ; 225(2): 166.e1-166.e12, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33727114

RESUMO

BACKGROUND: Women are disproportionately affected by urinary incontinence compared with men. Urinary incontinence results in physical and psychological adverse consequences and impaired quality of life and contributes to significant societal and economic burden. Previous studies reported high urinary incontinence burden in the United States. However, the current prevalence and recent trends in urinary incontinence and its subtypes among US women have not been described. In addition, correlates of urinary incontinence among US women have not been systematically evaluated in the contemporary population. OBJECTIVE: The purpose of this study was to determine the prevalence and trends in urinary incontinence among adult women in the United States from 2005 to 2018. In addition, this study aimed to investigate the relationship of urinary incontinence subtypes with several sociodemographic, lifestyle, health-related, and gynecologic factors. STUDY DESIGN: We used data from the National Health and Nutrition Examination Survey, a nationally representative series of surveys that was designed to evaluate the health status of the US population. Data on urinary incontinence from 7 consecutive 2-year cycles (2005-2006 to 2017-2018) were used for this study. A total of 19,791 participants aged ≥20 years were included. Weighted prevalence estimates and 95% confidence intervals were calculated in each study cycle for stress, urgency, and mixed urinary incontinence. Multivariate-adjusted weighted logistic regression was used to investigate the temporal trends in urinary incontinence, in addition to determining the association between urinary incontinence subtypes with several participants' factors. RESULTS: In the 2017-2018 cycle, stress urinary incontinence was the most prevalent subtype (45.9%; 95% confidence interval, 42.1-49.7), followed by urgency urinary incontinence (31.1%; 95% confidence interval, 28.6-33.6) and mixed urinary incontinence (18.1%; 95% confidence interval, 15.7-20.5). The prevalence rates of urgency and mixed urinary incontinence were higher in women aged 60 years and older (urgency, 49.5% [95% confidence interval, 43.9-55.2]; mixed, 31.4% [95% confidence interval, 26.2-36.6]) than in those aged 40 to 59 years (urgency, 27.9% [95% confidence interval, 23.6-32.1]; mixed, 15.9% [95% confidence interval, 12.9-19.0]) and those aged 20 to 39 years (urgency, 17.6% [95% confidence interval, 13.8-21.5]; mixed, 8.3% [95% confidence interval, 5.4-11.3]). The overall prevalence of stress and mixed urinary incontinence was stable throughout 2005 to 2018 (both Ptrend=.3), with increases in mixed urinary incontinence among women aged 60 years and older (P=.001). The prevalence of urgency urinary incontinence significantly increased, particularly among women aged 60 years and older (both P=.002). Age, obesity, smoking, comorbidities, and postmenopausal hormone therapy were associated with higher prevalence of all types of urinary incontinence. Black women were less likely to report stress urinary incontinence but more likely to report urgency urinary incontinence. CONCLUSION: Although the estimated overall prevalence of stress and mixed urinary incontinence remained stable from 2005 to 2018, the prevalence of urgency and mixed urinary incontinence significantly increased among women aged 60 years and older. All subtypes of urinary incontinence were higher among women with obesity and comorbidities, those who used postmenopausal hormone therapy, and those who smoke.


Assuntos
Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária de Urgência/epidemiologia , Adulto , Fatores Etários , Idoso , Comorbidade , Terapia de Reposição de Estrogênios/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Fumar/epidemiologia , Estados Unidos/epidemiologia , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária de Urgência/etnologia , Adulto Jovem
3.
Am J Obstet Gynecol ; 224(1): 80.e1-80.e9, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32697955

RESUMO

BACKGROUND: Urinary incontinence is influenced by multiple factors, and the prevalence of urinary incontinence subtypes may differ by race and ethnicity. OBJECTIVE: This study aimed to determine the prevalence of urinary incontinence subtypes and associated bother among women by race and ethnicity. STUDY DESIGN: This cross-sectional analysis used data from the Multi-Ethnic Study of Atherosclerosis, an observational cohort study of 4 racial and ethnic groups recruited from 6 communities from the United States. At the sixth follow-up examination, urinary symptoms were ascertained with the International Consultation on Incontinence Questionnaire. The prevalence rate ratios of stress urinary incontinence, urgency urinary incontinence, and mixed urinary incontinence by race and ethnicity were calculated using generalized linear models for the binomial family while adjusting for covariates. The degree of bother was based on a scale of 0 (none) to 10 (greatest bother), and presence of any bother was defined as a score of ≥3. RESULTS: Among the 1749 female participants in the Multi-Ethnic Study of Atherosclerosis who completed the sixth follow-up examination, 1628 (93%) completed the questionnaire. Women who did not complete the questionnaire were older than those who completed the questionnaire (average age, 82.2 [standard deviation, 9.5] vs 73.7 [standard deviation, 8.4] years; P<.01) and more likely to use diuretics (29.8% vs 18.9%; P<.01). Among those who completed the questionnaire (n=1628), 39.4% were white, 12.5% were Chinese, 27.2% were black, and 20.9% were Hispanic. After adjusting for covariates, stress urinary incontinence (prevalence rate ratio, 0.47; 95% confidence interval, 0.25-0.86) and mixed urinary incontinence (prevalence rate ratio, 0.58; 95% confidence interval, 0.38-0.89) regardless of bother scores were significantly less prevalent among black vs white women, although no significant racial and ethnic differences in stress or mixed urinary incontinence prevalence were noted for Chinese or Hispanic women vs white women. No racial and ethnic differences in the prevalence of urgency urinary incontinence were noted after the adjustment for covariates. Most women with urinary incontinence reported bother scores of ≥3 regardless of race and ethnicity and urinary incontinence subtype, and bother scores did not differ significantly by race and ethnicity. CONCLUSION: Frequency of urinary incontinence subtypes may differ by race and ethnicity, but older women who report urinary incontinence are likely to have associated bother regardless of race and ethnicity.


