Lower urinary tract symptoms in women with benign joint hypermobility syndrome: a case–control study

Abstract

Introduction and hypothesis Benign joint hypermobility syndrome (BJHS) is a connective tissue disorder associated with joint hypermobility. BJHS is under-recognised by medical professionals and is poorly managed. The aim of our study was to determine whether lower urinary tract symptoms (LUTS), including urinary incontinence (UI) and anterior compartment prolapse, are more common in women with BJHS than in the normal population.Methods This was a prospective case-control study. Women diagnosed with BJHS according to the Brighton criteria were recruited from a tertiary referral clinic. Controls were recruited from hospital personnel. Both groups completed the King's Health Questionnaire (KHQ) and the Prolapse Quality of Life Questionnaire (P-QoL). Objective assessment of pelvic organ prolapse (POP) was undertaken using the Pelvic Organ Prolapse Quantification (POP-Q) system. Analyses were performed using SPSS version 17.0. The statistical difference was analysed using McNemar's test. Comparison of QoL scores was performed with the Wilcoxon signed-rank test. Results Sixty individuals were recruited and matched with 60 healthy women. The prevalence of UI in those with BJHS was significantly higher than in controls(73.3 % vs. 48.3 %). The impact of UI on QoL was statistically significant in all domains of the KHQ. There was a significant difference between groups in most urinary-specific symptoms of the KHQ. A significant number of women with BJHS suffer from voiding difficulties. Prolapse of the anterior vaginal wall was objectively more severe in those with BJHS. Conclusions Women with BJHS have LUTS and anterior compartment prolapse, which significantly impair their QoL. It is important to identify women who are symptomatic. The addition of a systematic active case-finding approach may be more effective in identifying these cases.

Quality of life prediction in children with joint hypermobility syndrome

“…Lower self‐reported HRQOL when compared with healthy controls has recently been described in both adults and children with EDS‐HT/JHS . Worse HRQOL has been associated with both pain and fatigue in children with JHS.…”

“…Recently, JHS and Ehlers–Danlos Syndrome hypermobile type (EDS‐HT) have been identified by expert consensus as clinically indistinguishable . Extensive evidence of systemic manifestations of EDS‐HT/JHS – including bowel involvement, anxiety, lower urinary tract symptoms, dysautonomia and gastrointestinal involvement – has also been reported, although primarily in adults with JHS. Despite a growing body of literature detailing the symptoms experienced by individuals with JHS, knowledge of the impact of the condition upon an individual's health‐related quality of life (HRQOL) remains limited.…”

Síndrome De Hipermobilidade Articular Nos Pacientes Com Disfunções Do Diafragma Da Pelve: Revisão De Literatura

“…Encontraram maior prevalência de IU naquelas com SHAB (73,3%, n=44), quando comparadas com o grupo controle (48,3%, n=29), sendo que a incontinência urinária de urgência (IUU) foi mais significativa do que a incontinência urinária de esforço (IUE). Importante destacar que, durante análise estatística dos domínios do questionário de qualidade de vida entre os grupos, a frequência, noctúria, urgência, urge incontinência, enurese noturna, incontinência durante relação sexual, infecção do trato urinário e dor na bexiga, apresentaram diferença estatisticamente significativa, com um valor de p<0,05 (20) . Por outro lado, em uma análise da associação entre transtornos do colágeno e POP, dividiram 90 mulheres submetidas à histerectomia, em grupo controle (n=30), grupo com POP (n=30) e grupo com POP/IUE (n=30 (18) .…”

“…O sexo feminino, idade avançada, menopausa e predisposição genética são os principais fatores de risco, podendo incluir ainda a obesidade, gravidez e paridade, ressaltando que os mecanismos relacionados à "falha" do diafragma da pelve ainda não são totalmente compreendidos (12) . Geralmente a SHA se manifesta na infância ou no início da idade adulta, podendo ser um marcador precoce de risco (4) e resultar em alterações do diafragma da pelve em mulheres (20) . Além da identificação dos principais fatores de relação das disfunções do diafragma da pelve com a SHA, o presente estudo identificou a ausência de pesquisas que divulguem sugestões de prevenção.…”

“…A IU é definida como perda involuntária de urina que interfere negativamente na qualidade de vida e chega a apresentar uma prevalência de 12,8% a 46%. Algumas anormalidades gené-ticas intrínsecas na síntese de colágeno, que variam entre as formas mais graves de doenças do tecido conectivo, podem deixar o tecido mais elástico, resultando em problemas no diafragma da pelve (20) . Já a Disfunção Evacuatória Retal, é um termo amplo que engloba a insatisfação do individuo com sua capacidade evacuatória, podendo ter relação com qualquer etiologia inespecífica, inclusive com distúrbios do tecido conectivo que apresenta associação entre a abertura retal e/ou prolapso retal (21) .…”