, Volume 21, Issue 8, pp 939-946
Date: 06 May 2010

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

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Introduction and hypothesis

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


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).


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.


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.