Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
Department of Surgery, Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Neurourol Urodyn. 2020 Apr;39(4):1185-1202. doi: 10.1002/nau.24325. Epub 2020 Mar 2.
Although lower urinary tract symptoms (LUTS) may occur at different periods during the life course of women, a little research on LUTS has adopted a life course perspective. The purpose of this conceptual paper is to demonstrate how life course theory and life course epidemiology can be applied to study bladder health and LUTS trajectories. We highlight conceptual work from the Prevention of Lower Urinary Tract Symptoms Research Consortium to enhance the understanding of life course concepts.
Consortium members worked in transdisciplinary teams to generate examples of how life course concepts may be applied to research on bladder health and LUTS in eight prioritized areas: (a) biopsychosocial ecology of stress and brain health; (b) toileting environment, access, habits, and techniques; (c) pregnancy and childbirth; (d) physical health and medical conditions; (e) musculoskeletal health; (f) lifestyle behaviors; (g) infections and microbiome; and (h) hormonal status across the life span.
Life course concepts guided consortium members' conceptualization of how potential risk and protective factors may influence women's health. For example, intrapartum interventions across multiple pregnancies may influence trajectories of bladder health and LUTS, illustrating the principle of life span development. Consortium members also identified and summarized methodologic and practical considerations in designing life course research.
This paper may assist researchers from a variety of disciplines to design and implement research identifying key risk and protective factors for LUTS and bladder health across the life course of women. Results from life course research may inform health promotion programs, policies, and practices.
尽管下尿路症状（LUTS）可能在女性的生命历程中的不同时期出现，但很少有研究采用生命历程视角来研究 LUTS。本文的目的是展示生命历程理论和生命历程流行病学如何应用于研究膀胱健康和 LUTS 轨迹。我们强调了预防下尿路症状研究联合会的概念性工作，以增强对生命历程概念的理解。
联合会成员以跨学科团队的形式合作，生成了如何将生命历程概念应用于研究膀胱健康和 LUTS 的八个优先领域的示例：（a）应激和大脑健康的生物心理社会生态学；（b）如厕环境、通道、习惯和技术；（c）妊娠和分娩；（d）身体健康和医疗状况；（e）肌肉骨骼健康；（f）生活方式行为；（g）感染和微生物组；（h）整个生命周期的激素状态。
生命历程概念指导联合会成员概念化潜在风险和保护因素如何影响女性健康。例如，多次妊娠期间的分娩干预可能会影响膀胱健康和 LUTS 的轨迹，这说明了生命跨度发展的原则。联合会成员还确定并总结了设计生命历程研究的方法学和实际考虑因素。
本文可以帮助来自不同学科的研究人员设计和实施研究，以确定女性生命历程中 LUTS 和膀胱健康的关键风险和保护因素。生命历程研究的结果可以为健康促进计划、政策和实践提供信息。
