International Urogynecology Journal

, Volume 21, Issue 8, pp 939–946

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

  • Tondalaya L. Gamble
  • Hongyan Du
  • Peter K. Sand
  • Sylvia M. Botros
  • Magdalena Rurak
  • Roger P. Goldberg
Original Article


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.


Urge urinary incontinence Risk factors Overactive bladder Parity Obesity 


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Copyright information

© The International Urogynecological Association 2010

Authors and Affiliations

  • Tondalaya L. Gamble
    • 1
    • 4
  • Hongyan Du
    • 2
  • Peter K. Sand
    • 1
  • Sylvia M. Botros
    • 1
  • Magdalena Rurak
    • 3
  • Roger P. Goldberg
    • 1
  1. 1.NorthShore University HealthSystem, Division of Urogynecology, Department of Obstetrics and GynecologyUniversity of Chicago, Pritzker School of MedicineEvanstonUSA
  2. 2.Center for Clinical Research Informatics (CCRI)NorthShore University HealthSystemEvanstonUSA
  3. 3.Arizona College of Osteopathic Medicine (AZCOM)Midwestern University (MWU)GlendaleUSA
  4. 4.Department of Obstetrics and Gynecology, Evanston HospitalNorthShore University HealthSystemEvanstonUSA

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