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Francine Grodstein - One of the best experts on this subject based on the ideXlab platform.
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the epidemiology of urinary Incontinence in women with type 2 diabetes
The Journal of Urology, 2012Co-Authors: Elizabeth E Devore, Mary K. Townsend, Neil M. Resnick, Francine GrodsteinAbstract:Purpose: Little research has been conducted on the epidemiology of urinary Incontinence in individuals with type 2 diabetes. We examined prevalence, incidence and risk factors for urinary Incontinence among women with type 2 diabetes in the NHS (Nurses' Health Study) and NHS II.Materials and Methods: We obtained urinary Incontinence information at study baseline (2000 in NHS and 2001 in NHS II) and 2 followup periods (2002 and 2004 in the NHS, and 2003 and 2005 in the NHS II). Among women with type 2 diabetes we calculated the prevalence of urinary Incontinence for 9,994 women with baseline urinary Incontinence information, and urinary Incontinence incidence rates for 4,331 women with no urinary Incontinence at baseline and urinary Incontinence information during followup. Multivariable adjusted odds ratios and relative risks were estimated for associations between possible risk factors and urinary Incontinence.Results: The prevalence of at least monthly urinary Incontinence was 48% and at least weekly ur...
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Fluid intake and risk of stress, urgency, and mixed urinary Incontinence
American journal of obstetrics and gynecology, 2011Co-Authors: Mary K. Townsend, Ying H. Jura, Gary C. Curhan, Neil M. Resnick, Francine GrodsteinAbstract:Objective We investigated the relation between total fluid intake and incident urinary Incontinence in the Nurses' Health Study cohorts. Study Design We measured daily fluid intake using food frequency questionnaires among 65,167 women, who were 37-79 years old, without urinary Incontinence at study baseline (2000-2001). Women reported Incontinence incidence on questionnaires during 4 years of follow-up evaluation. Multivariable-adjusted hazard ratios and 95% confidence intervals were calculated with Cox proportional hazards models. Results We found no association between total fluid intake and risk of incident Incontinence (hazard ratio, 1.04; 95% confidence interval, 0.98–1.10; comparing top vs bottom quintile of fluid intake). In analyses of Incontinence type, total fluid intake was not associated with risks of incident stress, urgency, or mixed Incontinence. Conclusion No significant risk of incident urinary Incontinence was found with higher fluid intake in women. These findings suggest that women should not restrict their fluid intake to prevent Incontinence development.
Peter Frey - One of the best experts on this subject based on the ideXlab platform.
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Microfluidic production of bioactive fibrin micro-beads embedded in crosslinked collagen used as an injectable bulking agent for urinary Incontinence treatment.
Acta biomaterialia, 2017Co-Authors: Elif Vardar, Hans M. Larsson, Simone Allazetta, E.m. Engelhardt, Kalitha Pinnagoda, Ganesh Vythilingam, Jeffrey A. Hubbell, Matthias P. Lutolf, Peter FreyAbstract:Abstract Endoscopic injection of bulking agents has been widely used to treat urinary Incontinence, often due to urethral sphincter complex insufficiency. The aim of the study was to develop a novel injectable bioactive collagen-fibrin bulking agent restoring long-term continence by functional muscle tissue regeneration. Fibrin micro-beads were engineered using a droplet microfluidic system. They had an average diameter of 140 μm and recombinant fibrin-binding insulin-like growth factor-1 (α2PI1-8-MMP-IGF-1) was covalently conjugated to the beads. A plasmin fibrin degradation assay showed that 72.5% of the initial amount of α2PI1-8-MMP-IGF-1 loaded into the micro-beads was retained within the fibrin micro-beads. In vitro, the growth factor modified fibrin micro-beads enhanced cell attachment and the migration of human urinary tract smooth muscle cells, however, no change of the cellular metabolic activity was seen. These bioactive micro-beads were mixed with genipin-crosslinked homogenized collagen, acting as a carrier. The collagen concentration, the degree of crosslinking, and the mechanical behavior of this bioactive collagen-fibrin injectable were comparable to reference samples. This novel injectable showed no burst release of the growth factor, had a positive effect on cell behavior and may therefore induce smooth muscle regeneration in vivo, necessary for the functional treatment of stress and other urinary Incontinences. Statement of Significance Urinary Incontinence is involuntary urine leakage, resulting from a deficient function of the sphincter muscle complex. Yet there is no functional cure for this devastating condition using current treatment options. Applied physical and surgical therapies have limited success. In this study, a novel bioactive injectable bulking agent, triggering new muscle regeneration at the injection site, has been evaluated. This injectable consists of cross-linked collagen and fibrin micro-beads, functionalized with bound insulin-like growth factor-1 (α2PI1-8-MMP-IGF-1). These bioactive fibrin micro-beads induced human smooth muscle cell migration in vitro. Thus, this injectable bulking agent is apt to be a good candidate for regeneration of urethral sphincter muscle, ensuring a long-lasting treatment for urinary Incontinence.
