Predictors of urinary incontinence in a prospective cohort of postmenopausal women
Predictors of urinary incontinence in a prospective cohort of postmenopausal women
复制标题
DOI：
10.1097/01.aog.0000236446.17153.21
复制
发表时间：
2006-10-01
影响因子：
7.2
通讯作者：
Fihn, Stephan D.
中科院分区：
文献类型：
--
作者：
Jackson, Sara L.;Scholes, Delia;Fihn, Stephan D.
目的：前瞻性评估绝经后女性尿失禁发生的相关危险因素。方法：我们对 1,017 名年龄 55 至 75 岁的绝经后健康维护组织参与者进行了为期 2 年的随访。主要结局指标是在 12 或 24 个月的随访中报告的任何尿失禁和严重尿失禁。结果：过去一年任何程度或频率的尿失禁的基线患病率为 66%。在 345 名基线时没有失禁的女性中，65 名 (19%) 在 1 年时和 66 名 (19%) 在 2 年时报告有任何失禁。基线时失禁的 672 名女性中的 92 名 (14%) 和 672 名女性中的 96 名 (14%) 报告在第 1 年和第 2 年没有失禁。在调整后的多重 Logistic 回归模型中，任何失禁的独立预测因素包括白种人（比值比 [OR] 1.7，95% 置信区间 [CI] 1.1-2.6）、阴道雌激素霜（OR 2.0， CI 1.1-3.7）、阴道干燥（OR 1.6，CI 1.2-2.2）、阴道分泌物（OR 1.5，CI 1.0-2.2）、6 次或以上终生尿路感染（OR 1.8，CI 1.2-2.6）和糖尿病周围神经病变（OR 1.7，CI 1.0-3.1）。在调整后的模型中，严重尿失禁的预测因素是子宫切除史（OR 1.8，CI 1.1-2.7）和任何阴道症状（OR 1.7，CI 1.0-2.8）。 结论：相当一部分无失禁的绝经后妇女在 2 年随访期间出现尿失禁。由于阴道症状与尿失禁有关，因此它们与其他危险因素（包括阴道大肠杆菌定植和阴道雌激素霜的使用）的关系值得进一步研究。同样，糖尿病周围神经病变和子宫切除术的关联提出了未来研究的领域。
OBJECTIVE: To prospectively assess risk factors associated with occurrence of urinary incontinence among postmenopausal women.METHODS: We followed up 1,017 postmenopausal health maintenance organization enrollees, aged 55 to 75 years, for 2 years. The primary outcome measures were any urinary incontience and severe incontinence reported at 12- or 24-month follow-up visits.RESULTS: Baseline prevalence of any amount or frequency of urinary incontinence in the past year was 66%. Among the 345 women without incontinence at baseline, 65 (19%) at 1 year and 66 (19%) at 2 years reported any incontinence. Ninety-two of 672 (14%) and 96 of 672 (14%) women with incontinence at baseline reported no incontinence at years 1 and 2. In an adjusted multiple logistic regression model, independent predictors of any incontinence included white race (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1-2.6), vaginal estrogen cream (OR 2.0, CI 1.1-3.7), vaginal dryness (OR 1.6, CI 1.2-2.2), vaginal discharge (OR 1.5, CI 1.0-2.2), 6 or more lifetime urinary tract infections (OR 1.8, CI 1.2-2.6), and diabetic peripheral neuropathy (OR 1.7, CI 1.0-3.1). In adjusted models, predictors of severe incontinence were history of hysterectomy (OR 1.8, CI 1.1-2.7) and any vaginal symptom (OR 1.7, CI 1.0-2.8).CONCLUSION: A substantial proportion of incontinence-free postmenopausal women developed urinary incontinence during 2 years of follow-up. Because vaginal symptoms are associated with urinary incontinence, their relationship with other risk factors, including vaginal Escherichia coli colonization and vaginal estrogen cream use, warrant additional study. Similarly, diabetic peripheral neuropathy and hysterectomy associations suggest areas for future investigation.