Urinary Incontinence in Elderly Women: Urodynamic Evaluation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111142/1/j.1532-5415.1987.tb02296.x.pd

Methods Used to Manage Urinary Incontinence by Older Adults in the Community

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111237/1/j.1532-5415.1989.tb05502.x.pd

Cough transmission pressure to the bladder and urethra among continent and incontinent elderly women

Although cough transmission pressures to the bladder and urethra are now being measured as part of the evaluation of an incontinent woman, there has not been a comprehensive study specifically focused among continent and incontinent non-institutionalized elderly women in order to understand the meaning of such measurements. To determine the characteristics and significance of the cough transmission pressures to the bladder and urethra, measurements were obtained from 69 continent and 100 incontinent elderly female respondents as part of an extensive urodynamic testing. Results showed that during coughing in the standing position, the increase in bladder pressure is significantly stronger among stress incontinent respondents than among continent and non-stress incontinent respondents (p = 0.0022). The increase in urethral pressure in the same group is marginally significant (p = 0.066). The mean transmission pressure ratio (urethral pressure ÷ bladder pressure) is less than 100% in all groups. They were higher among continent respondents (90%) and non-stress incontinent respondents (97%) than stress incontinent respondents (83%); however, the mean values between the 3 groups were not significantly different. The mean cough transmission pressures were significantly higher among chronic coughers than non-chronic coughers. When controlled for chronic coughing, the stress incontinent respondents have a significantly higher bladder pressure than continent and non-stress incontinent respondents. Significance of these findings in relation to the mechanisms of female geriatric incontinence are presented.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42823/1/10715_2004_Article_BF00451858.pd

Relationship between use of diureticsand continence status in the elderly

Although diuretics have been implicated as a cause of urinary incontinence, no evidence has been presented prior to this report to confirm such a relationship. Our epidemiologic survey of 1,956 respondents sixty years of age and older in Washtenaw County, Michigan, revealed 24.6 percent of men and 36.9 percent of women were current users of a diuretic medication. Comparisons between users and non-users of diuretics and continence and incontinence status revealed no significant difference in the prevalence of incontinence in either gender. However, when male respondents who had cystometric examinations were analyzed, it was found that diuretic users who have uninhibited detrusor contractions (UDC) had a significantly higher prevalence of urinary incontinence (85.7%) when compared with non-users with UDC (25 %) (p = 0.009). Among men who did not have UDC, use or non-use of diuretics showed a similar relationship but did not reach statistical significance (p = 0.085). There were too few female respondents with UDC to make meaningful analysis in this group.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29233/1/0000288.pd

Novel Application of Statistical Methods to Identify New Urinary Incontinence Risk Factors

Longitudinal data for studying urinary incontinence (UI) risk factors are rare. Data from one study, the hallmark Medical, Epidemiological, and Social Aspects of Aging (MESA), have been analyzed in the past; however, repeated measures analyses that are crucial for analyzing longitudinal data have not been applied. We tested a novel application of statistical methods to identify UI risk factors in older women. MESA data were collected at baseline and yearly from a sample of 1955 men and women in the community. Only women responding to the 762 baseline and 559 follow-up questions at one year in each respective survey were examined. To test their utility in mining large data sets, and as a preliminary step to creating a predictive index for developing UI, logistic regression, generalized estimating equations (GEEs), and proportional hazard regression (PHREG) methods were used on the existing MESA data. The GEE and PHREG combination identified 15 significant risk factors associated with developing UI out of which six of them, namely, urinary frequency, urgency, any urine loss, urine loss after emptying, subject's anticipation, and doctor's proactivity, are found most highly significant by both methods. These six factors are potential candidates for constructing a future UI predictive index

Novel Application of Statistical Methods to Identify New Urinary Incontinence Risk Factors

Longitudinal data for studying urinary incontinence (UI) risk factors are rare. Data from one study, the hallmark Medical, Epidemiological, and Social Aspects of Aging (MESA), have been analyzed in the past; however, repeated measures analyses that are crucial for analyzing longitudinal data have not been applied. We tested a novel application of statistical methods to identify UI risk factors in older women. MESA data were collected at baseline and yearly from a sample of 1955 men and women in the community. Only women responding to the 762 baseline and 559 follow-up questions at one year in each respective survey were examined. To test their utility in mining large data sets, and as a preliminary step to creating a predictive index for developing UI, logistic regression, generalized estimating equations (GEEs), and proportional hazard regression (PHREG) methods were used on the existing MESA data. The GEE and PHREG combination identified 15 significant risk factors associated with developing UI out of which six of them, namely, urinary frequency, urgency, any urine loss, urine loss after emptying, subject’s anticipation, and doctor’s proactivity, are found most highly significant by both methods. These six factors are potential candidates for constructing a future UI predictive index

The economy on a cusp: The proposed VAT amendments and their larger significande

Debates on the revision of the value-added tax (VAT) are about to reach the penultimate stage. Once house and senate have passed their respective versions of the bill, congress - through a bicameral conference committee sometimes referred to as the 'third chamber' - must then agree on the final form of the law. After all the media-posturing, the politicking, and horse-trading have subsided, politicians of both chambers are still left to confront the nation's true interests - and their own consciences. It is vital that they finally pass a law that is right in form and adequate to the economy's needs

Continence for Women: Evidence-Based Practice

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72009/1/j.1552-6909.1997.tb02719.x.pd

A tale of two concessionaires: A natural experiment of water privatisation in Metro Manila

10.1177/0042098007085108Urban Studies451207-22

Prevalence of urinary incontinence in Andorra: impact on women's health.

BACKGROUND: Urinary incontinence (UI) is a frequent public health problem with negative social consequences, particularly for women. Female susceptibility is the result of anatomical, social, economic and cultural factors. The main objectives of this study are to evaluate the prevalence of UI in the female population of Andorra over the age of 15 and, specifically, to determine the influence of socio-demographic factors. A secondary aim of the study is to measure the degree of concern associated with UI and whether the involved subjects have asked for medical assistance, or not. METHODS: Women aged 15 and over, answered a self-administered questionnaire while attending professional health units in Andorra during the period November 1998 to January 2000. A preliminary study was carried out to ensure that the questionnaire was both understandable and simple. RESULTS: 863 completed questionnaires were obtained during a one year period. The breakdown of the places where the questionnaires were obtained and filled out is as follows: 32.4% – medical specialists' offices; 31.5% – outpatient centres served exclusively by nurses; 24% – primary care doctors' offices; 12% from other sources. Of the women who answered the questionnaire, 37% manifested urine losses. Of those,45.3% presented regular urinary incontinence (RUI) and 55.7% presented sporadic urinary incontinence (SporadicUI). In those women aged between 45 and 64, UI was present in 56% of the subjects. UI was more frequent among parous than non-parous women. UI was perceived as a far more bothersome and disabling condition by working, middle-class women than in other socio-economic groups. Women in this particular group are more limited by UI, less likely to seek medical advice but more likely to follow a course of treatment. From a general point of view, however, less than 50% of women suffering from UI sought medical advice. CONCLUSION: The prevalence of UI in the female population of Andorra stands at about 37%, a statistic which should encourage both health professionals and women to a far greater awareness of this condition