David H Thom - One of the best experts on this subject based on the ideXlab platform.
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interpersonal trauma as a marker of risk for urinary tract dysfunction in midlife and older women
Obstetrics & Gynecology, 2020Co-Authors: Brittni Boyd, Stephen K Van Den Eeden, David H Thom, Leslee L Subak, Carolyn J Gibson, Brigid Mccaw, Alison J HuangAbstract:Objective To examine relationships between interpersonal trauma exposures and urinary symptoms in community-dwelling midlife and older women. Methods We analyzed cross-sectional data from a multiethnic cohort of women aged 40-80 years enrolled in an integrated health care system in California. Lifetime history of intimate partner violence (IPV) and sexual assault, current posttraumatic stress disorder (PTSD) symptoms, and current urinary symptoms were assessed using structured-item questionnaires. Multivariable-adjusted logistic regression models examined associations between traumatic exposures and PTSD symptoms with any weekly urinary Incontinence, stress-type Incontinence, urgency-type Incontinence, and nocturia two or more times per night. Results Of the 1,999 participants analyzed, 21.7% women reported lifetime emotional IPV, 16.2% physical IPV, 19.7% sexual assault, and 22.6% reported clinically significant PTSD symptoms. Overall, 45% reported any weekly Incontinence, 23% stress-type Incontinence, 23% urgency-type Incontinence, and 35% nocturia. Exposure to emotional IPV was associated with any weekly Incontinence (odds ratio [OR] 1.33, 95% CI 1.04-1.70), stress-type Incontinence (OR 1.30, 95% CI 1.00-1.65), urgency-type Incontinence (OR 1.30, 95% CI 1.00-1.70), and nocturia (OR 1.73, 95% CI 1.36-2.19). Physical IPV exposure was associated with nocturia (OR 1.35, 95% CI 1.04-1.77), but not Incontinence. Sexual assault history was not associated with weekly Incontinence of any type or nocturia. Symptoms of PTSD were associated with all urinary symptoms assessed, including any weekly Incontinence (OR 1.46, 95% CI 1.15-1.85), stress-type Incontinence (OR 1.70, 95% CI 1.32-2.20), urgency-type Incontinence (OR 1.60, 95% CI 1.24-2.06), and nocturia (OR 1.95, 95% CI 1.55-2.45). Conclusion More than 20% of women in this multiethnic, community-based cohort reported a history of IPV, PTSD symptoms, or both, which were associated with symptomatic urinary tract dysfunction. Findings highlight the need to provide trauma-informed care of midlife and older women presenting with urinary symptoms.
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incidence of and risk factors for change in urinary Incontinence status in a prospective cohort of middle aged and older women the reproductive risk of Incontinence study in kaiser
The Journal of Urology, 2010Co-Authors: David H Thom, Arona I Ragins, Jeanette S Brown, Leslee L Subak, Michael Schembri, Stephen K Van Den EedenAbstract:Purpose: Urinary Incontinence is a dynamic condition that can progress and regress but few groups have examined risk factors for change in Incontinence status.Material and Methods: We used stratified random sampling to construct a racially and ethnically diverse, population based cohort of 2,109 women 40 to 69 years old. Data were collected by questionnaires and medical record review. A second survey approximately 5 years later was completed by 1,413 women (67%) from the original cohort. The frequency of urinary Incontinence was categorized as less than weekly, weekly and daily. Change in Incontinence status was defined as new onset Incontinence, Incontinence progression or regression between frequency categories and resolution of Incontinence. Predictor variables were demographics, body mass index and other medical conditions. We used logistic regression to estimate the adjusted OR and 95% CI.Results: Compared to white nonHispanic women, black women were less likely to have Incontinence progression (OR 0...
