Postpartum depression, urge urinary incontinence, and overactive bladder syndrome: is there an association?

Abstract

The purpose of this prospective, cross-sectional study was to determine if there was an association between postpartum depression and symptoms of overactive bladder in postpartum women. At their 6 week postpartum visit, participants completed questionnaires regarding lifestyle, personal health, urinary incontinence, and depression symptoms, including the Urge-Urinary Distress Inventory (URGE-UDI), the Urge-Incontinence Impact Questionnaire (URGE-IIQ), and the Edinburgh Postnatal Depression Scale (EPDS). Past medical history, including obstetric variables, family history, and medications were extracted from the medical record. One hundred patients completed the questionnaires at the University of Michigan Hospital and 46 patients at the University of Virginia Hospital (mean age 29.2+/-6.1 years; 18-47 years) at their postpartum visit (mean time 45.2+/-9.4 days postpartum; 11-79 days). Sixteen percent of the women had depression (EPDS score of >12) or were borderline (EPDS score of 9-12) for postpartum depression. There was no difference in age and race in women with and without depression. Type of delivery, vaginal vs cesarean section did not significantly impact their URGE-UDI or URGE-IIQ score. There was a significant correlation between the URGE-IIQ score and depression (0.24, p=0.003), but not the URGE-UDI score. In this cross-sectional study, we found an association between postpartum depression and symptoms of urge incontinence. Because birth is a predictable event, further studies evaluating the causal relationships and physiologic changes linking depression and incontinence can be studied using this model.

Is well-being associated with lower urinary tract symptoms in patients with stroke?

“…Similar differences were reported in three other studies [6][7][8], while Chiara et al [14] found no differences in depression scores between patients with SUI, UUI or mixed UI. In stroke patients, UUI is more prevalent than SUI [15], whereas nocturia, urgency and increased day-time frequency are the most prevalent and bothersome symptoms [3].…”

“…Previous studies have shown a clear association between LUTS and depression in both genders [5][6][7][8][9][10]. This association has also been found in elderly people [11].…”

Is mode of delivery associated with postpartum depression at 6 weeks: a prospective cohort study

“…Urinary incontinence as a predictor of postpartum depression has received little attention in the literature. Depression and urinary incontinence have only recently been linked in studies of postpartum women 58,59 . In a small study ( n = 149) using the EPDS, Hullfish and colleagues found that urge urinary incontinence was associated with depression at 6 weeks postpartum 58 .…”

“…Depression and urinary incontinence have only recently been linked in studies of postpartum women 58,59 . In a small study ( n = 149) using the EPDS, Hullfish and colleagues found that urge urinary incontinence was associated with depression at 6 weeks postpartum 58 . They postulated that the dysregulation of serotonergic mechanisms alone or together with other neuropathways may explain the potential association of urge incontinence and depression; serotonergic activity enhances bladder storage through the inhibition of central pathways regulating maturation 58 .…”

The role of serotonergic mechanism in the rat prefrontal cortex for controlling the micturition reflex: An in vivo microdialysis study

“…Combined with the working model of the micturition reflex in humans 20 , 5‐HT in the PFC may directly or indirectly regulate the PAG, resulting in the suppression of the micturition reflex. Furthermore, several clinical studies recently reported that abnormal 5‐HT levels in the CNS may cause OAB and urinary incontinence in patients with depression . Duloxetine, a serotonin‐noradrenaline reuptake inhibitor, was identified as one of that antidepressant agents used to effectively treat OAB patients .…”