Refractory urgency urinary incontinence treatment in women: impact of age on outcomes and complications

Komesu, Yuko M.; Amundsen, Cindy L.; Richter, Holly E.; Erickson, Stephen W.; Ackenbom, Mary F.; Andy, Uduak U.; Albo, Michael; Gregory, W. Thomas; Wallace, Dennis; Varner, R. Edward; Wilson, Timothy H.; Lloyd, L. Keith; Markland, Alayne D.; Holley, Robert L.; Ballard, Alicia; Ellington, David R.; Goode, Patricia S.; Sung, Vivian W.; Rardin, Charles R.; Hampton, Brittany Star; Korbly, Nicole B.; Wohlrab, Kyle; Carberry, Cassandra; Lukacz, Emily S.; Nager, Charles W.; Menefee, Shawn A.; Tan-Kim, Jasmine; Luber, Karl M.; Diwadkar, Gouri B.; Dyer, Keisha Y.; Nguyen, John N.; Jakus-Walman, Sharon; Gill, Bradley C.; Barber, Matthew D.; Vasavada, Sandip P.; Paraíso, Marie Fidela R.; Walters, Mark D.; Unger, Cécile A.; Ridgeway, Beri; Kawasaki, Amie; Siddiqui, Nazema Y.; Visco, Anthony G.; Weidner, Alison C.; Edwards, S. Renee; Denman, Mary Anna; Sajadi, Kamran P.; Rogers, Rebecca G.; Dunivan, Gena; Jeppson, Peter C.; Cichowski, Sara; Arya, Lily A.; Smith, Ariana L.; Bonidie, Michael; Chermansky, Christopher; Moalli, Pamela; Shepherd, Jonathan; Sutkin, Gary; Zyczynski, Halina M.

doi:10.1016/j.ajog.2017.10.006

Cited by 29 publications

(21 citation statements)

References 28 publications

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“…Young women are more likely to control UI, improve symptoms quickly, and have fewer urinary tract infections. 33 In our study, it was also found that the severity of SUI and UUI increased with age in people over 60 years old (29.4% vs 35.0% vs 45.3%, 25.5% vs 48.6% vs 67.0%). Based on the findings from previous studies, the occurrence of UI in the marital status of elderly women ( P = 0.001) had statistical significance.…”

Section: Discussionsupporting

confidence: 74%

Relationship Between Blood Glucose and Hemoglobin A1c Levels and Urinary Incontinence in Women

Liu

Mao

et al. 2021

IJGM

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Objective The purpose of this study was to evaluate the associations between blood glucose and hemoglobin A1c (HbA1c) levels with the degree of stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) in women. Methods We conducted a cross-sectional study of female participants in the National Health and Nutrition Examination Survey (NHANES) database between 2007 and 2012. Univariate and multivariate logistic regressions were used to assess the relationship between blood glucose and HbA1c levels and the degree of SUI and UUI. Results A total of 3821 participants were enrolled in the study, of whom 2421 (63.4%) had no SUI, 1133 (29.7%) had monthly SUI, 267 (7.0%) had weekly SUI; 2883 (75.5%) had no UUI, 735 (19.2%) had monthly UUI, 203 (5.3%) had weekly UUI. The levels of blood glucose and HbA1c were positively correlated with SUI and UUI, and increased with increasing degree of UUI. Multivariate logistic regression showed that there was a positive association between blood HbA1c level and degree of SUI. Conclusion Our study found that blood glucose and HbA1c levels can be used as indicators of SUI and UUI severity in women.

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Section: Discussionsupporting

confidence: 74%

Relationship Between Blood Glucose and Hemoglobin A1c Levels and Urinary Incontinence in Women

Liu

Mao

et al. 2021

IJGM

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“…A secondary analysis of the Refractory Overactive Bladder: Sacral Neuromodulation vs Botulinum Toxin Assessment (ROSETTA) study did not evaluate frailty, but did compare women <65 and ≥65 years randomized with sacral neuromodulation or onabotulinumtoxinA. The study found that women in the younger age group experienced greater rates of continence and symptom improvement with fewer urinary tract infections; however, women in both age groups demonstrated benefits in reduction in urgency urinary incontinence episodes with similar rates of adverse events and improvement in quality of life . While this study reported decreased efficacy in older adults compared with younger adults, older adults still demonstrated symptom improvement with both types of third‐line therapies.…”

