Influence of Stress Urinary Incontinence and Pelvic Organ Prolapse on Depression, Anxiety, and Insomnia—A Comparative Observational Study

Abstract

Background: Among pelvic floor disorders (PFDs), overactive bladder is a well-recognized condition affecting mental health. The aim of this study was to assess whether there is a correlation between stress urinary incontinence (SUI), pelvic organ prolapse (POP), and mental health in comparison to control subjects and whether objective or subjective aspects of diseases are responsible for the aforementioned symptoms. Methods: 192 patients with SUI, 271 with symptomatic prolapse (>2 in the POPQ scale), and 199 controls without pelvic floor disorders were included in this study. Patients completed questionnaires assessing levels of depression, anxiety, and insomnia. The 1-h pad test and IIQ-7 questionnaires were collected in SUI. The pelvic organ prolapse quantification scale and the POPDI6, UDI6, and CRADI-8 questionnaires were used in POP patients. Results: Higher scores in psychiatric scales were observed in SUI (p < 0.05) and POP (p < 0.05) compared to control. There were no correlations between the objective severity of PFDs and psychological symptoms, while subjective complaints correlated with psychological health. In conclusion, we showed that subjective perceptions of SUI and POP are factors that augment psychiatric symptoms, while objective severity is not correlated with mental status. Conclusions: Our findings suggest that patients with PFDs necessitate multidisciplinary attention, including psychiatric care.

The Influence of Successful Treatment of Stress Urinary Incontinence and Pelvic Organ Prolapse on Depression, Anxiety, and Insomnia—A Prospective Intervention Impact Assessment Study

“…Large-scale Asian cohort studies have further substantiated the link between depression, anxiety, and SUI, identifying SUI as an independent risk factor for these mental health conditions and highlighting its association with significant work impairments [ 25 ]. These findings are consistent with the initial findings of our study published in 2023 [ 8 ], where we demonstrated the adverse impact of SUI by comparing depression and anxiety scales between patients with pelvic floor disorders and healthy individuals.…”

“…Our findings indicate that individuals diagnosed with PFDs exhibit higher levels of severity in these symptoms, as quantitatively assessed using the Center for Epidemiological Studies Depression Scale (CESD), the State-Trait Anxiety Inventory (STAI), and the Insomnia Severity Index (ISI), compared to individuals without pelvic floor pathology. Drawing a parallel to the findings in women during the postpartum period, our study suggests that patients suffering from SUI and POP might also benefit from psychiatric evaluation and care [8].…”

“…Given our prior observations linking psychiatric symptoms mainly to the subjective experience of POP and SUI [ 8 ], we opted to investigate not only changes in mental symptoms post-surgery but also the correlation between improvements in subjective symptoms of SUI and POP, such as LUTS, colorectal symptoms, or prolapse symptoms themselves, with changes in depression, anxiety, and insomnia questionnaires. Correlation analysis of specific problem severities revealed that improvements in prolapse symptoms themselves (assessed in POPDI 6) correlated with enhancements in both anxiety and depression.…”