1 Division of Public Health Sciences, Department of Surgery, and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri.
2 National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.
J Womens Health (Larchmt). 2019 Jun;28(6):827-841. doi: 10.1089/jwh.2018.7364. Epub 2019 May 6.
Little research to date has focused on lower urinary tract symptom (LUTS) prevention and bladder health promotion in women. To address this gap, the Prevention of LUTS Research Consortium developed the following working bladder health definition: "A complete state of physical, mental, and social well-being related to bladder function [that] permits daily activities [and] allows optimal well-being." To begin to inform and quantify this definition, we used data from the Boston Area Community Health Survey, drawing upon its rare collection of information on LUTS and LUTS-specific interference with activities. At baseline, participants reported their frequency of 15 LUTS and interference with 7 activities. Prevalence ratios (PRs) were calculated by generalized linear models with robust variance estimation, adjusting for LUTS risk factors and individual LUTS. Of the 3169 eligible participants, 17.5% reported no LUTS or interference, whereas the remaining 82.5% reported some frequency of LUTS/interference: 15.1% rarely; 21.7% a few times; 22.6% fairly often/usually; and 22.9% almost always. LUTS independently associated with interference were urgency incontinence, any incontinence, urgency, nocturia, perceived frequency, and urinating again after <2 hours (PRs = 1.2-1.5, all < 0.05). Our findings suggest that bladder health exists on a continuum, with approximately one in five women considered to have optimal bladder health (no LUTS/interference), the majority to have intermediate health (LUTS/interference rarely to usually), and a further one in five to have worse or poor health (LUTS/interference almost always). These findings underscore the need for LUTS prevention and bladder health promotion.
目前，针对女性下尿路症状（LUTS）预防和膀胱健康促进的研究甚少。为了弥补这一空白，预防 LUTS 研究联盟提出了以下工作定义：“与膀胱功能相关的身体、心理和社会福祉的完整状态，[能够]进行日常活动，[并]保持最佳健康状态。”为了开始阐明和量化这一定义，我们使用了波士顿地区社区健康调查的数据，该调查罕见地收集了 LUTS 及其对活动的具体干扰的信息。在基线时，参与者报告了他们 15 种 LUTS 的发生频率和 7 种活动的干扰程度。通过广义线性模型和稳健方差估计计算了患病率比（PR），调整了 LUTS 风险因素和个体 LUTS。在 3169 名合格参与者中，有 17.5%的人没有 LUTS 或干扰，而其余 82.5%的人报告了一些 LUTS/干扰的频率：15.1%很少；21.7%几次；22.6%经常/通常；22.9%几乎总是。与干扰独立相关的 LUTS 有急迫性尿失禁、任何类型的尿失禁、急迫性、夜尿、感知的频率以及在<2 小时后再次排尿（PR=1.2-1.5，均<0.05）。我们的研究结果表明，膀胱健康是一个连续体，大约五分之一的女性被认为具有最佳的膀胱健康（没有 LUTS/干扰），大多数女性具有中等健康水平（LUTS/干扰很少到通常），还有五分之一的女性健康状况更差或不佳（LUTS/干扰几乎总是）。这些发现强调了预防 LUTS 和促进膀胱健康的必要性。
