Abstract
Introduction
We evaluated whether women with urge urinary incontinence (UUI) have lower quality of life (QOL) than women with other forms of urinary incontinence.
Methods
Patients completed three validated questionnaires when presenting for evaluation at a urogynecology practice and were divided into four groups based on their responses: those with symptoms of stress urinary incontinence (SUI), UUI, both SUI and UUI (mixed UI), and neither SUI nor UUI (controls).
Results
A total of 465 women were included: 53 women with UUI (11.4%), 101 with SUI (21.7%), 200 with mixed UI (43%), and 111 controls (23.9%). Overall, there was a significant difference (p < 0.001) in PFIQ bladder scale scores as a function of UI group, with individual mean PFIQ scores of 17.1 for controls, 22.3 for SUI, 32.7 for UUI, and 36.8 for mixed UI. Individually, all seven questions in the PFIQ bladder domain were significantly different by group (p ≤ 0.001).
Conclusions
Women with UUI and mixed UI have lower QOL scores than women without incontinence or with only SUI.
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The project was approved by the IRB at Hartford Hospital.
Appendices
Appendix 1: Pelvic floor distress inventory
Instructions: Please answer all of the questions in the following survey. These questions will ask you if you have certain bowel, bladder or pelvic symptoms and, if you do, how much they bother you. Answer these by putting an X in the appropriate box or boxes. While answering these questions, please consider your symptoms over the last 3 months.
Do you:
-
1.
Usually experience pressure in the lower abdomen? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
2.
Usually experience heaviness or dullness in the pelvic area? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
3.
Usually have a bulge or something falling out that you can see or feel in your vaginal area? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
4.
Ever have to push on the vagina or around the rectum to have or complete a bowel movement? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
5.
Usually experience a feeling of incomplete bladder emptying? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
6.
Ever have to push up on a bulge in the vaginal area with your fingers to start or complete urination? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
7.
Feel you need to strain too hard to have a bowel movement? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
8.
Feel you have not completely emptied your bowels at the end of a bowel movement? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
9.
Usually lose stool beyond your control if your stool is well formed? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
10.
Usually lose stool beyond your control if your stool is loose? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
11.
Usually lose gas from the rectum beyond your control? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
12.
Usually have pain when you pass stool? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
13.
Experience a strong sense of urgency and have to rush to the bathroom to have a bowel movement? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
14.
Does part of you bowel ever pass through the rectum and bulge out during or after a bowel movement? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
15.
Usually experience frequent urination? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
16.
Usually experience urine leakage associated with a feeling of urgency, that is, a strong sensation of needing to go to the bathroom? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
17.
Usually experience urine leakage related to coughing, sneezing, or laughing? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
18.
Usually experience small amounts of urine leakage (that is, drops)? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
19.
Usually experience difficulty emptying your bladder? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
-
20.
Usually experience pain or discomfort in the lower abdomen or genital region? □No □Yes
If yes, how much does it bother you? □Not at all □Somewhat □Moderately □Quite a bit
Appendix 2: Pelvic floor impact questionnaire
Instructions: Some women find that bladder, bowel or vaginal symptoms affect their activities, relationships, and feelings. For each question place an X in the response that best describes how much your activities, relationships or feelings have been affected by your bladder, bowel, or vagina, symptoms or conditions over the last 3 months.
Please make sure you mark an answer in all 3 columns for each question.
