Original Article

International Urogynecology Journal

, Volume 21, Issue 8, pp 939-946

First online:

Urge incontinence: estimating environmental and obstetrical risk factors using an identical twin study

  • Tondalaya L. GambleAffiliated withNorthShore University HealthSystem, Division of Urogynecology, Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of MedicineDepartment of Obstetrics and Gynecology, Evanston Hospital, NorthShore University HealthSystem Email author 
  • , Hongyan DuAffiliated withCenter for Clinical Research Informatics (CCRI), NorthShore University HealthSystem
  • , Peter K. SandAffiliated withNorthShore University HealthSystem, Division of Urogynecology, Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of Medicine
  • , Sylvia M. BotrosAffiliated withNorthShore University HealthSystem, Division of Urogynecology, Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of Medicine
  • , Magdalena RurakAffiliated withArizona College of Osteopathic Medicine (AZCOM), Midwestern University (MWU)
  • , Roger P. GoldbergAffiliated withNorthShore University HealthSystem, Division of Urogynecology, Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of Medicine

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Abstract

Introduction and hypothesis

The objective of this study was to determine risk factors for urge urinary incontinence (UUI).

Methods

A multi-item survey was administered to a community sample of identical twin sisters from 2002–2008. Generalized estimating equations accounting for co-twin correlation were used to perform three different regression models on the outcome: UUI (yes vs. no).

Results

Mean age, median parity, and BMI were 41.4 ± 16.4 (18–85), 1.0, and 26.0 ± 6.5 (13.5–55.8), respectively. Thirty-five percent of women were post-menopausal, and 27.5% had UUI. Urge urinary incontinence was reported in 40.1% of parous versus 14.1% among nulliparous women (p < .0001). The rate of UUI was 40.6% after vaginal delivery, 36.7% after cesarean delivery, and 14.1% in nulliparous women (p < .0001). Obesity, age >40, and chronic constipation were also identified as risk factors for urge urinary incontinence.

Conclusion

Risk factors for UUI include parity, age, obesity, and chronic constipation. There was a 2.5-fold increased risk of UUI after one or more births, regardless of type of delivery.

Keywords

Urge urinary incontinence Risk factors Overactive bladder Parity Obesity