Chendrimada Madhu

Coital incontinence: what can we learn from urodynamic assessment?

OBJECTIVE To evaluate the association of coital incontinence (CI) with lower urinary tract symptoms (LUTS) and to understand the pathophysiology of CI. METHODS A database of all women who underwent urodynamic testing in a tertiary referral center in the United Kingdom, from January 1991 to December 2009, was retrospectively analyzed. All women reporting CI were included in the study. Urodynamic testing and interpretation of results were performed in accordance with the recommendations of the International Continence Society. RESULTS The prevalence of CI in women with LUTS undergoing urodynamics was 11.8%, and they were significantly younger (mean age = 45.3 years; P <.001) than the rest of the group (mean age = 53.4 years). Obesity (body mass index >30 kg/m(2)) and parity were significantly associated with CI (P <.001). Women reporting CI significantly smoked cigarettes and used antidepressants (P <.001). There were fewer postmenopausal women (P <.001) with CI, and previous hysterectomy had a negative association with CI (P = .005). The majority of women had overactive bladder symptoms and stress urinary incontinence (P <.001). CI was significantly associated with urodynamic stress incontinence (UDSI; odds ratio = 2.35) and detrusor overactivity (DO; odds ratio = 1.22) but not DO incontinence (P <.001). Parity, overactive bladder symptoms, and UDSI reached statistical significance when analysis was performed for age-matched controls. CONCLUSION CI is not uncommon in women with LUTS, and they present earlier than women with LUTS and no CI. CI is significantly associated with risk factors like parity, obesity, cigarette smoking, and antidepressant usage. CI is multifactorial and associated with UDSI and DO but not DO incontinence.

The Functional Effects of Cigarette Smoking in Women on the Lower Urinary Tract

The aim of the study was to evaluate the urodynamic findings in women who smoke cigarettes, with bothersome lower urinary tract symptoms, to help develop an understanding of potential impact of smoking on the lower urinary tract function. Methods: A database of 11,678 women who underwent urodynamic testing in a tertiary referral centre in the United Kingdom, from January 1991 to December 2009 was retrospectively analysed. All women reporting cigarette smoking were included in the study group. Urodynamic testing and interpretation of results were done in accordance with the recommendations of the International Continence Society. Results: Overall, 2,476 (21.2%) women reported smoking cigarettes. Overactive bladder symptoms (OAB) were more common in smokers (OR 1.14, p = 0.006). Female smokers significantly complained of secondary nocturnal enuresis (OR 2.26, p < 0.001) and coital incontinence (CI; OR 1.14, p < 0.001). Detrusor overactivity (DO; OR 1.42, p < 0.001) and detrusor overactivity incontinence (DOI; OR 1.42, p < 0.001) were the most significant urodynamic findings. Smoking was not shown to be significantly associated with SUI (OR 1.08, p = 0.213) or urodynamic stress incontinence (OR 0.86, p = 0.001). Conclusion: Cigarette smoking is associated with OAB, secondary nocturnal enuresis and CI. DO and DOI are the most significant urodynamic findings.

Risk factors and functional abnormalities associated with adult onset secondary nocturnal enuresis in women

The study aims to evaluate bothersome lower urinary tract symptoms (LUTS), risk factors, and associated functional abnormalities in women reporting adult onset secondary nocturnal enuresis (SNE), to help understand factors associated with SNE.

How to use the Pelvic Organ Prolapse Quantification (POP-Q) system?

To set out the basic description of pelvic organ prolapse (POP) using the International Continence Society/International Urogynecology Association Pelvic Organ Prolapse Quantification (POP‐Q) system.