Department of Urology, University of Kansas Health System, Kansas City, Kansas.
Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee.
Neurourol Urodyn. 2020 Jun;39(5):1430-1436. doi: 10.1002/nau.24368. Epub 2020 Apr 23.
The aim of this study is to identify factors associated with urinary incontinence (UI) in a community sample of young nulligravid women.
This was a secondary analysis from a cross-sectional survey-based study of cisgender women aged 18 to 25 years recruited through a national registry of research volunteers. Participants completed validated questionnaires assessing toileting behaviors, lower urinary tract symptoms (LUTS), and bowel symptoms. Women were excluded from analysis if currently pregnant, any prior pregnancy, cystectomy, or any neurologic disease including spinal cord injury, stroke, or multiple sclerosis. Analyses determined the prevalence of symptoms and evaluated candidate risk factors for UI.
Final analyses included 964 women (mean age, 22.6 ± 2.0). Monthly UI was identified in 295 (30.6%) subjects, with mixed UI being the most common (56.9%; n = 168). Seventy-two women (7.4%) reported fecal incontinence (FI) and 24 (3.5%) women reported both UI and FI. After multivariable regression modeling, UI was associated with an intermittent urine stream and the delayed voiding toileting behavior subscale.
UI in this cohort of young nulliparous women was highly prevalent and warrants further study as to the cause. Therapeutic guidelines to prevent UI and LUTS may need to be adjusted by targeting populations earlier than traditionally considered.
本研究旨在确定年轻初产妇人群中与尿失禁(UI)相关的因素。
这是一项基于横断面调查的研究的二次分析,研究对象为通过全国研究志愿者登记处招募的 18 至 25 岁的顺性别女性。参与者完成了评估排尿行为、下尿路症状(LUTS)和肠道症状的有效问卷。如果当前怀孕、有过妊娠史、行膀胱切除术或患有任何神经疾病(包括脊髓损伤、中风或多发性硬化症),则将女性排除在分析之外。分析确定了症状的患病率,并评估了 UI 的候选危险因素。
最终分析纳入了 964 名女性(平均年龄 22.6±2.0)。964 名女性中有 295 名(30.6%)存在每月尿失禁,其中混合性尿失禁最为常见(56.9%,n=168)。72 名女性(7.4%)报告存在粪便失禁,24 名女性(3.5%)报告同时存在 UI 和 FI。多变量回归模型分析后,UI 与间歇性尿流和延迟排尿行为子量表相关。
在本年轻初产妇队列中,UI 的患病率很高,需要进一步研究其病因。预防 UI 和 LUTS 的治疗指南可能需要通过针对比传统上认为更早的人群来进行调整。