Urinary Incontinence

Pelvic Floor Muscle Training Using the Perifit Device for the Treatment of Urinary Incontinence: A Pragmatic Trial Using Real-World Data.

There is a need for home-based alternatives for women to self-manage urinary incontinence (UI). Using a real-world data approach, the aim of this analysis was to evaluate whether training with the Perifit device was effective in reducing UI symptoms.

Association between Sitting Time and Urinary Incontinence in the US population: Data from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2018.

Urinary incontinence (UI) is a common health problem that affects the quality of life and health of millions of people in the United States (US). We aimed to investigate the association between sitting time and UI symptoms in the US population.

Joint effect of physical activity and sedentary behavior with the female urinary incontinence: an analysis of NHANES 2011-2016.

Our study aimed to assess the independent and joint effects of leisure-time physical activity and sedentary behavior with urinary incontinence (UI).

Data were obtained from the National Health and Nutrition Examination Survey 2011-2016.

Urinary microbiome community types associated with urinary incontinence severity in women

Background Urinary microbiome (urobiome) studies have previously reported on specific taxa and community differences in women with mixed urinary incontinence compared with controls. Therefore, a hypothesis was made that higher urinary and vaginal microbiome diversity would be associated with increased urinary incontinence severity.

Objective This study aimed to test whether specific urinary or vaginal microbiome community types are associated with urinary incontinence severity in a population of women with mixed urinary incontinence.

Study Design This planned secondary, cross-sectional analysis evaluated associations between the urinary and vaginal microbiomes and urinary incontinence severity in a subset of Effects of Surgical Treatment Enhanced With Exercise for Mixed Urinary Incontinence trial participants with urinary incontinence. Incontinence severity was measured using bladder diaries and Urinary Distress Inventory questionnaires collected at baseline. Catheterized urine samples and vaginal swabs were concurrently collected before treatment at baseline to assess the urinary and vaginal microbiomes. Of note, 16S rRNA V4 to V6 variable regions were sequenced, characterizing bacterial taxa to the genus level using the DADA2 pipeline and SILVA database. Using Dirichlet multinomial mixtures methods, samples were clustered into community types based on core taxa. Associations between community types and severity measures (Urinary Distress Inventory total scores, Urinary Distress Inventory subscale scores, and the number of urinary incontinence episodes [total, urgency, and stress] from the bladder diary) were evaluated using linear regression models adjusted for age and body mass index. In addition, alpha diversity measures for richness (total taxa numbers) and evenness (proportional distribution of taxa abundance) were analyzed for associations with urinary incontinence episodes and community type.

Results Overall, 6 urinary microbiome community types were identified, characterized by varying levels of common genera (Lactobacillus, Gardnerella, Prevotella, Tepidimonas, Acidovorax, Escherichia, and others). The analysis of urinary incontinence severity in 126 participants with mixed urinary incontinence identified a Lactobacillus-dominated reference group with the highest abundance of Lactobacillus (mean relative abundance of 76%). A community characterized by fewer Lactobacilli (mean relative abundance of 19%) and greater alpha diversity was associated with higher total urinary incontinence episodes (2.67 daily leaks; 95% confidence interval, 0.76–4.59; P=.007) and urgency urinary incontinence episodes (1.75 daily leaks; 95% confidence interval, 0.24–3.27; P=.02) than the reference group. No significant association was observed between community type and stress urinary incontinence episodes or Urogenital Distress Inventory total or subscores. The composition of vaginal community types and urinary community types were similar but composed of slightly different bacterial taxa. Vaginal community types were not associated with urinary incontinence severity, as measured by bladder diary or Urogenital Distress Inventory total and subscale scores. Alpha diversity indicated that greater sample richness was associated with more incontinence episodes (observed genera P=.01) in urine. Measures of evenness (Shannon and Pielou) were not associated with incontinence severity in the urinary or vaginal microbiomes.

Conclusion In the urobiome of women with mixed urinary incontinence, a community type with fewer Lactobacilli and more diverse bacteria was associated with more severe urinary incontinence episodes (total and urgency) compared with a community type with high predominance of a single genus, Lactobacillus. Whether mixed urinary incontinence severity is due to lesser predominance of Lactobacillus, greater presence of other non–Lactobacillus genera, or the complement of bacteria consisting of urobiome community types remains to be determined.