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mixed urinary Incontinence greater impact on quality of life
The Journal of Urology, 2009Co-Authors: Anna C Frick, Alison J Huang, Stephen K Van Den Eeden, Sharon Knight, Jennifer M Creasman, Jennifer H Yang, Arona I Ragins, David H Thom, Jeanette S BrownAbstract:Purpose: We compared the impact of mixed, stress and urge urinary Incontinence on quality of life in middle-aged or older women.Materials and Methods: We analyzed cross-sectional data from a population based cohort of 2,109 ethnically diverse middle-aged or older women. Among participants reporting weekly Incontinence, clinical type of Incontinence was assessed by self-reported questionnaires and disease specific quality of life impact was evaluated using the Incontinence Impact Questionnaire. Multivariable logistic regression was used to compare the odds of greater quality of life impact from Incontinence, defined as an Incontinence Impact Questionnaire score in the 75th percentile or greater in women with stress, urge and mixed Incontinence.Results: More than 28% (598) of women reported weekly Incontinence, including 37% with stress, 31% with urge and 21% with mixed Incontinence. Unadjusted Incontinence Impact Questionnaire scores were higher for women with mixed vs urge or stress Incontinence (median s...
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urinary Incontinence and pelvic floor dysfunction in asian american women
American Journal of Obstetrics and Gynecology, 2006Co-Authors: Alison J Huang, Arona I Ragins, David H Thom, Alka M Kanaya, Christina Wasselfyr, S K Van Den Eeden, Leslee L Subak, Jeanette S BrownAbstract:Objective: The objective of the study was to describe the prevalence, risk factors, and impact of urinary Incontinence and other pelvic floor disorders among Asian-American women. Study design: This was a population-based cohort study of older women randomly selected from age and race strata. Results: Weekly urinary Incontinence was reported by 65 of 345 Asian women (18%), with stress and urge Incontinence being approximately equally common. In multivariate analysis, higher body mass index (greater than 25 kg/m 2 ) was associated with both stress Incontinence (odds ratio 4.90, 95% confidence interval 1.76 to 13.68) and urge Incontinence (odds ratio 2.49, 95% confidence interval 1.01 to 6.16) in Asians. Hysterectomy was a significant risk factor for stress Incontinence (odds ratio 2.79, 95% confidence interval 1.03 to 7.54). Only 34% of Asian women with weekly urinary Incontinence reported ever having sought treatment. Pelvic floor exercises were the most common form of treatment, being used by 29% of Asian women with weekly Incontinence. Asians were less likely then white women to report anal Incontinence (21% versus 29%, P = .007), although this difference became nonsignificant after adjusting for differences in risk factors. Conclusion: Asian women share some risk factors for stress and urge urinary Incontinence with white women. Urinary Incontinence is associated with anal Incontinence among Asian women.
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variation in estimates of urinary Incontinence prevalence in the community effects of differences in definition population characteristics and study type
Journal of the American Geriatrics Society, 1998Co-Authors: David H ThomAbstract:OBJECTIVES: Prevalence estimates for urinary Incontinence among community-dwelling adults vary from 2 to 55%. A review of the literature was undertaken to investigate the degree to which differences in definitions of Incontinence, age, and gender of the populations studied, response rates, measurement techniques, or location could explain differences in reported prevalences. DESIGN: A literature search was conducted to locate all studies published in English reporting the prevalence of urinary Incontinence in a population-based sample of adults. MEASUREMENT: Information was abstracted for study size, response rate, type of survey, definition of urinary Incontinence, and prevalence of Incontinence by age group and gender. Prevalence by type of Incontinence was also abstracted where available. Stratification was used to obtain prevalence estimates specific for age, gender, and frequency of Incontinence. Data were examined for associations between prevalence and survey type, response rate, year, and location of survey. RESULTS: A total of 21 studies met inclusion criteria. Stratification of reported prevalence by frequency, gender, and age substantially reduced the variation in prevalence estimates. For older women, the estimated prevalence of urinary Incontinence ranged from 17 to 55% (median = 35%, pooled mean = 34%), and for daily Incontinence it ranged from 3 to 17% (median = 14%, pooled mean = 12%). For older men, Incontinence prevalence was estimated to be 11 to 34% (median = 17%, pooled mean = 22%), and 2 to 11% reported daily Incontinence (median = 4%, pooled mean = 5%). Within studies, the prevalence of any Incontinence was 1.3 to 2.0 times greater for older women than for older men. Among middle-aged and younger adults, prevalence of Incontinence ranged from 12 to 42% (median = 28%, pooled mean = 25%) for women and from 3 to 5% (median = 4%, pooled mean = 5%) for men. The ratio of prevalence of any Incontinence for women to men in this age group ranged from 4.1 to 4.5. Stress Incontinence predominated in younger women, whereas urge and mixed Incontinence predominated in older women. There was a tendency for studies using in-person interviews to report higher prevalences. CONCLUSIONS: An accurate estimate of the prevalence of urinary Incontinence depends on specifying the definition of Incontinence and the age and gender groups of interest.
