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International Urogynecology Journal
Erschienen in: International Urogynecology Journal 5/2017

20.03.2017 | Special Contribution

Clinical epidemiological insights into urinary incontinence

verfasst von: Vatché A. Minassian, Tony Bazi, Walter F. Stewart

Erschienen in: International Urogynecology Journal | Ausgabe 5/2017

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Abstract

Introduction and hypothesis

Urinary incontinence (UI) is very common and heterogeneous among women with limited knowledge of progression or prognosis. Evidence based on clinical epidemiology can help to better understand the natural history of UI.

Methods

We examine the challenges of UI definition and its subtypes, its impact on quality of life and health-seeking behavior. We review the proposed pathophysiology of UI subtypes and known risk factors as they relate to our current knowledge of the disease state. Finally, we emphasize the role of epidemiology in the process of acquiring new insight, improving knowledge, and translating this information into clinical practice.

Results

Stress UI is most common overall, but mixed UI is most prevalent in older women. The three UI subtypes have some common risk factors, and others that are unique, but there remains a significant gap in our understanding of how they develop. Although the pathophysiology of stress UI is somewhat understood, urgency UI remains mostly idiopathic, whereas mixed UI is the least studied and most complex subtype. Moreover, there exists limited information on the progression of symptoms over time, and disproportionate UI health-seeking behavior. We identify areas of exploration (e.g., epigenetics, urinary microbiome), and offer new insights into a better understanding of the relationship among the UI subtypes and to develop an integrated construct of UI natural history.

