Mattox T F, Bhatia N N
Department of Obstetrics and Gynecology, Harbor-University of California, Los Angeles 90048, USA.
Am J Obstet Gynecol. 1996 Feb;174(2):646-8. doi: 10.1016/s0002-9378(96)70443-x.
Our purpose was to study the distribution of symptoms and disorders of urinary incontinence or prolapse among white and Hispanic women.
Data were collected for all new patients referred to the urogynecology clinic over a 2-year period. One hundred twenty-one Hispanic and 50 white women consecutively referred to the urogynecology clinic as new patients over 2 years were included in the study. All patients underwent a detailed history and physical examination and multichannel urodynamic studies. Differences between the two groups were analyzed for significant differences by use of demographic data, presenting symptoms, urodynamic profiles, and final diagnosis or disorder.
The symptoms of stress, urge, or mixed incontinence and prolapse were noted in 26%, 18%, 30%, and 14% of white women, respectively, compared with 41%, 9%, 21%, and 26% of Hispanic women (p=0.019). The diagnosis of genuine stress incontinence, motor urge incontinence, mixed incontinence, and pelvic organ prolapse without incontinence was made, respectively, in 16%, 44%, 6%, and 18% of white women versus 30%, 27%, 5%, and 18% of Hispanic women (p=0.33). The nondiagnostic rate after a complete evaluation for both groups was 10%. Hispanic women were of significantly higher gravidity (5.6 vs 3.8, p=0.001) and parity (4.7 vs 3.0, p=0.0006) than white women but were of comparable age. Medical problems and medications were too infrequent to allow meaningful comparison. White women were much more likely to have undergone a hysterectomy (36% vs 11.5%, p=0.0004, 95% confidence interval 1.8 to 10.3).
Although the distribution of presenting symptoms of incontinence differs between Hispanic and white women, the final diagnosis after a complete urogynecologic evaluation was similar. Therefore presenting complaints in patients of different ethnic groups appears to be a poor predictor of the type of incontinence. Hispanic women were of higher gravidity and parity than white women were, but white women were more likely to have undergone a hysterectomy. Because the power of this study was limited by the 50 white women, larger prospective and longitudinal studies are needed to determine the significance of possible difference in etiologic factors.
