Original Article

International Urogynecology Journal

, Volume 25, Issue 6, pp 775-782

First online:

Treatment status and risk factors for incidence and persistence of urinary incontinence in women

  • Nancy N. MaserejianAffiliated withDepartment of Epidemiology, New England Research Institutes Email author 
  • , Vatche A. MinassianAffiliated withDivision of Urogynecology, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital
  • , Shan ChenAffiliated withDepartment of Epidemiology, New England Research Institutes
  • , Susan A. HallAffiliated withDepartment of Epidemiology, New England Research Institutes
  • , John B. McKinlayAffiliated withDepartment of Epidemiology, New England Research Institutes
  • , Sharon L. TennstedtAffiliated withDepartment of Epidemiology, New England Research Institutes

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Abstract

Introduction and hypothesis

The objective of this analysis was to describe urinary incontinence (UI) incidence and persistence over 5 years in association with treatment status, sociodemographic, medical, and lifestyle factors, in a racially/ethnically diverse population-based female sample.

Methods

The Boston Area Community Health Survey enrolled 3,201 women aged 30-79 years of black, Hispanic, and white race/ethnicity. Five-year follow-up was completed by 2,534 women (conditional response rate 83.4 %), allowing population-weighted estimates of UI incidence and persistence rates. Predictors of UI were determined using multivariate logistic regression models.

Results

Incidence of UI at least monthly was 14.1 % and weekly 8.9 %. Waist circumference at baseline and increasing waist circumference over 5-year follow-up were the most robust predictors of UI incidence in multivariate models (P ≤ 0.01). Among 475 women with UI at baseline, persistence was associated with depression symptoms [monthly UI, odds ratio (OR) = 2.39, 95 % confidence interval (CI) 1.14–5.02] and alcohol consumption (weekly UI, OR = 3.51, 95 % CI 1.11–11.1). Among women with weekly UI at baseline, 41.7 % continued to report weekly UI at follow-up, 14.1 % reported monthly UI, and 44.2 % had complete remission. Persistence of UI was not significantly higher (58.2 % vs. 48.0 %, chi-square P = 0.3) among untreated women. Surgical or drug treatment for UI had little impact on estimates for other risk factors or for overall population rates of persistence or remission.

Conclusions

Women with higher gains in waist circumference over time were more likely to develop UI, but waist circumference was not predictive of UI persistence. UI treatments did not affect associations for other risk factors. Additional research on the role of alcohol intake in UI persistence is warranted.

Keywords

Urinary incontinence Female Lower urinary tract symptoms Epidemiology Urinary bladder Overactive