Vatché A Minassian1, Xiaowei Yan2, Anna L Pilzek3, Raisa Platte4, Walter F Stewart2. 1. Department of Urogynecology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA. vminassian@partners.org. 2. Sutter Research, Development & Dissemination, Sutter Health System, Walnut Creek, CA, USA. 3. Center for Health Research, Geisinger Health System, Danville, PA, USA. 4. Spectrum Health, Grand Rapids, MI, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: Mixed urinary incontinence (UI) is, on average, more severe than urgency UI or stress UI. We tested the hypothesis that mixed UI is a more advanced stage of UI by comparing transition probabilities among women with stress, urgency, and mixed UI. METHODS: We used data from the General Longitudinal Overactive Bladder Evaluation Study-UI, which included community-dwelling women, aged 40+ years, with UI at baseline. Study participants completed two or more consecutive bladder health surveys every 6 months for up to 4 years. Using sequential 6-month surveys, transition probabilities among UI subtypes were estimated using the Cox-proportional hazards model, with the expectation that probabilities from stress or urgency UI to mixed UI would be substantially greater than probabilities in the reverse direction. RESULTS: Among 6,993 women 40+ years of age at baseline, the number (prevalence) of women with stress, urgency, and mixed UI was 481 (6.9%), 557 (8.0%), and 1488 (21.3%) respectively. Over a 4-year period, the transition probabilities from stress UI (34%) and urgency UI (27%) to mixed UI was significantly higher than probabilities from mixed to stress UI (6%) or to urgency UI (rate = 9%). The adjusted transition hazard ratio for stress UI and urgency UI was 2.06 (95% CI: 1.73-2.92) and 1.85 (95% CI: 1.63-2.57) respectively compared with mixed UI. CONCLUSION: The substantially higher transition from stress UI and urgency UI to mixed UI supports the hypothesis that mixed UI might represent a more advanced stage of UI that may have implications for understanding disease progression.
INTRODUCTION AND HYPOTHESIS: Mixed urinary incontinence (UI) is, on average, more severe than urgency UI or stress UI. We tested the hypothesis that mixed UI is a more advanced stage of UI by comparing transition probabilities among women with stress, urgency, and mixed UI. METHODS: We used data from the General Longitudinal Overactive Bladder Evaluation Study-UI, which included community-dwelling women, aged 40+ years, with UI at baseline. Study participants completed two or more consecutive bladder health surveys every 6 months for up to 4 years. Using sequential 6-month surveys, transition probabilities among UI subtypes were estimated using the Cox-proportional hazards model, with the expectation that probabilities from stress or urgency UI to mixed UI would be substantially greater than probabilities in the reverse direction. RESULTS: Among 6,993 women 40+ years of age at baseline, the number (prevalence) of women with stress, urgency, and mixed UI was 481 (6.9%), 557 (8.0%), and 1488 (21.3%) respectively. Over a 4-year period, the transition probabilities from stress UI (34%) and urgency UI (27%) to mixed UI was significantly higher than probabilities from mixed to stress UI (6%) or to urgency UI (rate = 9%). The adjusted transition hazard ratio for stress UI and urgency UI was 2.06 (95% CI: 1.73-2.92) and 1.85 (95% CI: 1.63-2.57) respectively compared with mixed UI. CONCLUSION: The substantially higher transition from stress UI and urgency UI to mixed UI supports the hypothesis that mixed UI might represent a more advanced stage of UI that may have implications for understanding disease progression.
Authors: Doris Hägglund; Marie-Louise Walker-Engström; Gregor Larsson; Jerzy Leppert Journal: Scand J Prim Health Care Date: 2004-06 Impact factor: 2.581
Authors: W F Stewart; J B Van Rooyen; G W Cundiff; P Abrams; A R Herzog; R Corey; T L Hunt; A J Wein Journal: World J Urol Date: 2002-11-15 Impact factor: 4.226
Authors: Jordi Sabadell; Anabel Montero-Armengol; Nuria Rodríguez-Mias; Sabina Salicrú; Antonio Gil-Moreno; Jose L Poza Journal: Int Urogynecol J Date: 2019-11-28 Impact factor: 2.894