Serum estradiol does not differentiate stress, mixed and urge incontinent women around menopause. A report from the Women's Health in the Lund Area (WHILA) study

Objective

To outline serum estradiol levels in perimenopausal women with stress, mixed or urge incontinence. We believe the majority of urgency symptoms in perimenopausal women to be caused by a pelvic floor dysfunction and a hypermobility of the bladder neck. If this is the case, there would be no difference in estradiol levels between the groups.

Study design

Setting: University hospital. In the observational Women's Health in the Lund Area study, a subset of 400/2221 women reporting urinary incontinence completed a detailed questionnaire regarding lower urinary tract symptoms and had their serum steroid hormone levels measured. Statistical analyses were made by Chi-square test, nonparametrical tests, ANOVA, multi- and univariate logistic regression analysis.

Results

Stress incontinence was reported by 196, mixed incontinence by 153 and urge incontinence by 43 women; in 369, serumestradiol values were available. Serum estradiol did not differ significantly between stress incontinent (median 49.5 pmo/l, range 2.63-875.4), urge incontinent (median 31.6 pmol/l, range 2.63-460.7) or mixed incontinent women (median 35.5 pmol/l, range 2.63-787.9, p = 0.62). Logistic regression analysis correcting for age, parity, hormonal status, smoking, hysterectomy and BMI also failed to show any difference in estradiol levels between the groups (p = 0.41-0.58).

Conclusion

No significant differences in serum estradiol levels between stress, mixed or urge incontinent perimenopausal women could be demonstrated.     

Epidemiology of mixed urinary incontinence in China

Objectives

To determine the prevalence and risk factors for mixed urinary incontinence (MUI) among Chinese women.

Method

In this cross-sectional survey study we analyzed the answers to a modified Bristol Female Lower Urinary Tract Symptoms questionnaire provided by 19 024 women older than 20 years and from 6 regions in China.

Results

The overall prevalence of MUI was 9.4%. The prevalence of MUI increased with age and reached 24.1% among women older than 70 years. Multivariable logistic regression analysis revealed that age, vaginal delivery, chronic constipation, pelvic organ prolapse, chronic pelvic pain, respiratory system disease, menstrual disorder, urinary system disease, alcohol consumption, pelvic surgery, obesity, and a low educational level were independent risk factors for MUI.

Conclusion

We found age, vaginal delivery, and chronic constipation to be the main risk factors for MUI among adult women in China.     

Impact of the tension-free vaginal tape obturator procedure on sexual function in women with stress urinary incontinence

Objective

To evaluate prospectively the impact of the tension-free vaginal tape obturator (TVT-O) procedure on sexual function in women with stress urinary incontinence (SUI).

Methods

The present prospective study included women with SUI and no concomitant prolapse who underwent a TVT-O procedure at Fuzhou General Hospital in Fuzhou, Fujian, China. Before and 6 months after surgery, the patients had their sexual function evaluated using the Female Sexual Function Index (FSFI) questionnaire. Only sexually active women were included in the final analysis.

Results

Among the 55 sexually active patients, 21.8% had coital incontinence, which was cured in 11 of 12 patients (91.7%). More than half (54.5%) the women reported an improvement in sexual function after surgery and 45.5% reported no change. No statistically significant difference was found between preoperative and postoperative total or domain (desire, arousal, lubrication, orgasm, satisfaction, and pain) scores on the FSFI.

Conclusion

The TVT-O procedure in women with SUI did not significantly affect sexual function. Further studies are needed to verify the findings and compare the impact of TVT-O on sexual function with that of other anti-incontinence procedures.     

The predictive value of pre-treatment cystometry in the outcome of women with mixed incontinence treated with duloxetine

Objectives

Whilst auditing the results of women treated with duloxetine, it was noted that some women with mixed urodynamic stress incontinence (USI) and detrusor overactivity (DO) reported worsening of their incontinence. Duloxetine works by increasing urethral resistance and may alter voiding function. Worsening voiding may result in worsening irritative symptoms. The aim of our study was to assess whether pre-treatment pressure flow studies predicted which women with mixed USI and DO became worse after treatment with duloxetine.

Study design

Women were recruited from our one-stop urogynaecology clinic. All women complained of troublesome mixed urinary symptoms with moderate or severe stress incontinence. Their initial assessment included a detailed history, a physical examination, a 3-day urinary diary, King's Quality of Life questionnaire and filling cystometry.

