Mental Health, Sleep, and Physical Function in Treatment-Seeking Women With Urinary Incontinence

To examine how mental health measures, sleep, and physical function are associated with presence and type of urinary incontinence (UI) and severity in women seeking treatment for lower urinary tract symptoms (LUTS).

This is a baseline cross-sectional analysis in treatment-seeking women with LUTS. All participants completed the LUTS Tool, which was used to classify women based on UI symptoms and measure severity. Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires for depression, anxiety, sleep disturbance, and physical function; the Perceived Stress Scale (PSS); and the International Physical Activity Questionnaire Short Form (IPAQ-SF) were administered. Multivariable regression modeling was used to assess associations with the presence, type, and severity of urinary symptoms.

We studied 510 women; mean age was 56±14 years, 82% were Caucasian, 47% were obese, and 14% reported diabetes. Most women (n=420, 82.4%) reported UI (70 stress UI, 85 urgency UI, 240 mixed UI, 25 other UI). In adjusted analyses, there were no differences in any of the mental health, sleep, or physical function measures based on presence versus absence of UI. Among those with UI, PROMIS anxiety and sleep disturbance scores were higher for those with mixed UI compared to stress UI. Increasing UI severity was associated with higher PROMIS depression and anxiety, and higher PSS scores, though higher UI severity was not associated with differences in sleep or physical function.

Among treatment-seeking women with LUTS, increasing UI severity, rather than presence or type of UI, is associated with increased depression, anxiety, and stress.

The Journal of urology. 2018 May 03 [Epub ahead of print]

Nazema Y Siddiqui, Jonathan B Wiseman, David Cella, Catherine S Bradley, H Henry Lai, Margaret E Helmuth, Abigail R Smith, James W Griffith, Cindy L Amundsen, Kimberly S Kenton, J Quentin Clemens, Karl J Kreder, Robert M Merion, Ziya Kirkali, John W Kusek, Anne P Cameron, Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)

Division of Urogynecology & Reconstructive Surgery, Department of Obstetrics & Gynecology, Duke University, Durham, NC. Electronic address: ., Arbor Research Collaborative for Health, Ann Arbor, MI., Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL., Departments of Obstetrics & Gynecology and Urology, University of Iowa Carver College of Medicine, Iowa City, IA., Departments of Surgery and Anesthesiology, Washington University School of Medicine, St Louis, MO., Division of Urogynecology & Reconstructive Surgery, Department of Obstetrics & Gynecology, Duke University, Durham, NC., Feinberg School of Medicine, Northwestern University, Chicago, IL., University of Michigan, Ann Arbor, MI., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.

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