Lars Alling Møller

The prevalence and bothersomeness of lower urinary tract symptoms in women 40-60 years of age.

Aim. To assess the prevalence and bothersomeness of lower urinary tract symptoms in women aged 40–60 years.

Risk factors for lower urinary tract symptoms in women 40 to 60 years of age.

Objective To determine the relationship between lower urinary tract symptoms and possible associated risk factors in women 40–60 years old. Methods In a normal population study, 502 women with lower urinary tract symptoms and 742 women with no symptoms (controls) were asked about possible associated factors. Results Four hundred eighty-seven women (97.0%) with symptoms and 564 controls (76.0%) completed the study. Stress incontinence was associated with parity (primipara odds ratio [OR] 2.2, 95% confidence interval [CI] 1.0, 4.9; para 2 OR 3.9, 95% CI 1.9, 8.0; para 3 OR 4.5, 95% CI 2.1, 9.5), use of diuretics (OR 2.2, 95% CI 1.2, 3.9), hysterectomy (OR 2.4, 95% CI 1.6, 3.7), and increased body mass index (BMI). Urge incontinence was associated with use of diuretics (OR 4.0, 95% CI 2.2, 7.1) and BMI. Urgency was associated with parity (primipara OR 1.9, 95% CI 0.9, 4.2; para 2 OR 3.0, 95% CI 1.5, 5.9; para 3 OR 3.1, 95% CI 1.5, 6.5), use of diuretics (OR 2.7, 95% CI 1.5, 4.7) and BMI. Associations between non–incontinence symptoms (except urgency) and observed factors were weak and inconsistent. Straining at stool and constipation were inversely associated with lower urinary tract symptoms. Overall, lesion of sphincter ani, episiotomy, fetal weight, physical activity, and hormonal status had minor association with lower urinary tract symptoms. Conclusion Lower urinary tract symptoms were associated positively with parity, BMI, prior hysterectomy, use of diuretics, straining at stool, and constipation.

Prevalence and bother of nocturia, and causes of sleep interruption in a Danish population of men and women aged 60–80 years

To study the prevalence and bother of nocturia, and sleep interruptions in an unselected population of Danish men and women aged 60–80 years.

Incidence and remission rates of lower urinary tract symptoms at one year in women aged 40-60: longitudinal study

Abstract Objectives: To determine the incidence and rates of remission of lower urinary tract symptoms at one year in women aged 40-60, and to assess factors associated with remission. Design: Ongoing longitudinal cohort study. Setting: One rural and one urban county in Denmark. Participants: 4000 women recruited on a random basis, 2860 of whom were followed up at one year. Measurements: Incidence and rates of remission of lower urinary tract symptoms. Results: Prevalence, incidence, and rates of remission of lower urinary tract symptoms in 2284 women were respectively 28.5% (95% confidence interval 26.7% to 30.4%), 10.0% (8.5% to 11.4%), and 27.8% (25.6% to 30.0%). Overall, symptoms were not significantly associated with events performed or initiated in the study period: medical consultation (1.6, 0.8 to 2.8), pelvic floor physiotherapy (0.9, 0.5 to 1.8), treatment with antibiotics on suspicion of a lower urinary tract infection (1.3, 0.8 to 2.2), or other treatment (1.7, 0.7 to 4.1). Many of the individual symptoms were, however, associated with seeking professional help. Conclusions: Lower urinary tract symptoms constitute dynamic conditions, with women experiencing more or fewer symptoms, and eventually a cessation of symptoms. The distinction between permanent and fluctuating cases may have important clinical and scientific implications.

ADVERSE EFFECTS OF PSYCHOSOCIAL STRESS ON GONADAL FUNCTION AND INSULIN LEVELS IN MIDDLE-AGED MALES

Abstract. Objectives. To investigate the relationship between gonadal function, insulin and psychosocial stress in middle‐aged men.

Nocturia and associated morbidity in a Danish population of men and women aged 60–80 years

To evaluate the association between nocturia and medical diseases, medication, urinary incontinence (UI), recurrent cystitis, smoking, alcohol, parity, hysterectomy, pelvic organ prolapse surgery, UI surgery, and prostate surgery.

Social Class and Cardiovascular Disease — an Update

Cardiovascular disease is associated with a low social class position in numerous epidemiological studies. The mechanisms behind this finding are not fully known, although several factors may be of importance (e.g. lifestyle, neuroendocrine regulation, foetal deprivation). A better understanding of the biological basis for class-related disease may facilitate efforts in preventive medicine related to cardiovascular health.

Subtotal versus total abdominal hysterectomy: randomized clinical trial with 14-year questionnaire follow-up

OBJECTIVE The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN This was a long-term follow-up of a multicenter, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal hysterectomy. All women enrolled in the trial from 1996 to 2000 who were still alive and living in Denmark (n = 304) were invited to answer the validated questionnaire used in prior 1 and 5 year follow-ups. Hospital contacts possibly related to hysterectomy from 5 to 14 years postoperatively were registered from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse, constipation, pain, sexuality, quality of life (Short Form-36 questionnaire), hospital contacts, and vaginal bleeding. RESULTS The questionnaire was answered by 197 of 304 women (64.8%) (subtotal hysterectomy [n = 97] [63.4%]; total hysterectomy [n = 100] [66.2%]). Mean follow-up time was 14 years and mean age at follow-up was 60.1 years. After subtotal abdominal hysterectomy, 32 of 97 women (33%) complained of urinary incontinence compared with 20 of 100 women (20%) after total abdominal hysterectomy 14 years after hysterectomy (relative risk, 1.67; 95% confidence interval, 1.02-2.70; P = .035). After a multiple imputation analysis, this difference disappeared (relative risk, 1.36; 95% confidence interval, 0.86-2.13; P = .19). No differences were seen in any of the secondary outcomes. CONCLUSION Subtotal abdominal hysterectomy was not superior to total abdominal hysterectomy on any outcomes. More women seem to have subjective urinary incontinence 14 years after subtotal abdominal hysterectomy. This result was not confirmed by multiple imputation analysis and should be interpreted cautiously.

Treatment of vaginal recurrence in endometrial cancer : a review

Background. We have reviewed the literature concerning vaginal recurrence in endometrial cancer with emphasis on prognostics and therapeutic results. Compared to the overall outcome of recurrences (11‐17 per cent survive more than 3‐19 years) the survival rate of strictly vaginal recurrence appears significantly higher (up to 60‐70 per cent survive more than 5 years). However, the prognosis deteriorates significantly in cases where recurrences prove to be more widespread. Other factors towards predicting a poor outcome are high age, high stage, high grade, detection of papillary carcinoma, rapid recurrence, location to the lower part of vagina, large tumorsize, and previous radiation.

A comparison of three methods to evaluate maximum bladder capacity: cystometry, uroflowmetry and a 24-h voiding diary in women with urinary incontinence.

Background. Maximum bladder capacity (MBC) is an important parameter in the evaluation of lower urinary tract function. Yet, there is no consensus on how to measure MBC. The aim of this study was to compare estimates of the maximum bladder capacity (MBC) using cystometry, uroflowmetry, and a 24‐h voiding diary in women with urinary incontinence.