Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery

Objective. To determine baseline variables associated with urgency urinary incontinence (UUI) in women presenting for stress urinary incontinence (SUI) surgery. Methods. Baseline data from two randomized trials enrolling 1,252 women were analyzed: SISTEr (fascial sling versus Burch colposuspension)...

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Main Authors: Leslie M. Rickey, Liyuan Huang, David D. Rahn, Yvonne Hsu, Heather J. Litman, Elizabeth R. Mueller
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Advances in Urology
Online Access:http://dx.doi.org/10.1155/2013/567375
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author Leslie M. Rickey
Liyuan Huang
David D. Rahn
Yvonne Hsu
Heather J. Litman
Elizabeth R. Mueller
author_facet Leslie M. Rickey
Liyuan Huang
David D. Rahn
Yvonne Hsu
Heather J. Litman
Elizabeth R. Mueller
author_sort Leslie M. Rickey
collection DOAJ
description Objective. To determine baseline variables associated with urgency urinary incontinence (UUI) in women presenting for stress urinary incontinence (SUI) surgery. Methods. Baseline data from two randomized trials enrolling 1,252 women were analyzed: SISTEr (fascial sling versus Burch colposuspension) and TOMUS (retropubic versus transobturator midurethral sling). Demographic data, POP-Q measures, and validated measures of symptom severity and quality of life were collected. Charlson Comorbidity Index (CCI) and Patient Health Questionnaire-9 were measured in TOMUS. Multivariate models were constructed with UUI and symptom severity as outcomes. Results. Over two-thirds of subjects reported bothersome UUI at baseline. TOMUS patients with more comorbidities had higher UDI irritative scores (CCI score 0 = 39.4, CCI score 1 = 42.1, and CCI score 2+ = 51.0, P=0.0003), and higher depression scores were associated with more severe UUI. Smoking, parity, prior incontinence surgery/treatment, prolapse stage, and incontinence episode frequency were not independently associated with UUI. Conclusions. There were no modifiable risk factors identified for patient-reported UUI in women presenting for SUI surgery. However, the direct relationships between comorbidity level, depression, and worsening of UUI/urgency symptoms may represent targets for preoperative intervention. Further research is necessary to elucidate the pathophysiologic mechanisms that explain the associations between these medical conditions and bladder function.
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spelling doaj-art-dad59a9670c64170ab31e03ad748878a2025-02-03T06:06:02ZengWileyAdvances in Urology1687-63691687-63772013-01-01201310.1155/2013/567375567375Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence SurgeryLeslie M. Rickey0Liyuan Huang1David D. Rahn2Yvonne Hsu3Heather J. Litman4Elizabeth R. Mueller5Departments of Urology and Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, Female Pelvic Medicine & Reconstructive Surgery, Yale-New Haven Hospital, Yale University, 310 Cedar Street, FMB 329E, New Haven, CT 06519, USANew England Research Institute, Watertown, MA, USAUniversity of Texas Southwestern Medical Center, Dallas, TX, USAUniversity of Utah, Salt Lake City, UT, USABoston Children’s Hospital, Boston, MA, USALoyola University Medical Center, Maywood, IL, USAObjective. To determine baseline variables associated with urgency urinary incontinence (UUI) in women presenting for stress urinary incontinence (SUI) surgery. Methods. Baseline data from two randomized trials enrolling 1,252 women were analyzed: SISTEr (fascial sling versus Burch colposuspension) and TOMUS (retropubic versus transobturator midurethral sling). Demographic data, POP-Q measures, and validated measures of symptom severity and quality of life were collected. Charlson Comorbidity Index (CCI) and Patient Health Questionnaire-9 were measured in TOMUS. Multivariate models were constructed with UUI and symptom severity as outcomes. Results. Over two-thirds of subjects reported bothersome UUI at baseline. TOMUS patients with more comorbidities had higher UDI irritative scores (CCI score 0 = 39.4, CCI score 1 = 42.1, and CCI score 2+ = 51.0, P=0.0003), and higher depression scores were associated with more severe UUI. Smoking, parity, prior incontinence surgery/treatment, prolapse stage, and incontinence episode frequency were not independently associated with UUI. Conclusions. There were no modifiable risk factors identified for patient-reported UUI in women presenting for SUI surgery. However, the direct relationships between comorbidity level, depression, and worsening of UUI/urgency symptoms may represent targets for preoperative intervention. Further research is necessary to elucidate the pathophysiologic mechanisms that explain the associations between these medical conditions and bladder function.http://dx.doi.org/10.1155/2013/567375
spellingShingle Leslie M. Rickey
Liyuan Huang
David D. Rahn
Yvonne Hsu
Heather J. Litman
Elizabeth R. Mueller
Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery
Advances in Urology
title Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery
title_full Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery
title_fullStr Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery
title_full_unstemmed Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery
title_short Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery
title_sort risk factors for urgency incontinence in women undergoing stress urinary incontinence surgery
url http://dx.doi.org/10.1155/2013/567375
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