Conclusion

Future epidemiological strategies using longitudinal study designs could play a pivotal role in better elucidating the controversies in UI natural history and the pathophysiology of its subtypes leading to improved clinical care.
Literatur
1.
Gordis L. The natural history of disease: ways of expressing prognosis. In: Gordis L, editor. Epidemiology. Philadelphia: Elsevier/Saunders; 2004. p. 95–114.
2.
Hulley SB, Newman TB, Cummings SR. Getting started: the anatomy and physiology of clinical research. In: Hulley SB, Cumming SR, Browner WS, Grady D, Hearst N, Newman TB, editors. Designing clinical research. Philadelphia: Lippincott Williams and Wilkins; 2001, p. 3–16.
3.
Bates P, Bradley WE, Glen E, Griffiths D, Melchior H, Rowan D, et al. The standardization of terminology of lower urinary tract function. J Urol. 1979;121:551–4.PubMed
4.
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26.CrossRefPubMed
5.
Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet. 2003;82:327–38.CrossRefPubMed
6.
Komesu YM, Schrader RM, Ketai LH, Rogers RG, Dunivan GC. Epidemiology of mixed, stress, and urgency urinary incontinence in middle-aged/older women: the importance of incontinence history. Int Urogynecol J. 2016;27:763–72.CrossRefPubMed
7.
Kammerer-Doak D, Rizk DE, Sorinola O, Agur W, Ismail S, Bazi T. Mixed urinary incontinence: International Urogynecological Association research and development committee opinion. Int Urogynecol J. 2014;25:1303–12.CrossRefPubMed
8.
Molinuevo B, Batista-Miranda JE. Under the tip of the iceberg: psychological factors in incontinence. Neurourol Urodyn. 2012;31:669–71.CrossRefPubMed
9.
Nygaard I, Turvey C, Burns TL, Crischilles E, Wallace R. Urinary incontinence and depression in middle-aged United States women. Obstet Gynecol. 2003;101:149–56.PubMed
10.
Felde G, Bjelland I, Hunskaar S. Anxiety and depression associated with incontinence in middle-aged women: a large Norwegian cross-sectional study. Int Urogynecol J. 2012;23:299–306.CrossRefPubMed
11.
Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20:327–36.PubMed
12.
Thom DH, Haan MN, Van Den Eeden SK. Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality. Age Ageing. 1997;26:367–74.CrossRefPubMed
13.
Hu TW, Wagner TH, Bentkover JD, Leblanc K, Zhou SZ, Hunt T. Costs of urinary incontinence and overactive bladder in the United States: a comparative study. Urology. 2004;63:461–5.CrossRefPubMed
14.
Grodstein F, Fretts R, Lifford K, Resnick N, Curhan G. Association of age, race, and obstetric history with urinary symptoms among women in the Nurses’ Health Study. Am J Obstet Gynecol. 2003;189:428–34.CrossRefPubMed
15.
Wu JM, Hundley AF, Fulton RG, Myers ER. Forecasting the prevalence of pelvic floor disorders in U.S. Women: 2010 to 2050. Obstet Gynecol. 2009;114:1278–83.CrossRefPubMed
16.
Herzog AR, Fultz NH. Prevalence and incidence of urinary incontinence in community-dwelling populations. J Am Geriatr Soc. 1990;38:273–81.CrossRefPubMed
17.
Thom D. Variation in estimates of urinary incontinence prevalence in the community: effects of differences in definition, population characteristics, and study type. J Am Geriatr Soc. 1998;46:473–80.CrossRefPubMed
18.
Hunskaar S, Burgio K, Diokno A, Herzog AR, Hjalmas K, Lapitan MC. Epidemiology and natural history of urinary incontinence in women. Urology. 2003;62:16–23.CrossRefPubMed
19.
Hannestad YS, Rortveit G, Sandvik H, Hunskaar S, Norwegian EPINCONT study. Epidemiology of incontinence in the County of Nord-Trondelag. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of Incontinence in the County of Nord-Trondelag. J Clin Epidemiol. 2000;53:1150–7.CrossRefPubMed
20.
Melville JL, Katon W, Delaney K, Newton K. Urinary incontinence in US women: a population-based study. Arch Intern Med. 2005;165:537–42.CrossRefPubMed
21.
Minassian VA, Stewart WF, Wood CG. Urinary incontinence in Women: variation in prevalence estimates and risk factors. Obstet Gynecol. 2008;2:324–31.CrossRef
22.
Minassian VA, Stewart WF, Hirsch A. Why do stress and urge incontinence co-occur much more often than expected? Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:1429–40.CrossRefPubMed
23.
Minassian VA, Yan XS, Pitcavage J, Stewart WF. Mixed incontinence masked as stress induced urgency urinary incontinence. J Urol. 2016;196:1190–5.CrossRefPubMed
24.
Stewart WF, Minassian VA, Hirsch A, Lerch V, Kolodner K, Dilley A. Predictors of variability in urinary incontinence and overactive bladder. Neurourol Urodyn. 2010;29:328–35.PubMed
