Søren Mommsen

Parity as a correlate of adult female urinary incontinence prevalence.

STUDY OBJECTIVE--The aim was to investigate the possible association between parity, as indicated by the number of childbirths, and prevalence of urinary incontinence in an adult female population sample. DESIGN AND SETTING--A sample of 3114 women aged 30-59 years was selected at random from the population of Aarhus, Denmark, and mailed a self administered questionnaire on urinary incontinence and, among other things, parity. PARTICIPANTS--A total of 2631 questionnaires was returned (85%) with a slight but significant decrease in respondency by age. MAIN RESULTS--The 1987 urinary incontinence period prevalence was 17%. Seventy eight percent were parous, and 24% had had three or more childbirths. In women aged 30-44 years, the prevalence of urinary incontinence was found to be associated with parity and, in women aged 45 years and more, with three or more childbirths. In parous women 30-44 years of age, the prevalence of urinary incontinence increased with age at least childbirth and, in women aged 45 years and over, it increased with increasing parity but decreased with increasing age at first childbirth. In parous women, no association was found with time since last childbirth. Among clinical types of urinary incontinence, stress incontinence consistently showed the strongest associations with indicators of parity. In women aged 30-44 years, nearly two thirds of the 1987 prevalence of stress incontinence could be attributed to parity. CONCLUSIONS--These findings support the hypothesis that pregnancy and childbirth are potent causes of female urinary incontinence, so that they exert considerable impact on the level of population urinary incontinence prevalence. In the individual woman, the effect seems to be cumulative and long lasting but fades with age.

Body mass index and adult female urinary incontinence.

SummaryThe aim of the present investigation was to study the possible role of obesity in the etiology of adult female urinary incontinence (UI). A random population sample of 3,114 women aged 30–59 years were mailed a questionnaire concerning UI and, among other things, body weight and height. The overall rate of response was 85%, and the present analysis comprises 2,589 women who supplied information about their body weight and height. The period prevalence of all UI, stress UI, urge UI, and mixed stress and urge UI was 17%, 15%, 9%, and 7%, respectively. The mean body mass index (BMI) was 22.7 kg/m2. Irrespective of other risk indicators, BMI was positively associated with UI prevalence (OR, 1.07/BMI unit; P<0.0001). BMI interacted with childbirth in predicting stress UI prevalence, with cystitis in predicting urge UI, and with both in predicting mixed UI. Stress UI proved to be the UI type most closely associated with BMI.

Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth, and obstetric techniques.

OBJECTIVES This study examined the association between pregnancy, vaginal childbirth and obstetric techniques, and the prevalence of urinary incontinence among adult women aged 20 to 59 years. METHODS A cross-sectional survey enrolled a random sample of 6240 women aged 20 to 59 years who were mailed a self-administered questionnaire focusing on urinary incontinence and other health variables. More than 75% of the women responded. The present analysis includes 4345 women who were not pregnant and did not experience a vaginal childbirth during 1994. RESULTS Multivariate prevalence odds ratios showed increases in relation to urinary incontinence during pregnancy, urinary incontinence immediately after a vaginal childbirth, and age of 30 years or more at the second vaginal childbirth. No multivariate associations were found for forceps delivery or vacuum extraction delivery, episiotomy, or perineal suturing. CONCLUSION Not only the process of childbirth itself but also processes during pregnancy seem to be strongly associated with prevalent urinary incontinence. Perineal suturing may be associated with prevalent urinary incontinence, whereas other obstetric techniques inspected do not seem to be so.

Risk of postpartum urinary incontinence associated with pregnancy and mode of delivery

Aim.  The aim was to estimate the postpartum urinary incontinence (PP UI) impact of precursory UI during pregnancy (PR UI) and delivery performed by cesarean section (CS) vs. vaginal childbirth (VC).

Postpartum urinary incontinence

Background.  The aim of the present study was to identify prepregnancy, pregnancy and delivery correlates of urinary incontinence postpartum (PP UI) as reported by women in a cross‐sectional population sample.

