stres, urge ve mikst tip üriner inkontinans risk faktörleri

Abstract

Amaç: Üriner inkontinas tipleri ile ilişkili risk faktörlerinin belirlenmesi bu çalışmada amaçlanmıştır. Gereç ve Yöntemler: Bu kesitsel çalışma Eylül 2013 ile Temmuz 2014 tarihleri arasında yapılmıştır. Çalışmaya 1459 hasta katılmıştır. Bu hastalardan 958 inde idrar kaçırıyorken, 501 i idrar kaçırmıyordu. Üriner inkontinans tanısında ICIQ-SF (International Consultation on Incontinence Questionnaire Short Form)’un Türkçe versiyonu ile ürojinekolojik ve pelvik muayene kullanıldı. Hastaların ayrıntılı tıbbi öyküleri alındı. Kategorik değişkenler Pearson’s Ki-kare testi kullanılarak değerlendirildi. Sürekli değişkenleri analiz etmek için Tek Yönlü Varyans Analizi ve Kruskall-Wallis testleri kullanılmıştır. İstatistiksel olarak anlamlı üriner inkontinans ile ilişkili risk faktörlerini belirlemek için Multiple lojistik regresyon analizi kullanılmıştır. Bulgular: Hikayesinde >4000 gr doğum öyküsü olması, erken menarş, menapoz, konstipasyon, kahve tüketimi, astım, lumbal disk hernisi, aile öyküsü ve tekrarlayan üriner enfeksiyon tüm üriner inkontinans tipleri ile ilişkili bulundu. Evde doğum öyküsü, stres ve urge inkontinans açısından artmış risk faktörüdür. Sistosel ve rektosel ise hem stres hem de mikst tip üriner inkontinans için artmış risk faktörüdür. Hormon replasman tedavisi alan ve cuff prolapsusu olan hastalarda urge üriner inkontinans riskinin arttığı gösterilmiştir. Yüksek beden kitle indeksi ise mikst tip üriner inkontinans için spesifik risk faktörü olarak gösterildi. Sonuç: Risk faktörlerinin ve yüksek riskli kadınların belirlenmesi, üriner inkontinans için önleyici tıbbi yaklaşımların geliştirilmesi için çok önemlidir.

Keywords

• Üriner inkontinans
• stres üriner inkontinans
• urge üriner inkontinans
• üriner inkontinans risk faktörleri

RISK FACTORS FOR STRESS, URGE, AND MIXED URINARY INCONTINENCE

Abstract

Objective: The aim of the study was to determine the risk factors associated with specific subtypes of urinary incontinence (UI). Materials and Methods: This cross-sectional study was conducted between September 2013 and July 2014. There were 1459 patients included in our study. Of these, 958 women were incontinent, and 501 were continent. The Turkish version of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), urogynecologic and pelvic examination were used for UI diagnosis. Patients' detailed medical histories were obtained. Categorical variables were evaluated using Pearson’s Chi-squared test. One-way Analysis of Variance and Kruskall-Wallis tests were used to analyze continous variables. Multiple logistic regression analysis was used to obtain statistically significant UI-associated risk factors. Results: A history of giving birth to a baby weighing >4000 gr, early age at menarche, menopause, constipation, coffee consumption, asthma, lumbal disc hernia, family history, and recurrent urinary infections were associated with all types of UI. Delivery at home increased the risk of both stress and urge urinary incontinence (SUI and UUI, respectively). Cystocele and rectocele increased the risk of both SUI and mixed urinary incontinence (MUI). The risk of UUI was shown to increase in women who were receiving hormone replacement therapy and who had cuff prolapse. High body mass index was indicated as a specific risk factor for MUI. Conclusions: Determining risk factors and high risk women is very important for development of preventative medical approaches for UI.

Keywords

• stress urinary incontinence
• urge urinary incontinence
• urinary incontinence risk factors
• mixed urinary incontinence

References

1. 1. Beji NK, Ozbas A, Aslan E, Bilgic D, Erkan HA. Overview of the social impact of urinary incontinence with a focus on Turkish women. Urologic Nursing. 2010;30(6):327.
2. 2. Filiz TM, Uludag C, Cinar N, Gorpelioglu S, Topsever P. Risk factors for urinary incontinence in Turkish women. A cross-sectional study. Saudi medical journal. 2006;27(11):1688-92.
3. 3. Dursun P, Dogan NU, Kolusari A, Dogan S, Ugur MG, Komurcu O, et al. Differences in geographical distribution and risk factors for urinary incontinence in Turkey: analysis of 6,473 women. Urologia internationalis. 2013;92(2):209-14.
4. 4. Norton P, Brubaker L. Urinary incontinence in women. The Lancet. 2006;367(9504):57-67.
5. 5. Walker GJ, Gunasekera P. Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors. International urogynecology journal. 2011;22(2):127-35.
6. 6. Chiu A-F, Huang M-H, Wang C-C, Kuo H-C. Prevalence and factors associated with overactive bladder and urinary incontinence in community-dwelling Taiwanese. Tzu Chi Medical Journal. 2012;24(2):56-60.
7. 7. Rortveit G, Hannestad YS, Daltveit AK, Hunskaar S. Age‐and Type‐Dependent Effects of Parity on Urinary Incontinence: The Norwegian EPINCONT Study. Obstetrics & Gynecology. 2001;98(6):1004-10.
8. 8. Cetinel B, Ozkan B, Can G. The validation study of ICIQ-SF Turkish version. Turk J Urol. 2004;30(3):332-8.