25.
Townsend MK, Danforth KN, Lifford KL, et al. Incidence and remission of urinary incontinence in middle-aged women. Am J Obstet Gynecol. 2007;197:167.e1–5.CrossRef
26.
Jahanlu D, Qureshi SA, Hunskaar S. The Hordaland women’s cohort: a prospective cohort study of incontinence, other urinary tract symptoms and related health issues in middle-aged women. BMC Public Health. 2008;8:296.CrossRefPubMedPubMedCentral
27.
Nygaard IE, Lemke JH. Urinary incontinence in rural older women: prevalence, incidence and remission. J Am Geriatr Soc. 1996;44:1049–54.CrossRefPubMed
28.
Viktrup L, Lose G. Incidence and remission of lower urinary tract symptoms during 12 years after the first delivery: a cohort study. J Urol. 2008;180:992–7.CrossRefPubMed
29.
Komesu YM, Rogers RG, Schrader RM, Lewis CM. Incidence and remission or urinary incontinence in a community-based population of women ≥50 years. Int Urogynecol J. 2009;20:581–9.CrossRef
30.
Samuelsson EC, Victor FT, Svardsudd KF. Five-year incidence and remission rates of female urinary incontinence in a Swedish population less than 65 years old. Am J Obstet Gynecol. 2000;183:568–74.CrossRefPubMed
31.
Waetjen LE, Liao S, Johnson WO, et al. Factors associated with prevalent and incident urinary incontinence in a cohort of midlife women: a longitudinal analysis of data: study of women’s health across the nation. Am J Epidemiol. 2007;165:309–18.CrossRefPubMed
32.
Stewart WF, Hirsh AG, Kirchner HL, Clarke DN, Litchtenfeld MJ, Minassian VA. Urinary incontinence incidence: quantitative meta-analysis of factors that explain variation. J Urol. 2014;191:996–1002.CrossRefPubMed
33.
Legendre G, Ringa V, Panjo H, Zins M, Fritel X. Incidence and remission of urinary incontinence at midlife: a cohort study. BJOG. 2015;122:816–24.CrossRefPubMed
34.
Coyne KS, Zhou Z, Thompson C, Versi E. The impact on health-related quality of life of stress, urge and mixed urinary incontinence. BJU Int. 2003;92:731–5.CrossRefPubMed
35.
Frick AC, Huang AJ, Van den Eeden SK, Knight SK, Creasman JM, Yang J, et al. Mixed urinary incontinence: greater impact on quality of life. J Urol. 2009;182:596–600.CrossRefPubMedPubMedCentral
36.
Minassian VA, Devore E, Hagan K, Grodstein F. Severity of urinary incontinence and effect on quality of life in women by incontinence type. Obstet Gynecol. 2013;121:1083–90.CrossRefPubMedPubMedCentral
37.
38.
Milley PS, Nichols DH. The relationship between the pubo-urethral ligaments and the urogenital diaphragm in the human female. Anat Rec. 1971;170:281–3.CrossRefPubMed
39.
DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol. 1994;170:1713–20.CrossRefPubMed
40.
Petros PE, Ulmsten UI. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl. 1990;153:7–31.CrossRefPubMed
41.
Petros PE, Woodman PJ. The integral theory of continence. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:35–40.CrossRefPubMed
42.
43.
Abrams P, Wein A. Introduction to the overactive bladder: from basic science to clinical management. Urology. 1997;50(Suppl 6A):1–3.CrossRef
44.
Freeman RM, Adekanmi OA. Overactive bladder. Best Pract Res Clin Obstet Gynaecol. 2005;19:829–41.CrossRefPubMed
45.
Meng E, Lin WY, Lee WC, Chuang YC. Pathophysiology of overactive bladder. Low Urin Tract Symptoms. 2012;4 (Suppl 1):48–55.CrossRefPubMed
46.
Bradley WE. Cerebro-cortical innervation of the urinary bladder. Tohoku J Exp Med. 1980;131:7–13.CrossRefPubMed
47.
Anderson JT, Bradley WE. Bladder and urethral innervation in multiple sclerosis. Br J Urol. 1976;48:239–43.CrossRefPubMed
48.
de Groat WC. A neurologic basis for the overactive bladder. Urology. 1997;50(Suppl 6A):36–52.CrossRefPubMed
49.
Sibley GN. Developments in our understanding of detrusor instability. Br J Urol. 1997;80 Suppl 1:54–61.PubMed
50.
Norgaard JP, van Gool JD, Hjalmas K, Djurhuus JC, Hellstrom AL. Standardization and definitions in lower urinary tract dysfunction in children. International Children’s Continence Society. Br J Urol. 1998;81:1–16.CrossRefPubMed
51.
Petros PE, Ulmsten U. Bladder instability in women: a premature activation of the micturition reflex. Neurourol Urodyn. 1993;12:235–9.CrossRefPubMed
52.
Bump RC, Norton PA, Zinner NR, Yalcin I, Duloxetine Urinary Incontinence Study Group. Mixed urinary incontinence symptoms: urodynamic findings, incontinence severity, and treatment response. Obstet Gynecol. 2003;102:76–83.PubMed
53.