Megan U. Carnes PhD,1 Nazema Y. Siddiqui MD, MHSc,2 Lisa Karstens PhD,3 Marie G. Gantz PhD,1 Darrell L. Dinwiddie PhD,4 Vivian W. Sung MD, MPH,5 Megan Bradley MD,7 Linda Brubaker MD,8 Cecile A. Ferrando MD, MPH,9 Donna Mazloomdoost MD,10 Holly E. Richter PhD, MD,11 Rebecca G. Rogers MD,12 Ariana L. Smith MD,13 Yuko M. Komesu MD,13 On behalf of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network

  1. Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC
  2. Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Duke University, Durham, NC
  3. Division of Bioinformatics and Computational Biomedicine; Division of Urogynecology, Oregon Health & Science University, Portland, OR
  4. Division of Genetics, Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM
  5. Division of Urogynecology, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI
  6. Division of Urogynecology, Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA
  7. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, San Diego, CA
  8. Center for Urogynecology and Pelvic Reconstructive Surgery, Women’s Health Institute, Cleveland Clinic, Cleveland, OH
  9. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
  10. Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL
  11. Division of Urology, Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY
  12. Division of Urology, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
  13. Division of Urogynecology, Department of Obstetrics and Gynecology, University of New Mexico Health Sciences and Services Building, Albuquerque, NM
Source: Carnes MU, Siddiqui NY, Karstens L et al. Urinary microbiome community types associated with urinary incontinence severity in women. American Journal of Obstetrics and Gynecology. 2024. 230, 3, 344.e1-344.e20.

Urinary incontinence increases risk of post-partum depression: systematic review and meta-analysis.

Postpartum depression (PPD) is one of the most common complications after childbearing. Urinary incontinence (UI) is a frequent symptom during pregnancy and the postnatal period, often being the first time that women suffer from it.

Postoperative Complications After Sling Operations for Incontinence: Is Race a Factor?

Racial and ethnic disparities exist in urogynecologic surgery; however, literature identifying specific disparities after sling operations for stress incontinence are limited.

The objective of this study was to evaluate racial and ethnic disparities in surgical complications within 30 days of midurethral sling operations.

Predictors of Care-Seeking Behavior for Treatment of Urinary Incontinence in Women.

Urinary incontinence (UI) is a common and treatable medical condition among women, but only approximately one third of women seek care.

The objective of this study was to determine factors associated with care-seeking behavior in women with UI.

The minimal important difference of patient-reported outcome measures related to female urinary incontinence: a systematic review.

The minimal important difference is a valuable metric in ascertaining the clinical relevance of a treatment, offering valuable guidance in patient management. There is a lack of available evidence concerning this metric in the context of outcomes related to female urinary incontinence, which might negatively impact clinical decision-making.

Sex-specific independent risk factors of urinary incontinence in acute stroke patients: A multicentre registry-based cohort study.

The presence of urinary incontinence (UI) in acute stroke patients indicates poor outcomes in men and women. However, there is a paucity and inconsistency of data on UI risk factors in this group and hence we conducted a sex-specific analysis to identify risk factors.

Why Do Women Not Use the Bathroom? Women’s Attitudes and Beliefs on Using Public Restrooms

There are a variety of factors and influences, both internal and external, that may impact an individual’s public toileting experience and may ultimately have repercussions for bladder health. This study sought to identify predominant constructs underlying a woman’s attitude towards using restrooms at work, at school, and in public in order to develop a conceptual model incorporating these themes. We performed a secondary analysis of a cross-sectional, survey-based study that included open-ended questions about limitations to restroom use using a mixed-methods approach. Qualitative data coding and analysis was performed on 12,583 quotes and, using an iterative inductive-deductive approach, was used to construct the conceptual framework. Our conceptual framework reveals a complicated interplay of personal contexts, situational influences, and behavioral strategies used by women to manage their bladder and bowel habits away from home. These findings can inform future research and public policy related to bladder health awareness related to toilet access in the workplace and in public.

Siobhan M. Hartigan,1 Kemberlee Bonnet,2 Leah Chisholm,1 Casey Kowalik,3 Roger R. Dmochowski,1 David Schlundt,2 and W. Stuart Reynolds1

  1. Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
  2. Department of Psychology, Vanderbilt University Medical Center, Nashville, TN, USA
  3. Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
Source: Hartigan SM, Bonnet K, Chisholm L, et al. Why Do Women Not Use the Bathroom? Women’s Attitudes and Beliefs on Using Public Restrooms. Int J Environ Res Public Health. 2020 Mar; 17(6): 2053.