Assuntos
Incontinência Urinária por Estresse/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Etnicidade , Feminino , Serviços de Saúde para Idosos , Humanos , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Estados Unidos/epidemiologia , Incontinência Urinária por Estresse/etnologia , Serviços de Saúde da Mulher
4.
Eur J Obstet Gynecol Reprod Biol ; 222: 109-112, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29408740

RESUMO

OBJECTIVE: In order for a measure to reliably evaluate treatment efficacy, it is important that the measure used has adequate responsiveness. However, the responsiveness of the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, a highly recommended questionnaire by the International Consultation of Incontinence to assess sexual function in patients with incontinence, has not been established. To enable the use of GRISS to measure change in sexual function following incontinence treatment, we evaluated the short- and long-term responsiveness of the GRISS in couples with female stress urinary incontinence partners. STUDY DESIGN: Forty-eight couples with female stress urinary incontinence partners were included in the study. The GRISS, a 28-item multidimensional measure, comprises two sets of questionnaires to assess sexual function in both male and female partners. Responsiveness was investigated using data from our recent randomized controlled trials evaluating efficacy of pulsed magnetic stimulation for treatment of female patients with stress urinary incontinence. Effect size index and standardized response mean were used to measure responsiveness of the English and Chinese versions of GRISS. RESULTS: For short-term responsiveness, the overall female and male GRISS scores had effect sizes and standardized response means ranging from 0.60 to 0.83 and 0.44 to 0.78 respectively. For long-term responsiveness, the overall female and male GRISS scores had effect sizes and standardized response means ranging from 0.59 to 0.77 and 0.48 to 0.79 respectively. CONCLUSION: In conclusion, the English and Chinese versions of GRISS had adequate responsiveness for use in couples with incontinent partners. The GRISS can be a useful measure to detect change in sexual function of couples following treatment of females with stress urinary incontinence.


Assuntos
Características da Família , Magnetoterapia/efeitos adversos , Orgasmo , Incontinência Urinária por Estresse/terapia , Sistema Urogenital/fisiopatologia , Adulto , Características da Família/etnologia , Feminino , Seguimentos , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar , Ensaios Clínicos Controlados Aleatórios como Assunto , Autorrelato , Inquéritos e Questionários , Fatores de Tempo , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/fisiopatologia
5.
Aust N Z J Obstet Gynaecol ; 57(3): 351-357, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28397253

RESUMO

BACKGROUND: Urinary incontinence (UI) is likely to be high in Aboriginal women in rural Australia due to risk factors including high body mass index, parity and diabetes. However, UI appears to be under-reported with limited information on whether women access appropriate care. AIMS: To assess whether women who access specialist gynaecological services in rural and remote Top End Northern Territory (NT) through the specialist outreach program (SONT) are receiving care for UI aligned with best practice. METHODS: Review of all 1426 SONT referrals in 2012, with audit of management for those women referred for UI or prolapse. RESULTS: Of 1426 SONT referrals, there were 43/1426 (3%) women referred for UI, with 34/43 (79%) attending. Of those referred, 31/43 (72%) were Aboriginal. Of twenty-six women diagnosed with probable stress UI, less than a fifth, 5/26 (19%), were referred to physiotherapy, with 2/5 (40%) attending appointments. Referral occurred for 14/23 (61%) of those suitable for urodynamics but only 6/14 (43%) attended. Just under half of women 7/16 (14%) with stress UI were referred for surgery, with 6/7 (86%) attending. CONCLUSION: In rural and remote Top End NT, specialist health service management of female UI could be improved by increased provision of current best-practice and an integrated multi-disciplinary team approach with allied health. Under-reporting and under-referral for female UI could be addressed by increasing awareness among community and primary healthcare providers of the problem of female UI and the conservative, medical and surgical treatments available.


