OBESITY AND AGE AS A RISK FACTORS FOR URINARY INCONTINENCE IN WOMEN
Keywords:
risk factors, age, obesity, urinary incontinenceAbstract
According to the International Association for Urinary Incontinence, any involuntary leakage of urine is called urinary incontinence. The objectives of the study were: to determine the prevalence of urinary incontinence in women; to show the relationship between age over 60, obesity and urinary incontinence and to show that age and obesity are potential risk factors for urinary incontinence in women. The study is a prospective cohort study. The material is 312 patients aged 20 to 86 years, divided into two groups: examined and control. In all women we performed: urinary status with urinary sediment, urine culture, cystoscopy, urinary tract ultrasound, urodynamic tests, Marshall tests, questionnaire containing questions on risk factors for urinary incontinence and short consultation form International modular incontinence questionnaire to diagnose and classify urinary incontinence and calculate the Body Mass Index. Analysis of relationships between two series with attributive variables was done using a chi-square test. Analysis of relationships between two series with numerical variables was done using regression analysis and coefficient of linear correlation. The testing of the differences between the compared groups was done with the help of Student's t-test. The relative risk of urinary incontinence was estimated by calculating the Odds Ratio with a 95% Confidence Interval, using logistic regression. Data with p value <0.05 were considered statistically significant. According to the t-test, the percentage difference between the mean ages between the two groups is statistically insignificant for p˃0.05 (p = 0.3295, t = 0.8564, 95% CI: -4.34-6.65). Stress incontinence was detected in 48.40% (91/188) of women, urgent incontinence in 27.13% (51/188) of women, and mixed urinary incontinence in 24.47% (46/188) of women. Data analysis showed an association between urinary incontinence and patients over sixty years of age (chi-square test = 5.5317, p = 0.0202, p<0.05, with a relative risk of 2.89). Data analysis showed an association between urinary incontinence and patients with a body mass index above 35 (chi-square test = 5.8607, p = 0.0067, p<0.05, with a relative risk of 3.19). Our study showed there is an association between age, obesity and urinary incontinence and that age over 60 and obesity are potential risk factors for urinary incontinence in women.
References
Avery KNL, Bosch JLHR, Gotoh M, Naughton M, Jackson S, Radley SC, et al. (2007). Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol. 177:39–49
Abrams, P., Andersson, KE., Apostolidis, A., Birder, L., Bliss, D., & Brubaker, L. (2018). 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. Neurourol Urodyn, 37, 2271–2.
Abrams, P., Cardozo, L., Khoury, S., & Wein A. (2013). Incontinence fifthedition, the international consultation on urological diseases.
Alling, ML., Lose, G. & Jørgensen, T. (2000). Risk factors for lower urinary tract symptoms in women 40 to 60 years of age. Obstet Gynecol, 96, 446–51.
Avery, KNL., Bosch, JLHR., Gotoh, M., Naughton, M., Jackson, S., & Radley, SC. (2007). Questionnaires to assess urinary and anal incontinence: review and recommendations. J Urol, 177, 39– 49.
Barbosa, L., Boaviagem, A. & Moretti, E. (2018). Multiparity, age and overweight/obesity as risk factors for urinary incontinence in pregnancy: a systematic review and meta-analysis. Int Urogynecol J 29, 1413–1427.
Batmani, S., Jalali, R. & Mohammadi, M. (2021). Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies. BMC Geriatr, 21, 212.
Blackburn, H. & Jacobs, D. (2014). "Commentary: Origins and evolution of body mass index (BMI): continuing saga" (PDF). International Journal of Epidemiology, 43 (3): 665–669.
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, 13:1.
Eshkoor, S., Hamid, T.A., Shahar, S. & Mun, C. (2017). Factors related to urinary incontinence among the Malaysian elderly. J Nutr Health Aging, 21(2):220–6.
Di Angelantonio, E., Bhupathiraju, S., Wormser, D., Gao, P., Kaptoge, S., & Berrington de Gonzalez A (2016). "Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents". Lancet, 388 (10046): 776–86.
Forde, J.C., Chughtai, B., Cea, M., Stone, B.V., Te, A. & Bishop, T.F. (2017). Trends in ambulatory management of urinary incontinence in women in the United States. Female Pelvic Med Reconstr Surg, 23(4):250–5.
Gallas, S., Frioui, S., Rabeh, H. & Rejeb MB. (2018). Prevalence and risk factors for urinary and anal incontinence in Tunisian middle aged women. Afr J Urol, 24(4):368–73.
Giarenis, I. & Cardozo, L. (2014). Managing urinary incontinence: what works? Climacteric, 17 Suppl 2:26-33.
Hagan, K.A., Erekson, E., Austin, A., Minassian, V.A., Townsend, M.K. & Bynum, J.P. (2018). A prospective study of the natural history of urinary incontinence in women. Am J Obstetr Gynecol, 218(5):502. e1–8.
