Bladder health in US women: population-based estimates from the RISE FOR HEALTH study.

Autor: Smith AL; Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Electronic address: ariana.smith@pennmedicine.upenn.edu., Falke C; Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN., Rudser KD; Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN., McGwin G; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL., Brady SS; Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN., Brubaker L; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego, La Jolla, CA., Kenton K; Section of Urogynecology & Reconstructive Pelvic Surgery, Department of Obstetrics & Gynecology, University of Chicago, Chicago, IL., LaCoursiere DY; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Diego, La Jolla, CA., Lewis CE; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL., Low LK; School of Nursing, University of Michigan, Ann Arbor, MI., Lowder JL; Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO., Lukacz ES; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Diego, La Jolla, CA., Mueller ER; Departments of Urology & Obstetrics/Gynecology, Loyola University Medical Center, Loyola University Chicago, Chicago, IL., Newman DK; Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Nodora J; Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA., Markland A; Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, and the Geriatric Research, Education, and Clinical Center at the Birmingham Veterans Affairs Health Care System, Birmingham, AL., Putnam S; Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, MN., Rickey LM; Departments of Urology and Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, New Haven, CT., Rockwood T; Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN., Simon MA; Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL., Stapleton A; Division of Allergy and Infectious Disease, Department of Medicine, University of Washington, Seattle, WA., Vaughan CP; Division of Geriatrics & Gerontology, Department of Medicine, Emory University and the Birmingham/Atlanta Geriatric Research Education and Clinical Center, Atlanta, GA., Wyman JF; School of Nursing, University of Minnesota, Minneapolis, MN., Sutcliffe S; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO.
Jazyk: angličtina
Zdroj: American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2024 Nov 07. Date of Electronic Publication: 2024 Nov 07.
DOI: 10.1016/j.ajog.2024.10.044
Abstrakt: Background: Bladder health encompasses total bladder well-being and not merely the absence of urinary symptoms. While much is known about the prevalence of urinary symptoms in women, little is known about the distribution of bladder health (eg, optimal to poor).
Objective: We report the distributions of multiple dimensions of bladder health and function in a population-based sample of community-dwelling women, overall and separately in women without urinary symptoms to begin to explore bladder health dimensions that may precede the onset of symptoms.
Study Design: RISE FOR HEALTH is a regionally-representative cohort study of US women aged 18 and older. Baseline surveys included the validated Bladder Health Scales/Bladder Function Indices, the 10-item Symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index, and additional study items. Bladder well-being was assessed across 10 scales and bladder function across 6 indices. Bladder Health Scale scores were adjusted for adaptive/coping behaviors (eg, using/carrying pads, staying close to a toilet) to account for the perceived impact of urinary symptoms on well-being. Scores for scales and indices ranged from 0 (poor well-being/function) to 100 (optimal well-being/function). We calculated summary statistics for each scale (with and without adaptive behavior adjustment) and each index in the full study population and subset of women without urinary symptoms.
Results: The mean age of 3027 eligible participants was 49.8 years (standard deviation 17.9). The median global Bladder Health Scale score was 72 (interquartile range: 56, 84) before adjustment for adaptive/coping behaviors and 55 (interquartile range: 34, 78) after adjustment. Median scores for the other scales ranged from 75 to 100 before and 61 to 72 after adjustment. Sixty-nine percent of participants reported using adaptive/coping behaviors, including using pads (40%), toilet mapping (58%), and staying close to a toilet (3%). The median overall Bladder Function Index score was 77 (interquartile range: 63, 89); individual median scores ranged from 63 to 68 for frequency, sensation, continence, and emptying indices to 100 for biosis/urinary tract infection and comfort indices. Among participants without reported urinary symptoms (n=700), scores were higher across all scales (unadjusted medians=88-100 and adjusted medians=82-100) and indices (medians=93-100), indicating better, but not optimal health; however, 38% of asymptomatic women reported using adaptive/coping behaviors: 11% using pads, 30% toilet mapping, and 2% staying close to a toilet.
Conclusion: We observed a wide range of bladder well-being and function in RISE participants and high utilization of adaptive/coping behaviors. Bladder health variability and utilization of adaptive/coping behaviors was also observed in women without urinary symptoms, highlighting bladder health dimensions not captured by traditional urinary symptom tools and potentially identifying a group of women with "subclinical" symptoms who may be at greater risk of developing urinary symptoms. Future prospective analyses should investigate this novel group of women further.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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