Assuntos
Ginecologia/normas , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Serviços de Saúde Rural/normas , Incontinência Urinária por Estresse/terapia , Incontinência Urinária de Urgência/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Técnicas de Diagnóstico Urológico , Medicina Baseada em Evidências , Terapia por Exercício , Feminino , Ginecologia/estatística & dados numéricos , Humanos , Auditoria Médica , Pessoa de Meia-Idade , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Northern Territory , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Diafragma da Pelve/fisiopatologia , Prolapso de Órgão Pélvico/complicações , Prolapso de Órgão Pélvico/terapia , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Serviços de Saúde Rural/estatística & dados numéricos , Slings Suburetrais , Incontinência Urinária por Estresse/complicações , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária de Urgência/complicações , Incontinência Urinária de Urgência/etnologia , Urodinâmica
6.
Int Urogynecol J ; 27(5): 763-72, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26670573

RESUMO

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is common and the relationship among its subtypes complex. Our objective was to describe the natural history and predictors of the incontinence subtypes stress, urgency, and mixed, in middle-aged and older US women. We tested our hypothesis that UI subtype history predicted future occurrence, evaluating subtype incidence/remission over multiple time points in a stable cohort of women. METHODS: We analyzed longitudinal urinary incontinence data in 10,572 community-dwelling women aged ≥50 in the 2004-2010 Health and Retirement Study. Mixed, stress, and urgency incontinence prevalence (2004, 2006, 2008, 2010) and 2-year cumulative incidence and remissions (2004-2006, 2006-2008, 2008-2010) were estimated. Patient characteristics and incontinence subtype status 2004-2008 were entered into a multivariable, transition model to determine predictors for incontinence subtype occurrence in 2010. RESULTS: The prevalence of each subtype in this population (median age 63-66) was 2.6-8.9 %. Subtype incidence equaled 2.1-3.5 % and remissions for each varied between 22.3 and 48.7 %. Incontinence subtype incidence predictors included ethnicity/race, age, body mass index, and functional limitations. Compared with white women, black women had decreased odds of incident stress incontinence and Hispanic women had increased odds of stress incontinence remission. The age range 80-90 and severe obesity predicted incident mixed incontinence. Functional limitations predicted mixed and urgency incontinence. The strongest predictor of incontinence subtype was subtype history. The presence of the respective incontinence subtypes in 2004 and 2006 strongly predicted 2010 recurrence (odds ratio [OR] stress incontinence = 30.7, urgency OR = 47.4, mixed OR = 42.1). CONCLUSIONS: Although the number of remissions was high, a previous history of incontinence subtypes predicted recurrence. Incontinence status is dynamic, but tends to recur over the longer term.


Assuntos
Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária de Urgência/epidemiologia , Negro ou Afro-Americano/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Incidência , Estudos Longitudinais , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Recidiva , Remissão Espontânea , Fatores de Risco , Estados Unidos/epidemiologia , Incontinência Urinária por Estresse/complicações , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária de Urgência/complicações , Incontinência Urinária de Urgência/etnologia , População Branca/estatística & dados numéricos
7.
Climacteric ; 16(6): 653-62, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23560943

RESUMO

BACKGROUND: Urinary incontinence (UI) becomes more prevalent as women age, but little is known about UI in midlife, including stress incontinence (SUI) and urge incontinence (UUI) and their relationship to reproductive aging, reproductive history, health-related factors, and personal and social factors associated with midlife. OBJECTIVES: To determine the influence of age and reproductive aging factors (menopausal transition stages, follicle stimulating hormone (FSH), estrone glucoronide), reproductive history (number of live births), health-related factors (perceived health, body mass index (BMI), exercise, diabetes) and personal and social factors (race/ethnicity, education) on the experience of UI among midlife women during the menopausal transition and early postmenopause. METHODS: A subset of the Seattle Midlife Women's Health Study participants (n = 298 with up to 2249 observations) provided data during the late reproductive, early and late menopausal transition stages and early postmenopause, including menstrual calendars, annual health questionnaire and provided health diaries since 1990. Generalized estimating equation analysis was used to test models accounting for SUI and UUI that included age as a measure of time with predictors. RESULTS: Stress urinary incontinence was associated significantly with individual predictors of: worse perceived health (odds ratio (OR) 0.89, p = 0.025), history of ≥ three live births (OR 3.00, p = 0.002), being in the early menopausal transition stage (OR 1.53, p = 0.06), having less formal education (OR 0.33, p = 0.02), and being White/not Black (OR 0.32, p = 0.04). The most parsimonious model for SUI included: worse perceived health, ≥ three live births, and being White. Urge incontinence was associated significantly with individual predictors of: increasing age (OR 1.06, p = 0.001), worse perceived health (OR 0.78, p < 0.001), BMI ≥ 30 kg/m(2) (OR 2.96, p = 0.001), history of ≥ three live births (OR 2.81, p = 0.01), and lower FSH levels (OR 0.59, p = 0.08). The most parsimonious model for UUI included: being older, having worse perceived health, and having a high BMI. CONCLUSIONS: SUI risk was a function of reproductive history, poor health, and being White. UUI risk was a function of aging, having worse health, and higher BMI. Further exploration of UI during the menopausal transition is needed to articulate a lifespan view of UI and its typology.