Results

Fifty seven women were recruited. Thirty (52%) women recorded an improvement in their patient global impression of improvement (PGI-I) score; 18 (32%) recorded no change and nine (16%) women reported worsening bladder symptoms. Pressure flow studies of women who recorded a worsening of their incontinence were compared to those women who recorded no change or an improvement of their incontinence. The maximum flow rate (p = 0.78), average flow rate (p = 0.61), bladder capacity (p = 0.14), detrusor pressure at maximum flow (p = 0.68) and volume voided (0.66) showed no statistical difference when the two groups were compared. The pre-treatment voiding time (p = 0.04) was statistically longer in women who got worse following treatment with duloxetine.

Conclusion

Pre-treatment pressure flow studies may be useful in predicting the outcome of treatment with duloxetine. Women who report worsening of their incontinence are more likely to have a longer voiding time compared to women who do not report worsening. Hence a prolonged voiding time may predict a poorer outcome for women treated with duloxetine.     

Comparison of retropubic and transobturator tension-free vaginal implants for the treatment of stress urinary incontinence

Objective

To compare the perioperative complications, failure rate, operating time, and length of hospital stay associated with 2 minimally invasive suburethral slings in the management of stress urinary incontinence in women.

Methods

Women diagnosed with stress urinary incontinence were treated with tension-free vaginal tape (TVT) or transobturator tape (TOT). The participants were followed for the next 2 years, with scheduled evaluations 6 weeks, then 3, 6, 12, and 24 months after surgery.

Results

Of the 104 participants, 55 were treated with TVT and 49 were treated with TOT. The condition was classified as “cured” in 81.8% of cases in the TVT group and 83.7% in the TOT group, and improvement occurred in 10.9% and 10.2% of cases, respectively. The mean operating time was shorter for patients treated with TOT than for those treated with TVT. There were no significant differences between the groups in terms of perioperative complications (abnormal voiding dysfunction, urinary infections, and de novo overactive bladder). The temporary and permanent urinary obstruction rates in the TVT group were approximately twice those in the TOT group.

Conclusion

Comparable complications and outcomes were observed with TVT and TOT. Tension-free vaginal implants are effective for the treatment of female stress urinary incontinence.     

Fecal incontinence in pregnancy and post partum

Objective

To assess the prevalence of fecal incontinence (FI) during pregnancy and post partum, and to determine any associations with demographic and birth variables.

Methods

Secondary analysis of 240 primiparous women conducted during pregnancy and post partum. Women were asked at various time points if they had lost control over their stool or bowel movements, and if they were practicing Kegel exercises. Associations of bowel symptoms with demographic and birth data were evaluated.

Results

Most participants were white (87%), with a median age of 30 years (range, 18-42 years). Women who reported fecal incontinence at 1 year were more educated than those who did not report it. No other demographic or birth data were associated with fecal incontinence at 1 year.

Conclusions

Prevalence of FI during pregnancy and post partum is low and not linked to low-risk birth. Furthermore, when FI occurs it is often sporadic. This should be reassuring to patients and providers alike.     

Preoperative determinants for failure of transobturator tapes in the management of female urodynamic stress incontinence

Objectives

To determine significant preoperative risk factors for failure of transobturator tapes.

Methods

Secondary analysis of data from the E-TOT (Evaluation of Transobturator Tapes) study. Patient-reported outcomes (n = 310) and objective outcomes (n = 297) were analyzed using univariate and multivariate analyses.

Results

On univariate analysis, body mass index (BMI) ≥  35, maximum urethral closure pressure (MUCP) ≤ 30 cm H₂O, preoperative mixed incontinence on urodynamics, history of at least one previous incontinence procedure, and preoperative symptoms of urgency, nocturia, or urgency incontinence were associated with failure. On multivariate regression, BMI ≥ 35 (OR 6.37; 95% CI, 1.73-23.44; P = 0.005), nocturia (OR 2.18; 95% CI, 1.04-4.58; P = 0.039), urgency incontinence (OR 3.35; 95% CI, 1.07-10.51; P = 0.039), and previous incontinence surgery (OR 2.33; 95%CI, 1.1-5.48; P = 0.048) were independently associated with patient-reported failure. MUCP ≤ 30 cm H₂O (OR 7.06; 95% CI, 2.85-17.48; P < 0.001) and previous incontinence procedure (OR 6.22; 95%CI, 2.34-16.52; P < 0.001) were independently associated with objective failure.