9. 9. Barghouti FF, Yasein NA, Jaber RM, Hatamleh LN, Takruri AH. Prevalence and risk factors of urinary incontinence among Jordanian women: impact on their life. Health care for women international. 2013;34(11):1015-23.
10. 10. Cerruto MA, D’Elia C, Aloisi A, Fabrello M, Artibani W. Prevalence, incidence and obstetric factors’ impact on female urinary incontinence in Europe: a systematic review. Urologia internationalis. 2012;90(1):1-9.
11. 11. Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG: An International Journal of Obstetrics & Gynaecology. 2003;110(3):247-54.
12. 12. Nygaard IE, Heit M. Stress urinary incontinence. Obstetrics & Gynecology. 2004;104(3):607-20.
13. 13. Hunskaar S. A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women. Neurourology and urodynamics. 2008;27(8):749-57.
14. 14. Liu B, Wang L, Huang S-S, Wu Q, Wu D-L. Prevalence and risk factors of urinary incontinence among Chinese women in Shanghai. International journal of clinical and experimental medicine. 2014;7(3):686.
15. 15. Kirss F, Lang K, Toompere K, Veerus P. Prevalence and risk factors of urinary incontinence among Estonian postmenopausal women. Springerplus. 2013;2(1):1-7.
16. 16. Parazzini F, Chiaffarino F, Lavezzari M, Giambanco V. Risk factors for stress, urge or mixed urinary incontinence in Italy. BJOG: An International Journal of Obstetrics & Gynaecology. 2003;110(10):927-33.
17. 17. Persson J, Wølner-Hanssen P, Rydhstroem H. Obstetric Risk Factors for Stress Urinary Incontinence: A Population‐Based Study. Obstetrics & Gynecology. 2000;96(3):440-5.
18. 18. Rekers H, Drogendijk A, Valkenburg H, Riphagen F. The menopause, urinary incontinence and other symptoms of the genito-urinary tract. Maturitas. 1992;15(2):101-11.
19. 19. Seshan V, Muliira JK. Self-reported urinary incontinence and factors associated with symptom severity in community dwelling adult women: implications for women’s health promotion. BMC women's health. 2013;13(1):1.
20. 20. Townsend MK, Curhan GC, Resnick NM, Grodstein F. Postmenopausal hormone therapy and incident urinary incontinence in middle-aged women. American journal of obstetrics and gynecology. 2009;200(1):86. e1-. e5.
21. 21. Grodstein F, Lifford K, Resnick NM, Curhan GC. Postmenopausal hormone therapy and risk of developing urinary incontinence. Obstetrics & Gynecology. 2004;103(2):254-60.
22. 22. Moehrer B, Hextall A, Jackson S. Oestrogens for urinary incontinence in women. The Cochrane Library. 2003.
23. 23. Brown JS, Sawaya G, Thom DH, Grady D. Hysterectomy and urinary incontinence: a systematic review. The Lancet. 2000;356(9229):535-9.
24. 24. Horng SS, Huang N, Wu SI, Fang YT, Chou YJ, Chou P. The epidemiology of urinary incontinence and it's influence on quality of life in Taiwanese middle‐aged women. Neurourology and urodynamics. 2013;32(4):371-6.
25. 25. Tozun M, Ayranci U, Unsal A. Prevalence of urinary incontinence among women and its impact on quality of life in a semirural area of Western Turkey. Gynecologic and obstetric investigation. 2009;67(4):241-9.
26. 26. Timur-Taşhan S, Beji NK, Aslan E, Yalçin Ö. Determining lower urinary tract symptoms and associated risk factors in young women. International Journal of Gynecology & Obstetrics. 2012;118(1):27-30.
27. 27. Altintas R, Beytur A, Oguz F, Tasdemir C, Kati B, Cimen S, et al. Assessment of urinary incontinence in the women in Eastern Turkey. International urogynecology journal. 2013;24(11):1977-82.
28. 28. Bai S, Jeon M, Kim J, Chung K, Kim S, Park K. Relationship between stress urinary incontinence and pelvic organ prolapse. International urogynecology journal. 2002;13(4):256-60.
29. 29. Long CY, Hsu SC, Sun DJ, Chen CC, Tsai EM, Su JH. Abnormal clinical and urodynamic findings in women with severe genitourinary prolapse. Kaohsiung J Med Sci. 2002;18(12):593-7.
30. 30. Al-Badr A, Brasha H, Al-Raddadi R, Noorwali F, Ross S. Prevalence of urinary incontinence among Saudi women. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2012;117(2):160-3.