Division of Public Health Sciences, Department of Surgery; Department of Obstetrics and Gynecology; and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri.
Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
J Urol. 2022 May;207(5):1086-1095. doi: 10.1097/JU.0000000000002393. Epub 2021 Dec 30.
Our goal was to describe changes in bladder health, defined as "a complete state of physical, mental, and social well-being related to bladder function that permits daily activities, adapts to short-term stressors, and allows optimal well-being," in women over time.
We used data on 15 lower urinary tract symptoms (LUTS) and interference from urinary experiences assessed at the baseline and 5-year followup interviews of the BACH (Boston Area Community Health) Survey to estimate changes in bladder health over time in women. Associations between baseline and followup bladder health (defined as the maximum frequency of LUTS or interference at each time point) were calculated by ordinal logistic regression and generalized linear models.
A total of 2,526 women provided complete information on bladder health at baseline and followup. Over the 5-year followup, 6.5% of women maintained optimal bladder health (no LUTS or interference), 33.6% developed worse bladder health (including 10.4% who transitioned from optimal to less than optimal health), 31.4% maintained their less than optimal bladder health status and 28.7% improved. Despite these changes, women with poorer bladder health at baseline were still more likely to have poorer bladder health 5 years later (eg multivariable-adjusted relative risk=3.27, 95% confidence interval: 2.49-4.29 for severe LUTS/interference at followup among those with severe LUTS/interference at baseline).
Findings from our large secondary analysis of BACH Survey data suggest considerable variability in bladder health over time, and underscore the importance of bladder health promotion to prevent the initial onset and progression of poor bladder health in women.
本研究旨在描述女性的膀胱健康状况随时间的变化。我们将膀胱健康定义为“与膀胱功能相关的一种完全的身体、心理和社会福祉状态，这种状态允许日常活动，适应短期压力源，并能达到最佳健康状态”。
我们使用了波士顿地区社区健康调查（BACH）的基线和 5 年随访访谈中对 15 种下尿路症状（LUTS）和尿失禁相关困扰的评估数据，来估计女性膀胱健康状况随时间的变化。通过有序逻辑回归和广义线性模型计算基线和随访时膀胱健康状况（定义为每个时间点 LUTS 或干扰的最大频率）之间的关联。
共有 2526 名女性提供了基线和随访时完整的膀胱健康信息。在 5 年的随访期间，6.5%的女性保持了最佳的膀胱健康状态（无 LUTS 或干扰），33.6%的女性出现了更差的膀胱健康状态（包括 10.4%从最佳状态转为较差状态），31.4%的女性保持了较差的膀胱健康状态，28.7%的女性得到了改善。尽管存在这些变化，但基线时膀胱健康状况较差的女性在 5 年后仍更有可能出现较差的膀胱健康状况（例如，在基线时有严重 LUTS/干扰的女性，在随访时有严重 LUTS/干扰的多变量调整相对风险为 3.27，95%置信区间为 2.49-4.29）。
我们对 BACH 调查数据进行的大型二次分析结果表明，女性的膀胱健康状况随时间有很大的变化，这突显了促进膀胱健康的重要性，以预防女性膀胱健康状况的初始发生和恶化。
