Occupation and lower urinary tract symptoms in women: A rapid review and meta-analysis from the PLUS research consortium

Chronic, infrequent voiding may be a risk factor for lower urinary tract symptoms (LUTS) in women. To inform this hypothesis, we conducted a rapid literature review and meta-analysis of LUTS by occupation as an indirect measure of infrequent voiding behaviors.

Two independent medical librarians searched Pubmed.gov studies (1990-2017) on adult women for occupations, industries, and workplace environment and LUTS outcomes: overactive bladder (OAB), urinary incontinence (UI), urinary tract infections (UTIs), and individual voiding and storage LUTS. Two authors reviewed full text articles meeting content criteria. Among studies with similar UI definitions, we estimated the prevalence of monthly UI using a random effects meta-analysis model.

Of 1078 unique citations identified, 113 underwent full article review and 33 met inclusion criteria. Twenty-six of these studies examined specific occupation groups, including nurses/midwives (n = 6 studies), healthcare workers/support staff (n = 6), military personnel (n = 3), teachers (n = 3), and other groups (n = 7), whereas eight compared findings across broad occupation groups. UI was reported in 30 studies (23% using validated measures), OAB in 6 (50% validated), and UTIs in 2 (non-validated). In pooled models, the degree of heterogeneity was too high (I2 = 96.9-99.2%) among the studies to perform valid prevalence estimates for LUTS.

Current literature limits the ability to evaluate LUTS by occupation types. Future studies should characterize voiding frequency and toilet access in a consistent manner by occupation and explore its relation to LUTS development.

Neurourology and urodynamics. 2018 Sep 11 [Epub ahead of print]

Alayne Markland, Haitao Chu, C Neill Epperson, Jesse Nodora, David Shoham, Ariana Smith, Siobhan Sutcliffe, Mary Townsend, Jincheng Zhou, Tamara Bavendam, Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium

Department of Medicine, University of Alabama at Birmingham, Birmingham Geriatric Research, Education, and Clinical Center at the Birmingham VA Medical Center, Birmingham, Alabama., Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota., Departments of Psychiatry and Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania., Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California., Public Health Sciences, Loyola University, Chicago, Illinois., Department of Surgery, Division of Urology, University of Pennsylvania, Philadelphia, PennsylvaniaPennsylvania., Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri., Moffitt Cancer Center, Tampa, Florida., National Institutes of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Bethesda, Maryland.

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