Brubaker L, Stoddard A, Richter H, Zimmern P, Moalli P, Kraus SR, et al. Mixed incontinence: comparing definitions in women having stress incontinence surgery. Neurourol Urodyn. 2009;28:268–73.CrossRefPubMedPubMedCentral
54.
Brubaker L, Lukacz ES, Burgio K, Zimmern P, Norton P, Leng W, et al. Mixed incontinence: comparing definitions in non-surgical patients. Neurourol Urodyn. 2011;30:47–51.CrossRefPubMedPubMedCentral
55.
Dooley Y, Lowenstein L, Kenton K, FitzGerald M, Brubaker L. Mixed incontinence is more bothersome than pure incontinence subtypes. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:1359–62.CrossRefPubMed
56.
Landefeld CS, Bowers BJ, Feld AD, Hartmann KE, Hoffman E, Ingber MJ, et al. National institutes of health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008;148:449–58.CrossRefPubMed
57.
DeLancey JO. Current status of the subspecialty of female pelvic medicine and reconstructive surgery. Am J Obstet Gynecol. 2010;202:658.e1–4.CrossRef
58.
Tähtinen RM, Cartwright R, Tsui JF, Aaltonen RL, Aoki Y, Cárdenas JL, et al. Long-term impact of mode of delivery on stress urinary incontinence and urgency urinary incontinence: a systematic review and meta-analysis. Eur Urol. 2016;70:148–58.CrossRefPubMedPubMedCentral
59.
Rortveit G, Hannestad YS, Daltveit AK, Hunskaar S. Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynecol. 2001;98:1004–10.PubMed
60.
Townsend MK, Curhan GC, Resnick NM, Grodstein F. The incidence of urinary incontinence across Asian, black, and white women in the United States. Am J Obstet Gynecol. 2010;202:378.e1–7.CrossRef
61.
Graham CA, Mallett VT. Race as a predictor of urinary incontinence and pelvic organ prolapse. Am J Obstet Gynecol. 2001;185:116–20.CrossRefPubMed
62.
Lukacz ES, Lawrence JM, Contreras R, Nager CW, Luber KM. Parity, mode of delivery, and pelvic floor disorders. Obstet Gynecol. 2006;107:1253–60.CrossRefPubMed
63.
Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S, Norwegian EPINCONT study. Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med. 2003;348:900–7.CrossRefPubMed
64.
Bazi T, Takahashi S, Ismail S, Bo K, Ruiz-Zapata AM, Duckett J, et al. Prevention of pelvic floor disorders: International urogynecological association research and development committee opinion. Int Urogynecol J. 2016;27:1785–95.CrossRefPubMed
65.
Hirsch AG, Minassian VA, Dilley A, Sartorius J, Stewart WF. Parity is not associated with urgency with or without urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2010;21:1095–1102.CrossRef
66.
Townsend MK, Danforth KN, Rosner B, Curhan GC, Resnick NM, Grodstein F. Body mass index, weight gain, and incident urinary incontinence in middle-aged women. Obstet Gynecol. 2007;110:346–53.CrossRefPubMed
67.
Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT study. BJOG. 2003;110:247–54.CrossRefPubMed
68.
Wesnes SL. Weight and urinary incontinence: the missing links. Int Urogynecol J. 2014;25:725–9.CrossRefPubMed
69.
Cummings JM, Rodning CB. Urinary stress incontinence among obese women: review of pathophysiology therapy. Int Urogynecol J Pelvic Floor Dysfunct. 2000;11:41–4.CrossRefPubMed
70.
Lawrence JM, Lukacz ES, Liu IL, Nager CW, Luber KM. Pelvic floor disorders, diabetes, and obesity in women: findings from the Kaiser Permanente Continence Associated Risk Epidemiology Study. Diabetes Care. 2007;30:2536–41.CrossRefPubMed
71.
Ebbesen MH, Hannestad YS, Midthjell K, Hunskaar S. Diabetes and urinary incontinence—prevalence data from Norway. Acta Obstet Gynecol Scand. 2007;86:1256–62.CrossRefPubMed
72.
Yamaguchi C, Sakakibara R, Uchiyama T, Yamamoto T, Ito T, Liu Z, et al. Overactive bladder in diabetes: a peripheral or central mechanism? Neurourol Urodyn. 2007;26:807–13.CrossRefPubMed
73.
Bump RC, Norton PA. Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin N Am. 1998;25:723–46.CrossRef
74.
Albo ME, Richter HE, Brubaker L, Norton P, Kraus SR, Zimmern PE, et al. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med. 2007;356:2143–55.CrossRefPubMed
75.
Troko J, Bach F, Toozs-Hobson P. Predicting urinary incontinence in women in later life: a systematic review. Maturitas. 2016;94:110–6.CrossRefPubMed
76.
77.
Elia G, Bergman J, Dye TD. Familial incidence of urinary incontinence. Am J Obstet Gynecol. 2002;187:53–5.CrossRefPubMed
78.
Buchsbaum GM, Duecy EE, Kerr LA, Huang LS, Guzick DS. Urinary incontinence in nulliparous women and their parous sisters. Obstet Gynecol. 2005;106:1253–8.CrossRefPubMed
79.
Hannestad YS, Lie RT, Rortveit G, Hunskaar S. Familial risk of urinary incontinence in women: population based cross sectional study. BMJ. 2004;329:889–91.CrossRefPubMedPubMedCentral