Assuntos
Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária de Urgência/epidemiologia , Adulto , Fatores Etários , Índice de Massa Corporal , Escolaridade , Feminino , Hormônio Foliculoestimulante/sangue , Nível de Saúde , Inquéritos Epidemiológicos , Humanos , Nascido Vivo , Pessoa de Meia-Idade , Percepção , Incontinência Urinária por Estresse/sangue , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária de Urgência/etnologia , Washington/epidemiologia
8.
Int Urogynecol J ; 24(8): 1361-9, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23291858

RESUMO

INTRODUCTION AND HYPOTHESIS: For decades women with pelvic floor dysfunction (PFD) have been referred to pelvic floor muscle training (PFMT), but there is only little information on whether the women complete the programmes and why. The objectives of this study were to investigate to which extent women completed a PFMT programme to which they were referred by gynaecologists and urologists and to identify associated factors for completion. METHODS: In a hospital-based, retrospective clinical design women with PFD referred to a free PFMT programme as outpatients were included. The PFMT programme consisted of: (a) vaginal digital palpation test of PFM, (b) individual instructions, (c) introduction (theory), (d) weekly supervised PFMT in groups for 3 months (12 sessions) and (e) progressive home exercises (10 sets). RESULTS: Data were analysed in 1,544 women, mean age 54 (SD 13) years, with PFD (urinary incontinence, n = 1,214; anal incontinence, n = 41; pelvic organ prolapse, n = 162; other PFD, n = 127). In total 747 (48 %) subjects completed (attended ≥8 sessions) the PFMT programme, 466 (30 %) dropped out and 331 (22 %) cancelled or stayed away. Age, year of referral and nationality were significantly different (p < 0.01) between completers and non-completers. Likewise, year of referral, distance from home to hospital, waiting list times and diagnosis were significantly different (p < 0.01) between dropouts and subjects who cancelled or stayed away. CONCLUSIONS: The results showed that less than half of the women with PFD completed a PFMT programme to which they were referred by gynaecologists and urologists. The most important associated factors for completion were age, year of referral and nationality.


Assuntos
Terapia por Exercício/métodos , Ginecologia , Cooperação do Paciente/estatística & dados numéricos , Diafragma da Pelve/fisiopatologia , Encaminhamento e Consulta/estatística & dados numéricos , Treinamento Resistido/métodos , Especialização , Urologia , Adulto , Fatores Etários , Idoso , Etnicidade , Incontinência Fecal/etnologia , Incontinência Fecal/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Força Muscular/fisiologia , Cooperação do Paciente/etnologia , Educação de Pacientes como Assunto , Prolapso de Órgão Pélvico/etnologia , Prolapso de Órgão Pélvico/terapia , Estudos Retrospectivos , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/terapia
9.
Zhonghua Fu Chan Ke Za Zhi ; 48(12): 916-9, 2013 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-24495685

RESUMO

OBJECTIVE: To evaluate the prevalence and associated risk factors of stress urinary incontinence(SUI) in adult women in Xinjiang. METHODS: In the cross-sectional study, 3403 Uygur women aged over 20 years were interviewed through a questionnaire of International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module (ICIQ-FLUTS) and the adult questionnaire were used in our research. All parts of the content were according to the characteristics of women in Xinjiang and the purpose of our research. The risk factors were studied by Logistic regression analysis. RESULTS: The prevalence of urinary incontinence(UI) was 41.96% (1428/3403) and 28.21% (960/3403) of SUI in Uygur women. In multivariate logistic regression analysis, the risk factors of SUI are body mass index (OR = 1.672, 95%CI:1.082-2.584), parity (OR = 5.092, 95%CI:3.889-6.666), neonatal birth weight (OR = 5.623, 95%CI:3.335-9.480), the mode of delivery (OR = 2.247, 95%CI:1.634-3.090), the lateral episiotomy (OR = 4.448, 95%CI:3.112-6.357), menopause(OR = 5.145, 95%CI: 3.613-7.328), chronic pelvic pain (OR = 3.869, 95%CI:1.051-14.250), pelvic organ prolapse (OR = 3.501, 95%CI:2.508-4.887). CONCLUSION: The incidence of SUI is related with multiple factors, especially with obesity and the obstetric factor.