Jeanette S Brown - One of the best experts on this subject based on the ideXlab platform.
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incidence of and risk factors for change in urinary Incontinence status in a prospective cohort of middle aged and older women the reproductive risk of Incontinence study in kaiser
The Journal of Urology, 2010Co-Authors: David H Thom, Arona I Ragins, Jeanette S Brown, Leslee L Subak, Michael Schembri, Stephen K Van Den EedenAbstract:Purpose: Urinary Incontinence is a dynamic condition that can progress and regress but few groups have examined risk factors for change in Incontinence status.Material and Methods: We used stratified random sampling to construct a racially and ethnically diverse, population based cohort of 2,109 women 40 to 69 years old. Data were collected by questionnaires and medical record review. A second survey approximately 5 years later was completed by 1,413 women (67%) from the original cohort. The frequency of urinary Incontinence was categorized as less than weekly, weekly and daily. Change in Incontinence status was defined as new onset Incontinence, Incontinence progression or regression between frequency categories and resolution of Incontinence. Predictor variables were demographics, body mass index and other medical conditions. We used logistic regression to estimate the adjusted OR and 95% CI.Results: Compared to white nonHispanic women, black women were less likely to have Incontinence progression (OR 0...
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mixed urinary Incontinence greater impact on quality of life
The Journal of Urology, 2009Co-Authors: Anna C Frick, Alison J Huang, Stephen K Van Den Eeden, Sharon Knight, Jennifer M Creasman, Jennifer H Yang, Arona I Ragins, David H Thom, Jeanette S BrownAbstract:Purpose: We compared the impact of mixed, stress and urge urinary Incontinence on quality of life in middle-aged or older women.Materials and Methods: We analyzed cross-sectional data from a population based cohort of 2,109 ethnically diverse middle-aged or older women. Among participants reporting weekly Incontinence, clinical type of Incontinence was assessed by self-reported questionnaires and disease specific quality of life impact was evaluated using the Incontinence Impact Questionnaire. Multivariable logistic regression was used to compare the odds of greater quality of life impact from Incontinence, defined as an Incontinence Impact Questionnaire score in the 75th percentile or greater in women with stress, urge and mixed Incontinence.Results: More than 28% (598) of women reported weekly Incontinence, including 37% with stress, 31% with urge and 21% with mixed Incontinence. Unadjusted Incontinence Impact Questionnaire scores were higher for women with mixed vs urge or stress Incontinence (median s...
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urinary Incontinence and pelvic floor dysfunction in asian american women
American Journal of Obstetrics and Gynecology, 2006Co-Authors: Alison J Huang, Arona I Ragins, David H Thom, Alka M Kanaya, Christina Wasselfyr, S K Van Den Eeden, Leslee L Subak, Jeanette S BrownAbstract:Objective: The objective of the study was to describe the prevalence, risk factors, and impact of urinary Incontinence and other pelvic floor disorders among Asian-American women. Study design: This was a population-based cohort study of older women randomly selected from age and race strata. Results: Weekly urinary Incontinence was reported by 65 of 345 Asian women (18%), with stress and urge Incontinence being approximately equally common. In multivariate analysis, higher body mass index (greater than 25 kg/m 2 ) was associated with both stress Incontinence (odds ratio 4.90, 95% confidence interval 1.76 to 13.68) and urge Incontinence (odds ratio 2.49, 95% confidence interval 1.01 to 6.16) in Asians. Hysterectomy was a significant risk factor for stress Incontinence (odds ratio 2.79, 95% confidence interval 1.03 to 7.54). Only 34% of Asian women with weekly urinary Incontinence reported ever having sought treatment. Pelvic floor exercises were the most common form of treatment, being used by 29% of Asian women with weekly Incontinence. Asians were less likely then white women to report anal Incontinence (21% versus 29%, P = .007), although this difference became nonsignificant after adjusting for differences in risk factors. Conclusion: Asian women share some risk factors for stress and urge urinary Incontinence with white women. Urinary Incontinence is associated with anal Incontinence among Asian women.