Conclusion

History of previous incontinence surgery was the only independent risk factor for failure of transobturator tapes based on both the patient-reported and objective outcome.     

Transvaginal repair of complex and complicated vesicovaginal fistulae

Objective

To document the experience at a tertiary referral hospital in India with managing complex and complicated vesicovaginal fistulae (VVF) by the transvaginal route, and to document the complications and the long-term outcome of the patients.

Methods

The medical records of 102 patients with complex or complicated VVF who underwent transvaginal surgical repair during 2000-2009 were reviewed retrospectively.

Results

The mean age of the patients was 24 years and the mean duration of urinary incontinence was 3 years (range 6 months to 12 years). The patients were followed up for a median of 48 months. In total, 78 patients had obstetric fistulae, 20 patients had surgical (gynecologic) fistulae, and 4 patients had postradiation fistulae. The overall success rate for the transvaginal approach was 86.3%. Fourteen patients remained incontinent despite the surgical repair. Early failure of the repair was observed in 11.8% of the patients and delayed failure in 2.0%. Postoperative complications included stress urinary incontinence (9.8%), urge urinary incontinence (7.8%), dyspareunia (5.9%), and chronic labial pain (2.0%).

Conclusion

The transvaginal approach to the repair of complex and complicated VVF gives good long-term results with low complication rates.     

Does urinary incontinence subtype affect sexual function?

Objective

Urinary incontinence (UI) may affect a woman's physical and psychological well-being in different aspects. The aim of this study was to compare the effects of urinary stress incontinence (USI), detrusor overactivity (DO) and mixed urinary incontinence (MUI) on sexual function.

Study design

One-hundred and seventy urinary incontinent, sexually active women were included in this cross-sectional study. After urodynamic evaluation, participants were divided into three subgroups as USI (n = 61), DO (n = 55) and MUI (n = 54). Patients were matched according to age, parity and body mass index (BMI), rendering the sample size to 41 patients in each group. Turkish version short form of the Pelvic Organ Prolapse/Incontinence Sexual Function Questionnaire (PISQ-12) was filled out by each of the participants. Totally, 52 patients were excluded from the study (47 could not be matched and 5 incomplete questionnaire). Demographic characteristics of the participants, total and three domain scores of PISQ-12 were compared among three UI subgroups.

Results

The study group was consisted of 38 (32.2%) DO, 41 (34.7%) USI and 39 (33.1%) MUI patients. Demographic characteristics of the patients were similar in three subgroups. Patients with a diagnosis of MUI had significantly lower mean PISQ-12 scores than the ones with USI and DO whereas patients with USI had lower mean PISQ-12 scores than patients with DO.

Conclusion

Although urinary stress incontinence effects sexual function more than detrusor overactivity in terms of PISQ-12 scores, mixed urinary incontinence has the greatest impact on sexual function when compared with urinary stress incontinence and detrusor overactivity.     

Urodynamic findings in women with pelvic organ prolapse and obstructive voiding symptoms

Objective

To determine whether obstructive voiding symptoms in women with advanced pelvic organ prolapse (POP) were associated with objective bladder outflow tract obstruction.

Methods

We reviewed preoperative data from patients with advanced POP who underwent surgical correction at the Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel, between December 1, 2005, and November 30, 2007. Obstructive voiding symptoms were recorded from Pelvic Floor Distress Inventory-20 questionnaires.

Results

Of the 81 women aged 44-80 years who were included in the study, 40 (49.4%) reported incomplete bladder emptying preoperatively. There was no significant difference between these women and asymptomatic women in terms of demographic and clinical parameters such as age, parity, and stage of prolapse. Furthermore, there was no significant difference with regard to postvoid residual bladder volume (52.8 ± 65.8 vs 41.6 ± 41.2 mL), maximal (23.8 ± 11 vs 21.9 ± 9.6 mL/second) and average (10.3 ± 6.2 vs 9.3 ± 4 mL/second) urinary flow velocities, prevalence of increased postvoid residual volume (10.0% vs 4.8%), or obstructive urinary flow (17.5% vs 7.3%).

Conclusion

Almost half of all women with advanced POP experienced incomplete bladder emptying; however, this symptom did not correlate with objective urodynamic bladder outflow tract obstruction.     