Assuntos
Obesidade , Paridade , Incontinência Urinária por Estresse/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Parto Obstétrico , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Análise de Regressão , Fatores de Risco , Inquéritos e Questionários , Incontinência Urinária por Estresse/etnologia , Adulto Jovem
10.
Int Urogynecol J ; 23(5): 639-45, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22411207

RESUMO

INTRODUCTION AND HYPOTHESIS: Low socioeconomic factors may influence the development of stress urinary incontinence (SUI). Thus far, there is little research available on SUI in developing countries. We aimed to determine whether the prevalence of SUI in a northeastern Brazilian municipality was higher or lower than in the general female population. METHODS: Cross-sectional household cluster study of 1,180 climacteric women in the São Luís municipality (Maranhão state, Brazil) was conducted using a standardized questionnaire that was previously tested in a pilot study and administered by interviewers to obtain socioeconomic and cultural information, climacteric aspects, and life habits related to SUI. RESULTS: From this population, 15.34% (n = 181) had SUI; this prevalence did not change with age. More than half (57.92%) of the patients replied that they had not consulted a physician for their SUI. The presence of SUI was not associated with any socioeconomic or gynecological variables after multivariate analysis. CONCLUSIONS: The prevalence of SUI in São Luís was similar to the rates observed in the general global female population. Socioeconomic and gynecological variables were not associated with SUI.


Assuntos
Climatério , Características da Família/etnologia , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/epidemiologia , Idoso , Brasil/epidemiologia , Climatério/fisiologia , Estudos de Coortes , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Incontinência Urinária por Estresse/fisiopatologia
11.
Int Urogynecol J ; 23(5): 563-72, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22278711

RESUMO

INTRODUCTION AND HYPOTHESIS: We sought to characterize risk factors of urinary incontinence (UI) during pregnancy and the postpartum period in primiparous women in China. METHODS: We enrolled 10,098 women from the seven regions of China ≥28 weeks' gestation from September 2007 to May 2009 and administered the Bristol Female Lower Urinary Tract Symptoms questionnaire to estimate the presence of different types of UI during late pregnancy (37 to 42 weeks' gestation) and at 6 weeks and 6 months postpartum. We also collected details of pregnancy and childbirth and demographic data. McNemar's test, multinomial logistic regression models, and binary logistic regression models were used. RESULTS: Multivariable analysis revealed six independent risk factors for SUI: age, more frequent exercise, alcohol consumption, higher body mass index, larger waist circumference, and history of constipation. For those with no UI in late pregnancy, 3.7% and 3.0% developed new cases at 6 weeks and 6 months postpartum, respectively. Risk factors for UI at 6 months were frequent exercise, rural residence, perineal laceration, and lateral episiotomy. Prevalence of all UI was 26.7% in late pregnancy, 9.5% at 6 weeks postpartum, and 6.8% at 6 months postpartum. Most cases were stress urinary incontinence (18.6%, 6.9%, and 5.0%, at the respectively times). CONCLUSIONS: Rates of UI in primiparous women in China are consistent with those reported elsewhere. Rural location, frequent exercise, and birth-related injuries are risk factors for UI at 6 months postpartum.


Assuntos
Paridade , Período Periparto , Período Pós-Parto , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/epidemiologia , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/efeitos adversos , Índice de Massa Corporal , China/epidemiologia , Exercício Físico , Feminino , Humanos , Estudos Longitudinais , Análise Multivariada , Gravidez , Prevalência , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários
12.
Int Urogynecol J ; 23(4): 473-9, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22159561

RESUMO

INTRODUCTION AND HYPOTHESIS: The purpose of this pilot study was to evaluate the prevalence and associated risk factors for urinary incontinence in a Northern Plains tribe of American Indian women. METHODS: The Urogenital Distress Inventory-Short Form was used to assess urinary incontinence in a sample of American Indian women from one tribe. This was a cross-sectional convenience sampling of 234 eligible participants. Participant's ages ranged from 18 to 80 years. Stata/Se 9.1 software was used in statistical analysis. RESULTS: The overall prevalence of urinary stress incontinence was 15.4%, urgency incontinence 2.14%, and mixed incontinence 20.5%. Both stress and urgency incontinence was found to be low in this sample population. CONCLUSIONS: A reduced prevalence of stress and urgency incontinence is seen in our sample. Our study group showed a high prevalence of known risk factors associated with urinary incontinence. We intend to extend our study for further understanding of this patient population.


Assuntos
Indígenas Norte-Americanos/etnologia , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária de Urgência/etnologia , Incontinência Urinária de Urgência/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Prevalência , Fatores de Risco , South Dakota/epidemiologia , Inquéritos e Questionários , Adulto Jovem
13.
Int Urogynecol J ; 22(10): 1293-8, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21560011

RESUMO

INTRODUCTION AND HYPOTHESIS: This study aims to describe multichannel urodynamic indices and pelvic organ prolapse quantification (POP-Q) in primiparous women 3 months after vaginal delivery. METHODS: This was a secondary analysis of a group of women who had been randomized to either coached or non-coached pushing during the second stage of labor. Primiparous women were evaluated with POP-Q examination and multichannel urodynamic testing 3 months after vaginal delivery. RESULTS: Of 128 women evaluated, the cumulative stage of prolapse was distributed as 4.7% stage 0, 39% stage I, 56% stage II, and none with stage III prolapse or greater. For the anterior compartment, most had stage II prolapse. Stage I prolapse predominated for both the central and posterior compartments. Of the women, 14.1% had urodynamic stress incontinence, 12.5% had detrusor overactivity, and 6% had both. CONCLUSIONS: In a predominantly Hispanic primiparous population, ICS POP-Q stage II prolapse of the vagina, urodynamic stress incontinence, and detrusor overactivity are common findings at a 3-month postpartum assessment.