How do symptoms or conditions related to the following →→→ Usually affect your ↓ | Bladder or Urine | Bowel or rectum | Vagina or pelvis |
1. Ability to do household chores (cooking, housecleaning, laundry)? | □Not at all | □Not at all | □Not at all |
□Somewhat | □Somewhat | □Somewhat | |
□Moderately | □Moderately | □Moderately | |
□Quite a bit | □Quite a bit | □Quite a bit | |
2. Ability to do physical activities such as walking, swimming or other exercise? | □Not at all | □Not at all | □Not at all |
□Somewhat | □Somewhat | □Somewhat | |
□Moderately | □Moderately | □Moderately | |
□Quite a bit | □Quite a bit | □Quite a bit | |
3. Entertainment activities such as going to a movie or concert? | □Not at all | □Not at all | □Not at all |
□Somewhat | □Somewhat | □Somewhat | |
□Moderately | □Moderately | □Moderately | |
□Quite a bit | □Quite a bit | □Quite a bit | |
4. Ability to travel by car or bus for a distance greater than 30 minutes away from home? | □Not at all | □Not at all | □Not at all |
□Somewhat | □Somewhat | □Somewhat | |
□Moderately | □Moderately | □Moderately | |
□Quite a bit | □Quite a bit | □Quite a bit | |
5. Participating in social activities outside your home? | □Not at all | □Not at all | □Not at all |
□Somewhat | □Somewhat | □Somewhat | |
□Moderately | □Moderately | □Moderately | |
□Quite a bit | □Quite a bit | □Quite a bit | |
6. Emotional health (nervousness, depression, etc.)? | □Not at all | □Not at all | □Not at all |
□Somewhat | □Somewhat | □Somewhat | |
□Moderately | □Moderately | □Moderately | |
□Quite a bit | □Quite a bit | □Quite a bit | |
7. Feeling frustrated? | □Not at all | □Not at all | □Not at all |
□Somewhat | □Somewhat | □Somewhat | |
□Moderately | □Moderately | □Moderately | |
□Quite a bit | □Quite a bit | □Quite a bit |
Appendix 3: Pelvic organ prolapse/urinary incontinence sexual function questionnaire
Instructions: Following are a list of questions about you and your partner’s sex life. All information is strictly confidential and anonymous. Your confidential and anonymous answers will be used only to help doctors understand what is important to patients about their sex lives. Please check the box that best answers the question for you. While answering the questions, consider your sexuality over the past 6 months. Thank you for your help and time.
-
1.
How frequently do you feel sexual desire? This feeling may include wanting to have sex, planning to have sex, feeling frustrated due to lack of sex, etc.
□Daily □Weekly □Monthly □Less than once per month □Never
-
2.
Do you climax (have an orgasm) when having sexual intercourse with your partner?
□Always □Usually □Sometimes □Seldom □Never
-
3.
Do you feel sexually excited (turned on) when having sexual activity with your partner?
□Always □Usually □Sometimes □Seldom □Never
-
4.
How satisfied are you with the variety of sexual activities in your current sex life?
□Always □Usually □Sometimes □Seldom □Never
-
5.
Do you feel pain during sexual intercourse?
□Always □Usually □Sometimes □Seldom □Never
-
6.
Are you incontinent of urine (leak urine) with sexual activity?
□Always □Usually □Sometimes □Seldom □Never
-
7.
Does fear of incontinence (either stool or urine) restrict your sexual activity?
□Always □Usually □Sometimes □Seldom □Never
-
8.
Do you avoid sexual intercourse because of bulging in the vagina (either the bladder, rectum, or vagina falling out)?
□Always □Usually □Sometimes □Seldom □Never
-
9.
When you have sex with your partner, do you have negative emotional reactions such as fear, disgust, shame or guilt?
□Always □Usually □Sometimes □Seldom □Never
-
10.
Does your partner have a problem with erections that affects your sexual activity?
□Always □Usually □Sometimes □Seldom □Never
-
11.
Does your partner have a problem with premature ejaculation that affects your sexual activity?
□Always □Usually □Sometimes □Seldom □Never
-
12.
Compared to orgasms you have had in the past, how intense are the orgasms you have had in the past six months?
□Much less intense □Less intense □Same intensity □More intense □Much more intense
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Schimpf, M.O., Patel, M., O’Sullivan, D.M. et al. Difference in quality of life in women with urge urinary incontinence compared to women with stress urinary incontinence. Int Urogynecol J 20, 781–786 (2009). https://doi.org/10.1007/s00192-009-0855-4
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DOI: https://doi.org/10.1007/s00192-009-0855-4