Association between adolescent marriage and marital violence among young adult women in India

Objective

To assess whether a history of adolescent marriage (< 18 years) places women in young adulthood in India at increased risk of physical or sexual marital violence.

Methods

Cross-sectional analysis was performed on data from a nationally representative household study of 124 385 Indian women aged 15-49 years collected in 2005-2006. The analyses were restricted to married women aged 20-24 years who participated in the marital violence (MV) survey module (n = 10 514). Simple regression models and models adjusted for participant demographics were constructed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between adolescent marriage and MV.

Results

Over half (58%) of the participants were married before 18 years of age; 35% of the women had experienced physical or sexual violence in their marriage; and 27% reported such abuse in the last year. Adjusted regression analyses revealed that women married as minors were significantly more likely than those married as adults to report ever experiencing MV (adjusted OR 1.77; 95% CI, 1.61-1.95) and in the last 12 months (adjusted OR 1.51; 95% CI, 1.36-1.67).

Conclusions

Women who were married as adolescents remain at increased risk of MV into young adulthood.     

Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia

Objective

To assess whether supplementation with Coenzyme Q10 (CoQ10) during pregnancy reduces the risk of pre-eclampsia.

Methods

Women at increased risk of pre-eclampsia were enrolled in a randomized, double-blind, placebo-controlled trial. Women were assigned to receive 200 mg of CoQ10 or placebo daily from 20 weeks of pregnancy until delivery. The primary outcome was rate of pre-eclampsia. Statistical analyses were by intention-to-treat.

Results

Of the 235 women enrolled in the trial, 118 were randomized to receive CoQ10 and 117 received a placebo. A total of 197 (83.8%) women were followed-up. The overall rate of pre-eclampsia was 20% (n = 47). Thirty women (25.6%) in the placebo group developed pre-eclampsia compared with 17 women (14.4%) in the CoQ10 group, and this reduction was significant (P = 0.035) (relative risk [RR] 0.56; 95% confidence interval [CI], 0.33-0.96).

Conclusion

Supplementation with CoQ10 reduces the risk of developing pre-eclampsia in women at risk for the condition.     

A prospective study of pelvic floor dysfunctions related to delivery

Objective

To estimate the prevalence and impact on quality of life of urinary incontinence (UI) and anal incontinence (AI) three months after first delivery; to identify risk factors involved in UI or AI; to evaluate possible changes in sexual behaviour and anatomical modifications of pelvic floor after childbirth.

Study design

A multicenter prospective study, in six Italian Ob/Gyn departments, of nulliparous women who delivered at term (37-42 weeks of gestation) between April and September 2005. A structured questionnaire investigated several maternal and obstetric variables. UI and AI were assessed by administration of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and according to Wexner's Continence Grading Scale, at 2-3 days post-partum and at 3 months after delivery. Changes in sexual behaviour, and pelvic floor condition after delivery, were also recorded. Statistical analysis included comparison of means (Mann-Whitney or Student's t-test) and proportions (Chi-square test). Multiple logistic regression analysis was performed including variables that were significant in univariate comparisons.

Results

Of 960 enrolled women, 744 were evaluated 3 months after delivery and included in final analysis. The prevalences of UI and AI at that time were 21.6% and 16.3%, respectively. Onset of incontinence during pregnancy was an independent predictor for persistent UI (Odds Ratio (OR) 4.6, Confidence Interval (CI) 3.1-6.8, p < 0.001) and AI (OR 3.6, CI 2.2-6.1, p < 0.001). Family history of urinary or anal incontinence were respectively associated with UI (OR 2.6, CI 1.6-4.0, p < 0.001) and AI (OR 2.4, CI 1.4-4.0, p < 0.001) 3 months after delivery. Among obstetric factors, vaginal delivery was a strong risk factor for UI (OR 3.3, CI 2.0-5.3, p < 0.001). The sexual score improved 3 months after delivery in 72.4% of women. Urogynaecological evaluation showed a significant association between grade 1-2 anterior prolapse, urethral hypermobility and UI.

Conclusion

New onset of UI or AI during pregnancy, positive family history and vaginal delivery are independent risk factors for the persistence of symptoms of UI and AI in the early postpartum period. Adequate counselling and the implementation of targeted strategies to prevent or early identify these conditions are therefore mandatory to improve the patient's quality of life.     