Haylen, B., Ridder, DD., Freeman, RM., Swift, SE., Berghmans, B., & Lee, J. (2010). An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J, 21, 5– 26.
Hu, JS. & Pierre, EF. (2019). Urinary incontinence in women: evaluation and management. Am Fam Physician, 100(6), 339-348.
Hunskaar, S., Lose, G., Sykes, D., & Voss S. (2004). The prevalence of urinary incontinence in women in four European countries. BJU Int, 93, 324–30.
Irwin, DE., Kopp, ZS., Agatep, B., Milsom, I. & Abrams, P. (2011). Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int, 108, 1132–8.
Khan, S., Ansari, M.A., Vasenwala, S.M. & Mohsin Z. (2017). The influence of menopause on urinary incontinence in the women of the community: a cross-sectional study from North India. Int J Reprod Contracept Obstetr Gynecol, 6(3):911–8.
Kiyumi, MH., Belushi, Z., Jaju, S. & Mahrezi, AM. (2020). Urinary incontinence among Omani women: prevalence, risk factors and impact on quality of life. Sultan Qaboos Univ Med J, 20(1), 45-53.
Lasserre A. (2009). Utinary incontinence in French women: prevalence, risk factors, and impact of quality of life. Eur Urol, 56(1), 177-83.
Lim, R., Liong, M.L., Leong, W.S., Lau, Y.K., Khan, N.A.K. & Yuen KH. (2018). The impact of stress urinary incontinence on individual components of quality of life in Malaysian women. Urology, 112:38–45.
Lukacz, ES., Santiago-Lastra, Y., Albo, ME. & Brubaker, L. (2017). Urinary Incontinence in Women: A Review. JAMA, 318(16):1592-1604.
Melville, JL., Katon, W., Delaney, K. & Newton, K. (2005). Urinary incontinence in US women. Arch Intern Med, 165, 537–42.
Minassian, VA., Drutz, HP. & Al-Badr, A. (2003). Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet, 82, 327–38.
Muller, N. (2005). What Americans understand about how they are affected by bladder control problems: Highlights of recent nationwide consumer research. Urol Nurs, 25, 109–15.
Nasaj, G., Omidpour, P. & Shah Ali, S.Z.S. (2017). Relationship between pelvic floor muscle strength and severity of urinary incontinence on quality of life in women with urinary incontinence. Iran J.
Ninomiya, S., Naito, K., Nakanishi, K. & Okayama, H. (2018). Prevalence and risk factors of urinary incontinence and overactive bladder in J apanese women. LUTS, 10(3):308–14.
Noblett, KL., Jensen, JK. & Ostergard DR. (1997). The relationship of body mass index to intra‐abdominal pressure as measured by multichannel cystometry. Int Urogynecol J Pelvic Floor Dysfunct, 8, 323–6.
Nygaard, C.C. (2018). Urinary Incontinence and Quality of Life in Female Patients with Obesity. Revista Brasileira de Ginecologia e Obstetrícia, 40, n. 09 [Accessed 19 September 2021] , pp. 534-539.
Ozerdogan, N., Kizilkaya, N., & Yalcin, O .(2004). Urinary incontinence: its prevelance, risk factors, effects on the quality of life in Turkey. Gynecol Obstet Invest, 58, 145–150.
Peate, I. (2019). Urinary incontinence in women: treatment recommendations. Br J Nurs, 28(22):1486–8.
Song, YF, Zhang, WJ., Song, J. & Xu B. (2005). Prevalence and risk factors of urinary incontinence in Fuzou Chinese women. Chin Med J, 18(11), 887-92.
Suhr, R. & Lahmann, N.A. (2018). Urinary incontinence in home care: a representative multicenter study on prevalence, severity, impact on quality of life, and risk factors. Aging Clin Exp Res, 30(6):589–94.
Suskind, A.M., Cawthon, P.M., Nakagawa, S., Subak, L.L., Reinders, .I, Satterfield, S., Cummings, S., Cauley, J.A., Harris, T. & Huang, A.J. (2017). Health ABC Study. Urinary incontinence in older women: the role of body composition and muscle strength: from the health, aging, and body composition study. J Am Geriatr Soc, 65(1):42–50.
Tkacheva, O.N., Runikhina, N.K., Ostapenko, V.S., Sharashkina, N.V., Mkhitaryan, E.A., Onuchina, J.S., Lysenkov, S.N., Yakhno, N.N. & Press Y. (2018). Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow. Clin Interv Aging, 13:251–9.
Xue, K., Palmer, M. H., & Zhou, F. (2020). Prevalence and associated factors of urinary incontinence in women living in China: a literature review. BMC urology, 20(1), 159.
Vaisi-Raygani, A.A., Mohammadi, M., Jalali, R., Ghobadi, A. & Salari, N. (2019). The prevalence of obesity in older adults in Iran: a systematic review and meta-analysis. BMC Geriatr, 19(1):371.
