Pelvic floor symptoms and lifestyle factors in older women.
ABSTRACT To measure the prevalence of pelvic floor symptoms in noncare-seeking older women and the association between symptoms and lifestyle factors.
Women enrolled at one site of the Women's Health Initiative Hormone Therapy clinical trial completed a questionnaire, modified from the Pelvic Floor Distress Inventory, on bladder, bowel, and prolapse symptoms. Individual symptoms and symptom groups were examined in a cross-sectional analysis.
In the 297 women who participated, mean age was 68.2 years, mean body mass index (BMI) was 30.2 kg/m(2), and median vaginal parity was 3. The median number of symptoms endorsed was 3 (range 0-18). The most prevalent symptoms were stress urinary incontinence (51.2%), urge urinary incontinence (49.2%), urinary frequency (29.0%), straining for bowel movements (25.0%), a sense of incomplete bowel movements (34.8%), and involuntary loss of gas (33.0%). The symptom groups most frequently endorsed were stress urinary incontinence, overactive bladder, obstructive voiding, and obstructive colorectal groups (>/=1 symptom per group in 51.2%, 61.3%, 40.8%, and 48.3%, respectively). In analyses adjusted for age, BMI, caffeine ingesting, smoking, and exercise, older women more frequently reported incomplete bladder emptying (adjusted OR 3.4, 95% CI 1.3, 9.2), weak urinary stream (adjusted OR 6.4, 95% CI 2.0, 20.0), intermittent urinary stream (adjusted OR 4.0, 95% CI 1.6, 10.4), and a feeling of incomplete bowel movements (adjusted OR 2.7, 95% CI 1.2, 5.9). Women who exercised weekly had less fecal urgency (adjusted OR 0.3, 95% CI 0.2, 0.8). Coffee drinking was associated with difficulty emptying the bladder (adjusted OR 8.6, 95% CI 1.4, 55.0) and weak stream (adjusted OR 5.3, 95% CI 1.5, 19.0).
Pelvic floor symptoms, especially urinary incontinence and irritative and obstructive urinary and bowel symptoms, are common in older women. Some symptoms are associated with potentially modifiable lifestyle factors.
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Article: Geriatric Urology[Show abstract] [Hide abstract]
ABSTRACT: Urology is one of the surgical specialties that has been most affected by the growing demographic of older adults in the United States. Urological problems are common in elderly people, and care of patients aged 65 and older represents a large proportion of many urologists' practices. However, this has also presented unique challenges to the development of the field of geriatric urology as an identified subspecialty. Until recently, formal educational requirements and opportunities in geriatric urology were limited. In addition, there is a paucity of basic science and clinical research related specifically to urological problems in older adults, despite the growing numbers of patients in this age group. This article reviews recent efforts to increase the activity, content, and visibility of the field of geriatric urology. Curriculum materials have been developed for urology training programs, research needs have been assessed and targeted, and a new professional organization (the Geriatric Urology Society) has been established. Current activities in the field of geriatric urology at the local, regional, and national levels, and goals for the future are reviewed.Journal of the American Geriatrics Society 08/2003; 51(7 Suppl):S355-8. DOI:10.1046/j.1532-5415.51.7suppplement.6.x · 4.22 Impact Factor