The prevalence of fecal incontinence and urinary incontinence in primiparous postpartum Chinese women

Objective

This study investigated the prevalence of fecal incontinence (FI) and urinary incontinence (UI) in primiparous postpartum Chinese women.

Study design

Questionnaires about FI and UI symptoms were completed via telephone interviews conducted within 6 months postpartum.

Results

A total of 1889 primiparous postpartum women were asked to participate in this investigation. Only 13 (0.69%) of them had FI within 6 months after parturition, including loss of flatus in six women (0.32%), loss of solid stool in one (0.05%), loss of liquid stool in two (0.11%) and fecal urgency in four (0.21%). Bivariate logistic regression analysis showed that FI was significantly associated with forceps delivery OR = 37.91 (95% CI 4.20-342.18, P = 0.001) and medio-lateral episiotomy OR = 11.79 (95% CI 1.47-94.46, P = 0.02). The prevalence of UI, stress urinary incontinence (SUI), urge urinary incontinence (UUI) and mixed urinary incontinence (MUI) was 9.9% (186), 8.0% (151), 1.0% (18) and 0.9% (17), respectively. Multinomial logistic regression analysis found that SUI prevalence was related to age OR = 1.08 (95% CI 1.04-1.12, P = 0.000), maternal weight OR = 1.04 (95% CI 1.02-1.06, P = 0.001), neonate head circumference OR = 1.17 (95% CI 1.01-1.36, P = 0.043), spontaneous labor OR = 5.42 (95% CI 2.60-11.32, P = 0.000), forceps delivery OR = 7.0 (95% CI 2.40-20.41, P = 0.000), and medio-lateral episiotomy OR = 5.24 (95% CI 3.15-8.72, P = 0.000).

Conclusions

1. FI and UI prevalence was lower in our department than reported in previous studies in other areas. 2. Vaginal delivery has a risk impact on women's FI and UI, especially forceps delivery and medio-lateral episiotomy. 3. Maternal age, weight, newborn head circumference, spontaneous vaginal delivery, forceps delivery, and medio-lateral episiotomy increase the risk of UI.     

Body mass index, recreational physical activity and female urinary incontinence in Gansu, China

Objective

To elucidate the influence of recreational physical activity, body mass index (BMI), and waist circumference on the risk of specific types of urinary incontinence.

Study design

We conducted a population-based cross-sectional survey in Gansu, China among 2603 women aged 20 years or older.

Results

The study found that BMI was positively associated with urinary incontinence (P for trend = 0.008) and the association was mainly observed for stress urinary incontinence (OR = 1.4, 95% CI: 1.1, 1.9 for BMI = 24.0-27.9 kg/m²; OR = 2.3, 95% CI: 1.5, 3.6 for BMI ≥ 28.0 kg/m²; P for trend = 0.0005). A positive association between stress incontinence (OR = 1.7, 95% CI: 1.2, 2.5) and waist circumference was observed for women who had waist circumference between 70 cm and 75 cm compared to waist circumference less than 70 cm. Recreational physical activity was inversely associated with overall and mixed urinary incontinence (P for trend <0.0001 for both). A significant interaction between physical activity and waist circumference was found for overall (P = 0.0007) and stress incontinence (P = 0.001).

Conclusions

The findings that physical activity inversely associated with urinary incontinence and its interaction with waist circumference warrant further investigation, particularly in prospective studies.     

The risk of urinary incontinence after partial urethral resection in patients with anterior vulvar cancer

Objective

The number of women with vulvar carcinoma located in the anterior fourchette in immediate proximity to the urethral opening has increased. A retrospective analysis was performed in order to evaluate the risk of urinary incontinence after tumor-resection, standard inguinal lymphadenectomy and additional partial urethral resection.

Study design

Between 2002 and 2007, 19 women with vulvar carcinomas located close to the urethral opening and consequently treated by additional partial urethral resection of up to 1.5 cm, were evaluated for urinary loss postoperatively by standard incontinence questionnaire. All patients complaining about some kind of urinary loss underwent urodynamic measurement. Results were compared with 21 controls (women with anterior vulvar cancer treated without urethral resection).

Results

Five of 19 women (26%) of the study group complained about urinary disturbances and received urodynamic evaluation. Ninety-five percent of the patients (18/19 women) were continent by urodynamic criteria; in one woman the measurement was unreliable. One patient in the control group (1/21 women) complained of an increase of urge symptoms that had been present preoperatively.

