Department of Urology, Massachusetts General Hospital, Boston, Massachusetts; Institute of Urology, Keck School of Medicine of University of Southern California (EIK), Los Angeles, California.
Department of Urology, Massachusetts General Hospital, Boston, Massachusetts; Institute of Urology, Keck School of Medicine of University of Southern California (EIK), Los Angeles, California.
J Urol. 2018 Feb;199(2):522-527. doi: 10.1016/j.juro.2017.08.093. Epub 2017 Aug 26.
Pelvic floor integrity is an important predictor of stress urinary incontinence. Androgen receptors have been found in the pelvic floor musculature and fascia, and testosterone administration has been shown to increase levator ani hypertrophy and improve stress incontinence in a rodent model. We examined the relationship between serum total testosterone levels and self-reported urinary incontinence in women.
We included women older than 20 years in the 2012 NHANES (National Health and Nutrition Examination Survey) cycle who underwent serum total testosterone measurement and answered self-reported urinary incontinence questions. A weighted, multivariate logistic regression model was used to determine the association between incontinence and serum testosterone levels after adjusting for age, body mass index, diabetes, race, parity, menopause and time of venipuncture.
A total of 2,321 women were included in analysis, of whom 37.5% had stress incontinence, 29.8% had urge incontinence and 16.4% had mixed incontinence. Women in the lowest quartile of serum testosterone were more likely to complain of stress and mixed incontinence (OR 1.45, 95% CI 1.03-2.12 and OR 1.68, 95% CI 1.23-2.22, respectively). No association was noted between serum testosterone levels and urge incontinence.
Low serum testosterone is associated with an increased likelihood of stress and mixed incontinence in women. Given the role of pelvic musculature in maintaining urethral support and the anabolic effect of androgens on skeletal muscle, a physiological mechanism for this relationship can be proposed and further evaluated in prospective and translational studies.
盆底完整性是压力性尿失禁的重要预测指标。已在盆底肌肉和筋膜中发现雄激素受体，并且已证明睾丸酮给药可增加提肛肌肥大并改善啮齿动物模型中的压力性尿失禁。我们研究了血清总睾丸酮水平与女性自我报告的尿失禁之间的关系。
我们纳入了 2012 年 NHANES（国家健康和营养检查调查）周期中年龄大于 20 岁的女性，她们接受了血清总睾丸酮测量并回答了自我报告的尿失禁问题。使用加权多变量逻辑回归模型，在调整年龄，体重指数，糖尿病，种族，产次，绝经和静脉穿刺时间后，确定失禁与血清睾丸酮水平之间的关联。
共有 2321 名女性纳入分析，其中 37.5％有压力性尿失禁，29.8％有急迫性尿失禁，16.4％有混合性尿失禁。血清睾丸酮最低四分位数的女性更有可能抱怨压力性和混合性尿失禁（OR 1.45，95％CI 1.03-2.12 和 OR 1.68，95％CI 1.23-2.22）。血清睾丸酮水平与急迫性尿失禁之间没有关联。
低血清睾丸酮与女性压力性和混合性尿失禁的可能性增加有关。鉴于盆底肌肉在维持尿道支撑中的作用以及雄激素对骨骼肌的合成代谢作用，可以提出这种关系的生理机制，并在前瞻性和转化研究中进一步评估。