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prevalence and risk factors for urinary Incontinence in women with type 2 diabetes and impaired fasting glucose findings from the national health and nutrition examination survey nhanes 2001 2002
Diabetes Care, 2006Co-Authors: Jeanette S Brown, Eric Vittinghoff, Feng Lin, Leroy M Nyberg, John W Kusek, Alka M KanayaAbstract:OBJECTIVE —Diabetes is associated with increased risk of urinary Incontinence. It is unknown whether women with pre-diabetes, or impaired fasting glucose (IFG), have increased prevalence of Incontinence. We determined the prevalence of, and risk factors for, Incontinence among U.S. women with diabetes and IFG. RESEARCH DESIGN AND METHODS —The 2001–2002 National Health and Nutrition Examination Survey measured fasting plasma glucose and obtained information about diabetes and urinary Incontinence among 1,461 nonpregnant adult women. Self-reported weekly or more frequent Incontinence, both overall and by type (urge and stress), was our outcome. RESULTS —Of the 1,461 women, 17% had diabetes and 11% met criteria for IFG. Prevalence of weekly Incontinence was similar among women in these two groups (35.4 and 33.4%, respectively) and significantly higher than among women with normal fasting glucose (16.8%); both urge and stress Incontinence were increased. In addition to well-recognized risk factors including age, weight, and oral estrogen use, two microvascular complications caused by diabetes, specifically macroalbuminuria and peripheral neuropathic pain, were associated with Incontinence. CONCLUSIONS —Physicians should be alert for Incontinence, an often unrecognized and therefore undertreated disorder, among women with diabetes and IFG, in particular those with microvascular complications. The additional prospect of improvements in their Incontinence may help motivate some high-risk women to undertake difficult lifestyle changes to reduce their more serious risk of diabetes and its sequelae.
Elif Vardar - One of the best experts on this subject based on the ideXlab platform.
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Microfluidic production of bioactive fibrin micro-beads embedded in crosslinked collagen used as an injectable bulking agent for urinary Incontinence treatment.
Acta biomaterialia, 2017Co-Authors: Elif Vardar, Hans M. Larsson, Simone Allazetta, E.m. Engelhardt, Kalitha Pinnagoda, Ganesh Vythilingam, Jeffrey A. Hubbell, Matthias P. Lutolf, Peter FreyAbstract:Abstract Endoscopic injection of bulking agents has been widely used to treat urinary Incontinence, often due to urethral sphincter complex insufficiency. The aim of the study was to develop a novel injectable bioactive collagen-fibrin bulking agent restoring long-term continence by functional muscle tissue regeneration. Fibrin micro-beads were engineered using a droplet microfluidic system. They had an average diameter of 140 μm and recombinant fibrin-binding insulin-like growth factor-1 (α2PI1-8-MMP-IGF-1) was covalently conjugated to the beads. A plasmin fibrin degradation assay showed that 72.5% of the initial amount of α2PI1-8-MMP-IGF-1 loaded into the micro-beads was retained within the fibrin micro-beads. In vitro, the growth factor modified fibrin micro-beads enhanced cell attachment and the migration of human urinary tract smooth muscle cells, however, no change of the cellular metabolic activity was seen. These bioactive micro-beads were mixed with genipin-crosslinked homogenized collagen, acting as a carrier. The collagen concentration, the degree of crosslinking, and the mechanical behavior of this bioactive collagen-fibrin injectable were comparable to reference samples. This novel injectable showed no burst release of the growth factor, had a positive effect on cell behavior and may therefore induce smooth muscle regeneration in vivo, necessary for the functional treatment of stress and other urinary Incontinences. Statement of Significance Urinary Incontinence is involuntary urine leakage, resulting from a deficient function of the sphincter muscle complex. Yet there is no functional cure for this devastating condition using current treatment options. Applied physical and surgical therapies have limited success. In this study, a novel bioactive injectable bulking agent, triggering new muscle regeneration at the injection site, has been evaluated. This injectable consists of cross-linked collagen and fibrin micro-beads, functionalized with bound insulin-like growth factor-1 (α2PI1-8-MMP-IGF-1). These bioactive fibrin micro-beads induced human smooth muscle cell migration in vitro. Thus, this injectable bulking agent is apt to be a good candidate for regeneration of urethral sphincter muscle, ensuring a long-lasting treatment for urinary Incontinence.