Conclusions

Twenty-six percent of our patients after partial urethral resection reported incontinence symptoms, though this was not always confirmed by urodynamics. We conclude that the risk of urinary stress incontinence after partial urethral resection in anterior vulvar carcinoma is acceptable.     

Patient reported late effects of gynecological cancer treatment

Objective

There are a large number of gynecological cancer survivors in the United States living with long term sequelae of their treatment. Patient reported outcomes are essential in capturing patients' experiences in order to address survivorship issues; however, patient reported toxicities are not often collected or reported.

Methods

A web-based survivorship care plan tool was used to collect patient reported toxicity data for 390 women who had undergone treatment for gynecological cancer. Demographic, diagnosis, treatment modality and toxicity data were reviewed.

Results

Median age of diagnosis was 49 years, and 88% (n = 334) of the women were Caucasian and had attended at least some college. Only 10% (n = 38) had previously been offered a survivorship care plan or survivorship information. Almost half of the patients had ovarian cancer (46%, n = 180), 23% had cervical cancer (n = 92) and 28% had uterine cancer (n = 109). Late effects most commonly reported for all gynecological malignancy survivors using this tool were cognitive changes, sexual side effects, changes in bowel patterns, peripheral neuropathy and skin changes.

Conclusion

Women with gynecological cancers experience a plethora of late effects; however, very few of them have access to a survivorship plan to cope with these issues. Patient reported side effects, especially sexual dysfunction, occur more commonly than previously reported. Patient-focused tools to evaluate these side effects and access to survivorship plans are needed for comprehensive care of gynecologic cancer survivors.     

Conservative management as an initial approach for post-operative voiding dysfunction

Objectives

The management of voiding dysfunction after tension-free vaginal tape (TVT) remains controversial. Timing of surgical intervention is debatable and the role of conservative management is not well researched. This study aims to determine whether self catheterisation is an effective first line management option for these patients.

Study design

389 women underwent a TVT operation over a five year period. Twenty-two (5.6%) developed post-operative voiding dysfunction. Twenty women commenced CISC and their progress was monitored by recording voided volumes and residual urine volumes in a voiding diary and uroflowmetry. Residual volumes of less than 100 ml s were considered normal.

Results

Voiding function returned to normal with self catheterisation in 72% of patients and of these, 85% were cured in less than 12 weeks.

Conclusion

CISC is a suitable and effective initial approach to managing the majority of cases of voiding dysfunction and avoids the risks associated with further surgery, including the recurrence of stress incontinence.     

Short vs long second stage of labour: is there a difference in terms of postpartum anal incontinence?

Objective

Our purpose was to determine if prolonged second-stage labour independently increases postpartum anal incontinence.

Study design

360 primiparous women were studied retrospectively after vaginal delivery of term cephalic singletons, including a group with short second-stage labour (<30 min, n = 163) and a group with a prolonged second stage (>90 min, n = 197). A quality of life questionnaire on anal incontinence (FIQOL) was sent out at 15 months after delivery.

Results

184 women (96 with short second-stage labour and 88 with a prolonged second stage) answered the questionnaire (response rate 51%). Flatus incontinence was reported after prolonged second-stage labour in 9.1% of women vs 15.6% after short second stage (p = 0.18). Fecal incontinence was reported after prolonged second-stage labour in 2.3% vs 5.2% after a short second stage (p = 0.45).

Conclusion

We suggest that prolonged second stage of labour should not be associated with an increased risk of postpartum incontinence.     

Urinary incontinence in hospital-based nurses working in Turkey

Objective

To determine the changes in quality of life due to urinary incontinence in female hospital-based nurses working in Turkey and whether professional help was sought by the nurses. Another aim was to determine the prevalence of urinary incontinence and its risk factors in working nurses.

Methods

Data were collected through administration of a questionnaire and the Incontinence Quality-of-Life Instrument. The data were analyzed via χ² test, t test, one-way analysis of variance, and binary logistic regression analysis.

Results

The prevalence of urinary incontinence was 21.5%. Explanatory variables for developing urinary incontinence were age, parity, and recurrent urinary tract infections. Nurses with stress incontinence or urge incontinence had better quality of life than did those with mixed incontinence.

Conclusion

In the present study, urinary incontinence was common in working nurses, and had a negative impact on their general quality of life.