Correlates of Urinary Incontinence in Pregnancy

Abstract In a population sample, the period prevalence of urinary incontinence (UI) during pregnancy was found to be 19.9% and 24.1% among 352 nulliparous and 290 primiparous women, respectively. The first UI episode ever was experienced by 16.7% and 7.0% during the two last trimesters of the first and second pregnancies, respectively. None of the pregnancy-specific risk factors, such as emesis and birthweight, was significantly associated with UI during pregnancy. Previous UI was a significant risk factor for period prevalent UI during pregnancy, explaining 34% and 83% of pregnancy UI for the nulliparous and the primiparous, respectively. The present data suggest pregnancy UI not to be provoked by the mere onset of pregnancy, but by increasing hormonal concentrations or local tissue changes caused by hormones, whereas there was no support for a theory based on increasing pressure on the bladder caused by the weight of the fetus.

Adult Female Urinary Incontinence And Childhood Bedwetting

A cross-sectional random population sample of women 30 to 59 years old was sent a questionnaire on urinary incontinence and, among other things, childhood bedwetting. Among 2,613 responders 17.0% reported prevalent urinary incontinence (14.7% stress provoked, 8.3% associated with urge, 6.8% stress and urge overlap, 2.2% occurring especially during sleep and 3.9% occurring especially when anxious), and 6.5% reported childhood bedwetting after age 5 years and 3.3% after age 10 years. Childhood bedwetting was associated with prevalent urge urinary incontinence (p < 0.01) and incontinence occurring during sleep (p < 0.0001) but was less marked with urinary incontinence occurring in situations of anxiety (p < 0.025). It is concluded that some individuals suffer a long-lasting disturbance of the balance between micturition and sleep processes.

The International Continence Society (ICS) incontinence definition : Is the social and hygienic aspect appropriate for etiologic research?

OBJECTIVE To investigate the effect of applying a problem assessment versus a pure symptom urinary incontinence (UI) caseness definition in etiologic research. SUBJECTS A random population sample of 2613 women aged 30-59 years, who responded to a postal questionnaire. MAIN PARAMETERS: One-year period prevalence of the symptom of stress UI; UI assessed by the woman to be a social and/or hygienic problem; childbirth and history of abdominal, gynecological, obstetric or urologic surgery. RESULTS Among the 388 women (14.8% of the population sample) who reported stress UI, 62.6% considered it a social or hygienic problem, and 21.9% had ever abstained socially because of UI. Applying a problem assessment caseness definition caused under-estimation of the role of childbirth, as compared with analyses including a pure symptom caseness definition. CONCLUSION The International Continence Society (ICS) incontinence definition presents intrinsic logical problems that invalidates its use in biomedical, if not in sociomedical, research. As definition and medical decision are different concepts, this does not necessarily affect the potential utility of the problem assessment aspect when used in everyday clinical practice as a basis for the decision whether to treat women with UI or not.

Male Genitourinary Tuberculosis: Report of 12 Cases and Review of the Literature

The incidence of genitourinary tuberculosis is constant in western countries, despite dramatically falling prevalence of pulmonary tuberculosis. The kidney is especially involved in urinary tuberculosis, and genital tuberculosis mostly affects the epididymis in males and the fallopian tubes in females. Twelve cases of male genitourinary tuberculosis are presented and the literature is briefly reviewed.

Transurethral Catheter Removal after Bilateral Orchiectomy for Prostatic Carcinoma Associated with Acute Urinary Retention

In the period 1986-1990 a total of 69 patients with advanced prostate cancer and urinary retention underwent orchiectomy followed by removal of the indwelling catheter during the 3 month/postoperative period. The mean follow-up time was 32 months. Regarding urination after catheter removal the success-rate was 62% (43/69) and 84% of these patients were satisfied with the procedure. For these 43 patients the median time without the catheter was 21.5 months. Eleven patients with success developed a new attack of urinary retention. Bladder catheter removal during 3 months after orchiectomy for patients with advanced prostate cancer and urinary retention is recommended.