Assuntos
Parto Obstétrico/métodos , Prolapso de Órgão Pélvico/epidemiologia , Bexiga Urinária Hiperativa/epidemiologia , Incontinência Urinária por Estresse/epidemiologia , Urodinâmica/fisiologia , Vagina , Adolescente , Adulto , Feminino , Seguimentos , Hispânico ou Latino/etnologia , Humanos , Incidência , Paridade , Prolapso de Órgão Pélvico/etnologia , Prolapso de Órgão Pélvico/fisiopatologia , Período Pós-Parto , Gravidez , Fatores de Tempo , Bexiga Urinária Hiperativa/etnologia , Bexiga Urinária Hiperativa/fisiopatologia , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/fisiopatologia , Adulto Jovem
14.
Am J Obstet Gynecol ; 202(6): 584.e1-584.e12, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20510959

RESUMO

OBJECTIVE: We sought to compare continence system function of black and white women in a population-based sample. STUDY DESIGN: As part of a cross-sectional population-based study, black and white women ages 35-64 years were invited to have pelvic floor testing to achieve prespecified groups of women with and without urinary incontinence. We analyzed data collected from 335 women classified as continent (n = 137) and stress (n = 102) and urge (n = 96) incontinent based on full bladder stress test and symptoms. Continence system functions were compared across racial and continence groups. RESULTS: Comparing black to white women, maximal urethral closure pressure (MUCP) was 22% higher in blacks than whites (68.0 vs 55.8 cm H(2)O, P < .0001). White and black women with stress incontinence had MUCP 19% and 23% lower than continent women. MUCP in urge incontinent white women was as low as stress incontinent whites, but blacks with urge had normal urethral function. CONCLUSION: Black women have higher urethral closure pressures than white women. White women with urge incontinence, but not black women, have reduced MUCP.


Assuntos
Diafragma da Pelve/fisiopatologia , Uretra/fisiopatologia , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária de Urgência/etnologia , Adulto , Negro ou Afro-Americano , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Incontinência Urinária por Estresse/fisiopatologia , Incontinência Urinária de Urgência/fisiopatologia , Urodinâmica , População Branca
15.
Rev. obstet. ginecol. Venezuela ; 69(3): 172-178, sep. 2009. tab
Artigo em Espanhol | LILACS | ID: lil-631393

RESUMO

Evaluar la prevalencia de la disfunción del piso pélvico, factores relacionados, tratamientos y evolución en pacientes gineco-obstétricas de un hospital privado. Estudio descriptivo, retrospectivo, epidemiológico. Se revisaron 4555 historias desde 1998 a 2008 y se seleccionaron 430 con alteraciones del piso pélvico. Se evaluaron los factores asociados: edad, embarazos, partos, distocias, episiotomías, peso máximo fetal, masa corporal, incontinencia urinaria de esfuerzo, infecciones urinarias bajas recurrentes, alteraciones tiroideas, diabetes, fibromatosis uterina, menopausia, intervenciones ginecológicas previas, estreñimiento, trabajos forzados, tos crónica y uso de fajas. Se clasificaron los tipos y grados de prolapsos, tratamientos y complicaciones. Instituto Médico Quirúrgico Ribas. Los Teques, Estado Miranda, Venezuela. Promedio de edad 47,72 ± 11,88 años. Incidencia de disfunción 9,4 por ciento; en 72 por ciento fue un hallazgo del médico, 73,2 por ciento referían incontinencia urinaria de esfuerzo, 18 por ciento infecciones urinarias bajas recurrentes, paridad promedio 3,86 ± 2,59; 21,4 por ciento distocias y 48,8 por ciento episiotomías. Diagnóstico de prolapso 97,4 por ciento, grado II más frecuente 73,3 por ciento. Entre los factores relacionados se encontró: masa corporal elevada, fibromatosis uterina, estreñimiento e intervenciones anteriores. Se indicó tratamiento conservador en 67,3 por ciento, cirugía vaginal 8 por ciento y abdominal 11 por ciento. La incidencia de disfunciones es baja, el cistocele grado II es el más frecuente y está relacionados con incontinencia urinaria de esfuerzo, infecciones urinarias bajas recurrentes, grupo etario entre 40 y 50 años, multiparidad, mayor índice de masa corporal, estreñimiento, fibromatosis uterinas e intervenciones pélvicas previas. El tratamiento más aceptado es la rehabilitación muscular


