The finding that maximal urethral closure pressure and not urethral support is the factor most strongly associated with stress incontinence implies that improving urethral function may have therapeutic promise.

Purpose-To examine racial differences in urinary incontinence (UI) prevalence, frequency, quantity, type, and risk factors in a population-based sample of community-dwelling black and white women.Materials and Methods-Women ages 35-64 were sampled from telephone records from three southeast Michigan counties. Women self-identifying as black or white race completed a telephone interview that assessed demographics, health history, lifestyle factors, and UI experience. Statistical analysis included descriptive statistics, factor analysis, and multivariable logistic regression to determine adjusted odds of UI. Estimates were weighted to reflect probability and nonresponse characteristics of the sample and to increase generalizability of the findings.Results-Interviews were completed by 1,922 black and 892 white women (response rate=69%). The overall prevalence of UI was 26.5%. By race, UI prevalence was 14.6% for black women and 33.1% for white women (p<0.001). Among incontinent women, there was no difference by race in the frequency of UI; however, black women reported more urine loss per episode (p<0.05). A larger proportion of white women with incontinence (39.2%) reported symptoms of pure stress incontinence compared to black women (25.0%), whereas a larger proportion of black women (23.8%) reported symptoms of pure urge incontinence compared to white women (11.0%). Risk factors for UI were generally similar for white and black women.Conclusions-In this population-based study we observed racial differences in prevalence, quantity, and type of UI. Frequency of and risk factors for UI were generally similar for white and black women.

Implementation of ERAS protocols in gynecologic surgery was associated with a substantial decrease in intravenous fluids and morphine administration coupled with reduction in length of stay for open procedures combined with improved patient satisfaction and decreased hospital costs.

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