80.
Nguyen A, Aschkenazi SO, Sand PK, et al. Nongenetic factors associated with stress urinary incontinence. Obstet Gynecol. 2011;117(2 Pt 1):251–5.CrossRefPubMed
81.
Rohr G, Kragstrup J, Gaist D, Christensen K. Genetic and environmental influences on urinary incontinence: a Danish population-based twin study of middle-aged and elderly women. Acta Obstet Gynecol Scand. 2004;83:978–82.CrossRefPubMed
82.
Wennberg A, Altman D, Lundholm C, et al. Genetic influences are important for most but not all lower urinary tract symptoms: a population-based survey in a cohort of adult Swedish twins. Eur Urol. 2011;59:1032–8.CrossRefPubMedPubMedCentral
83.
Cartwright R, Kirby AC, Tikkinen KA, Mangera A, Thiagamoorthy G, Rajan P, et al. Systematic review and metaanalysis of genetic association studies of urinary symptoms and prolapse in women. Am J Obstet Gynecol. 2015;212:199.e1–24.CrossRef
84.
Eiberg H, Shaumburg H, Von Gontard A, Rittig S. Linkage study of a large Danish 4-generation family with urge incontinence and nocturnal enuresis. J Urol. 2001;166:2401–3.CrossRefPubMed
85.
Norton P, Milsom I. Genetics and the lower urinary tract. Neurourol Urodyn. 2010;29:609–11.CrossRefPubMed
86.
McKenzie P, Rohozinski J, Badlani G. Genetic influences on stress urinary incontinence. Curr Opin Urol. 2010;20:291–5.CrossRefPubMed
87.
Skorupski P, Krol J, Starega J, Adamiak A, Jankiewicz K, Rechberger T. An alpha-1 chain of type I collagen Sp1-binding site polymorphism in women suffering from stress urinary incontinence. Am J Obstet Gynecol. 2006;194:346–50.CrossRefPubMed
88.
Wen Y, Man WC, Sokol ER, Polan ML, Chen BH. Is alpha2-macroglobulin important in female stress urinary incontinence? Hum Reprod. 2008;23:387–93.CrossRefPubMed
89.
Allen-Brady K, Norton PA, Farnham JM, Teerlink C, Cannon-Albright LA. Significant linkage evidence for a predisposition gene for pelvic floor disorders on chromosome 9q21. Am J Hum Genet. 2009;84:678–82.CrossRefPubMedPubMedCentral
90.
Richter HE, Whitehead N, Arya L, Ridgeway B, Allen-Brady K, Norton P, et al. Genetic contributions to urgency urinary incontinence in women. J Urol. 2015;193:2020–7.CrossRefPubMed
91.
Thomas-White K, Brady M, Wolfe AJ, Mueller ER. The bladder is not sterile: history and current discoveries on the urinary microbiome. Curr Bladder Dysfunct Rep. 2016;11:18–24.CrossRefPubMedPubMedCentral
92.
Schneeweiss J, Koch M, Umek W. The human urinary microbiome and how it relates to urogynecology. Int Urogynecol J. 2016;27:1307–12.CrossRefPubMed
93.
Pearce MM, Hilt EE, Rosenfeld AB, Zilliox MJ, Thomas-White K, Fok C, et al. The female urinary microbiome: a comparison of women with and without urgency urinary incontinence. MBio. 2014;5:e01283-14.CrossRefPubMedPubMedCentral
94.
Thomas-White KJ, Hilt EE, Fok C, Pearce MM, Mueller ER, Kliethermes S, et al. Incontinence medication response relates to the female urinary microbiota. Int Urogynecol J. 2016;27:723–33.CrossRefPubMed
95.
Koch M, Mitulovic G, Hanzal E, Umek W, Seyfert S, Mohr T, et al. Urinary proteomic pattern in female stress urinary incontinence: a pilot study. Int Urogynecol J. 2016;27:1729–34.CrossRefPubMedPubMedCentral
96.
Minassian VA, Yan X, Lichtenfeld MJ, Sun H, Stewart WF. The iceberg of health care utilization in women with urinary incontinence. Int Urogynecol J. 2012;23:1087–93.CrossRefPubMedPubMedCentral
97.
Myers DL. Female mixed urinary incontinence: a clinical review. JAMA. 2014;311:2007–14.
98.
Scotti RJ, Angell G, Flora R, Greston WM. Antecedent history as a predictor of surgical cure of urgency symptoms in mixed incontinence. Obstet Gynecol. 1998;91:51–4.CrossRefPubMed
99.
Holmgren C, Nilsson S, Lanner L, Hellberg D. Long-term results with tension-free vaginal tape on mixed and stress urinary incontinence. Obstet Gynecol. 2005;106:38–43.CrossRefPubMed
100.
Sung VW, Borello-France D, Dunivan G, Gantz M, Lukacz ES, Moalli P, et al. Methods for a multicenter randomized trial for mixed urinary incontinence: rationale and patient-centeredness of the ESTEEM trial. Int Urogynecol J. 2016;27:1479–90.CrossRefPubMed
Metadaten
Titel
Clinical epidemiological insights into urinary incontinence
verfasst von
Vatché A. Minassian
Tony Bazi
Walter F. Stewart
Publikationsdatum
20.03.2017
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 5/2017
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-017-3314-7

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