To evaluate the prevalence of pelvic floor dysfunction, related factors, treatment and evolution in gyneco-obstetric patients in a private hospital. A descriptive, retrospective, epidemiologic study. 4555 records were reviewed from 1998 to 2008 and 430 with pelvic floor disorders were selected. Associated factors such as age, pregnancy, dystocia, episiotomy, fetal weight, body mass, stress urinary incontinence, recurrent lower urinary tract infections, thyroid disorders, diabetes, uterine fibromatosis, menopause, previous gynecologic interventions, constipation, hard work, chronic cough and use of belts were evaluated. Types and degrees of prolapse, treatments and complications were classified. Instituto Médico Quirúrgico Ribas. Los Teques, Estado Miranda, Venezuela. Average age 47.72 ± 11.88 years. 9.4 percent dysfunction incidence; in 72 percent was medical finding, 73.2 percent referred stress urinary incontinence, 18 percent urinary tract infections, average parity 3.86 ± 2.59, 21.4 percent dystocia and 48.8 percent episiotomy. Prolapse diagnosis 97.4 percent, grade II 73.3 percent more frequent. Among the factors were: high body mass, uterine fibromatosis, constipation, and previous interventions. Non surgical treatment was indicated in 67.3 percent, 8 percent vaginal surgery and abdominal 11 percent. The incidence of dysfunction is low, the grade II cystocele is the more common and is associated with stress urinary incontinence, urinary tract infections, age group between 40 and 50 years, multiparity, higher body mass index, constipation, uterine fibromatosis and previous pelvic interventions. The most accepted treatment is the muscular rehabilitation


Assuntos
Humanos , Diafragma da Pelve/patologia , Incontinência Urinária por Estresse/etnologia , Prolapso Uterino/complicações , Prolapso Uterino/diagnóstico , Prolapso Uterino/etiologia , Constipação Intestinal/etiologia , Fibroma/etnologia , Infecções Urinárias/etnologia
16.
Urol Int ; 82(2): 191-5, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19322009

RESUMO

INTRODUCTION: The purpose of the present study was to assess the objective and subjective efficacy of the distal urethral polypropylene sling (DUPS) for urodynamic stress incontinence (USI) in Korean women. PATIENTS AND METHODS: We performed DUPS in 89 consecutive patients with USI. The Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6) were used to evaluate the surgical outcomes. RESULTS: The mean operative time was 29.4 min (range 25-40). Concomitant procedures were performed including rectocele repair (n = 48), laparoscopically assisted vaginal hysterectomy (n = 12) and laparoscopic myomectomy (n = 1). There were no intraoperative complications or major postoperative complications. The average follow-up was 15 months (range 12-18). Both mean IIQ-7 and UDI-6 scores decreased significantly after DUPS. In addition, 87% of the patients reported no symptoms of USI under any circumstances and 95% of the patients reported never or rarely being bothered by USI. CONCLUSIONS: DUPS is a safe, inexpensive, simple, and effective surgical method for USI. The procedure provides a high cure rate in Korean women.


Assuntos
Povo Asiático , Polipropilenos , Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Urodinâmica , Procedimentos Cirúrgicos Urológicos/instrumentação , Adulto , Idoso , Feminino , Humanos , Coreia (Geográfico) , Pessoa de Meia-Idade , Desenho de Prótese , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/fisiopatologia , Procedimentos Cirúrgicos Urológicos/efeitos adversos
17.
Int Urogynecol J Pelvic Floor Dysfunct ; 19(8): 1085-92, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18373047

RESUMO

The objective of this study was to evaluate the prevalence, demographics and complications of stress urinary incontinence (SUI) surgery across races in the United States (US) in 2003. We hypothesized that there would be racial differences in surgical rates. Data from the 2003 National Census and National Hospital Discharge Survey were used. Continuous variables were tested for statistical significance by one-way analysis of variance and categorical variables by chi2 analysis. 129,778 women underwent SUI surgery in the US in 2003, a rate of 12 surgical procedures per 10,000 women (95% CI 10-14). By race, rates (per 10,000 women, 95% CI) of SUI surgery were: ten (7-12) in white women, three (0-9) in black women, and six (0-13) in women of other races. Racial disparities in the receipt of SUI surgery may exist.


Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/cirurgia , Negro ou Afro-Americano/estatística & dados numéricos , Comorbidade , Feminino , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Prevalência , Estados Unidos/epidemiologia , Incontinência Urinária por Estresse/epidemiologia , Prolapso Uterino/etnologia , Prolapso Uterino/cirurgia , População Branca/estatística & dados numéricos
18.
Obstet Gynecol ; 111(2 Pt 1): 324-31, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18238969

RESUMO

OBJECTIVE: To understand variation in prevalence of urinary incontinence (UI) and risk factors, given different definitions. METHODS: The National Health and Nutrition Examination Survey 2001-2002 data on UI were used. Prevalence, severity, and associated risk factors of stress, urge, mixed, and any UI were estimated in 2,875 adult women. Severe UI was defined as incontinence a few times or more per week. Moderate UI was defined as an incontinence frequency of a few times per month only, and mild UI was defined as incontinence frequency of a few times per year only. Odds ratios for the association of potential risk factors were examined in a logistic regression model. RESULTS: The overall prevalence of stress, urge, mixed, and any UI was 23.7%, 9.9%, 14.5%, and 49.2%, respectively. Prevalence of stress UI peaked at the fifth decade. Prevalence of urge and mixed UI increased with age. The largest number of risk factors and the strongest associations were found with severe UI. Age, ethnic background, and weight were significant risk factors common to all UI severity levels. Although parity and hysterectomy were risk factors for moderate and severe UI, they were not for mild UI. CONCLUSION: Prevalence of UI varies substantially by type and case definition. The stronger associations of known risk factors with severe UI and the lack of risk factors with lesser UI severity types suggest that severe UI includes primarily clinically significant cases, whereas mild UI represents transient or nonpathologic states that may not be clinically significant. LEVEL OF EVIDENCE: III.


Assuntos
Peso Corporal/fisiologia , Etnicidade , Inquéritos Epidemiológicos , Incontinência Urinária/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Comorbidade , Etnicidade/estatística & dados numéricos , Feminino , Humanos , Histerectomia/efeitos adversos , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Paridade , Gravidez , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários , Estados Unidos/epidemiologia , Incontinência Urinária/etnologia , Incontinência Urinária/patologia , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/patologia , Incontinência Urinária de Urgência/epidemiologia , Incontinência Urinária de Urgência/etnologia , Incontinência Urinária de Urgência/patologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-17701092

RESUMO

The purpose of the study was to provide estimates of stress urinary incontinence (SUI) and practice of pelvic floor muscle training (PFMT) postpartum as well as counseling during and after pregnancy among Hispanic women. Two hundred Hispanic women were surveyed 6 months postpartum. Twenty-three percent had SUI with onset primarily during pregnancy (70%). Only 20% had received information regarding SUI and PFMT during pregnancy or postpartum. Most women not counseled wished they were (81%). Less counseling occurred among Hispanic women with lower levels of education (odds ratio [OR]= .39; 95% confidence interval [CI]=0.19-0.82; p=0.02) and those whose primary language was Spanish (OR= .36; 95% CI=0.15-0.87; p=0.02), while higher rates occurred among women with a forceps delivery (OR=2.94; 95% CI=1.06-7.78; p=0.03). Fifty-seven percent of women counseled practiced the exercises. Primary reasons for noncompliance were belief that PFMT would not help (47%), and not understanding the instructions (39%). SUI and PFMT counseling is low among Hispanic women. Most women desire such information, and improvement in performance of PFMT among this group is possible.


Assuntos
Aconselhamento/métodos , Terapia por Exercício/métodos , Hispânico ou Latino , Diafragma da Pelve/fisiopatologia , Período Pós-Parto , Incontinência Urinária por Estresse/prevenção & controle , Adulto , Estudos Transversais , Feminino , Seguimentos , Humanos , Razão de Chances , Educação de Pacientes como Assunto , Gravidez , Prevalência , Estudos Retrospectivos , Inquéritos e Questionários , Texas/epidemiologia , Incontinência Urinária por Estresse/etnologia , Incontinência Urinária por Estresse/fisiopatologia
20.
Am J Obstet Gynecol ; 197(1): 92.e1-6, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17618773

RESUMO

OBJECTIVE: The purpose of this study was to determine whether race/ethnicity affects urinary incontinence (UI) severity and bother in women who undergo surgery for stress incontinence. STUDY DESIGN: We used baseline data from participants in the Stress Incontinence Surgical Treatment Efficacy trial. UI severity was measured by the number of leakage episodes during a 3-day urinary diary and by urodynamic evaluation. UI bother was measured with the Urogenital Distress Inventory. Race/ethnicity classification was based on self-report. RESULTS: Of the 654 women, 72 women (11%) were Hispanic; 480 women (73%) were non-Hispanic white; 44 women (6.7%) were non-Hispanic black, and 58 women (8.9%) were of other race/ethnicity. No differences were seen in any UI severity measures. Non-Hispanic white women had the lowest Urogenital Distress Inventory scores on bivariate analysis, which was explained by socioeconomic status, body mass index, and age on multivariate analysis. CONCLUSION: Factors other than racial/ethnic differences underlie variations in UI symptoms and bother in this group of women who sought surgery for stress incontinence.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Incontinência Urinária por Estresse/etnologia , População Branca/estatística & dados numéricos , Adulto , Fatores Etários , Índice de Massa Corporal , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Classe Social , Incontinência Urinária por Estresse/cirurgia , Procedimentos Cirúrgicos Urogenitais
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