Section: Discussionmentioning

confidence: 99%

The impact of frailty on treatment for overactive bladder in older adults

Suskind

Kowalik

Quanstrom

et al. 2019

Neurourology and Urodynamics

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Aims: To examine the impact of frailty on treatment outcomes for overactive bladder (OAB) in older adults starting pharmacotherapy, onabotulinumtoximA, and sacral neuromodulation. Methods: This is a prospective study of men and women age ≥60 years starting pharmacotherapy, onabotulinumtoxinA, or sacral neuromodulation. Subjects were administered questionnaires at baseline and again at 1- and 3-months. Frailty was assessed at baseline using the timed up and go test (TUGT), whereby a TUGT time of ≥12 seconds was considered to be slow, or frail. Response to treatment was assessed using the overactive bladder symptom score (OABSS) and the OAB-q SF (both Bother and HRQOL subscales). Information on side effects/adverse events was also collected. Mixed effects linear modeling was used to model changes in outcomes over time both within and between groups. Results: A total of 45 subjects enrolled in the study, 40% (N=18) of whom had a TUGT ≥12 seconds. Both TUGT groups demonstrated improvement in OAB symptoms over time and there were no statistically significant differences in these responses per group (all p-values >0.05). Similar trends were found for both OAB-q SF Bother and OAB-q SF HRQOL questionnaire responses. Side effects and adverse events were not significantly different between groups (all p’s >0.05). Conclusions: Adults ≥60 years of age starting second- and third-line treatments for OAB, regardless of TUGT time, demonstrated improvement in OAB symptoms at 3 months. These findings suggest that frail older adults may receive comparable benefit and similar rates of side effects compared to less frail older individuals.

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“…There were 20,437 female participants from NHANES between 2007 and 2014. The exclusion criteria followed in this study were as follows: (1) with no incomplete UUI survey or unknown UUI; (2) with no PFCs data; (3) unknown BMI; (4) unknown creatinine (Figure 1).…”

Section: Study Populationmentioning

confidence: 99%

Effect of polyfluoroalkyl chemicals on the occurrence of urge urinary incontinence: a population-based study

Cui

Zhao

Chu

et al. 2021

Therapeutic Advances in Urology

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Background: The artificial fluorinated group of compounds polyfluoroalkyl chemicals (PFCs) has been applied extensively in daily life for decades, and is present in food, drinking water, and indoor dust. The nephrotoxicity of PFCs has been widely studied for its characteristics of being mainly excreted through passing urine and affecting urodynamics. This work aimed to investigate the relationship between PFCs and the occurrence of urge urinary incontinence (UUI) in the United States (US) population. Methods: There were 3157 eligible female participants retrieved from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2014. A logistic regression model was used to examine the relationship between UUI and eight kinds of PFCs. The dose–response relationship was investigated through restricted cubic spline analysis in this retrospective study. Results: Of the 3157 eligible female participants, 913 self-reported a history of UUI. Total PFCs, perfluorohexane sulfonic acid (PFHS), 2-(N-methyl-perfluorooctane sulfonamido) acetate (MPAH), and perfluorononanoic acid (PFNA) correlated positively with the occurrence of UUI after adjusting for age, race, education, vigorous recreational activities, hypertension, diabetes, body mass index (BMI), creatinine, and estimated glomerular filtration rate (eGFR). Based on the results of sub-group analysis, the increasing tertiles contained odds ratios [OR; 95% confidence intervals (CI)] of 1.25 (95% CI, 1.03–1.51, p = 0.026) and 1.56 (95% CI, 1.29–1.89, p < 0.001) for total PFCs compared with the lowest tertile. The OR for PFHS, MPAH, and PFNA were 1.75, 1.71, and 1.41 respectively, in the highest tertile. Conclusion: This study investigated the relationship between PFCs and UUI in female and found total PFCs, PFHS, MPAH, and PFNA were positively correlated with the risk of UUI. The results will contribute to developing individualized treatment for female patients suffering UUI.

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Refractory urgency urinary incontinence treatment in women: impact of age on outcomes and complications

Abstract: Younger women experienced greater absolute continence, symptom improvement, and fewer urinary tract infections; both older and younger women had beneficial urgency urinary incontinence episode reduction, similar rates of other treatment adverse events, and improved quality of life.

Cited by 29 publications

References 28 publications

Relationship Between Blood Glucose and Hemoglobin A1c Levels and Urinary Incontinence in Women

Relationship Between Blood Glucose and Hemoglobin A1c Levels and Urinary Incontinence in Women

The impact of frailty on treatment for overactive bladder in older adults

Effect of polyfluoroalkyl chemicals on the occurrence of urge urinary incontinence: a population-based study

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