WHY DO WOMEN WITH URINARY INCONTINENCE USE PADS? A STUDY OF RISK FACTORS AND URODYNAMIC FINDINGS
ELHODAIBY1, D. ENKI 2, A. SHARAF 1, L. THOMAS 1, H. HASHIM 3, C. K. MADHU 4;
1Bristol Urological Institute, Southmead Hosp., Bristol, United Kingdom, 2Plymouth University, Peninsula Sch.s of Med. and Dentistry, Plymouth, United Kingdom, 3Bristol Urological Inst., Bristol, United Kingdom, 4Department of Urogynaecology, Southmead Hosp., Bristol, United Kingdom.
Introduction: Urinary incontinence is a common medical condition and many women use absorbent pads to manage it.
Objective: The aim of this study was to investigate the risk factors and urodynamic findings affecting the use of pads.
Methods: This study was conducted in a tertiary teaching hospital in the UK. All women presenting with bothersome lower urinary tract symptoms for urodynamic assessment were included in the study. Pad usage was routinely enquired. Urodynamic assessment was done in accordance with the international continence society recommendations. Negative binomial regression analysis was done to analyse the results.
Results: 12657 women were included in this study (from Jan 1990 to Dec 2010). 7402 (58.5%) women reported using one or more pads during the day (Median: 2/day); 3096 (24.4%) women also reported using pads during night (Median: 1/night). Women reported using pads for safety and necessity. Significant number of women using pads complained of overactive bladder symptoms (P=0.02, RR= 1.1), but not stress urinary incontinence (p= 0.366). Smoking (p< 0.001 RR= 1.3), use of antidepressants (p=0.03, RR= 1.12), high body mass index (BMI >35) (p< 0.001, RR= 1.02) and a history of previous hysterectomy (p= 0.008, RR= 1.1) were all significantly associated with pad usage. Urodynamically, detrusor overactivity (p= 0.006, RR= 1.16) and reduced maximum urethral closure pressure (MUCP) (p=0.006, RR= 1.1), but not urodynamic stress incontinence (USI) (p= 0.996) were associated with the use of pads.
Conclusions: Pad usage is common in women with urinary problems. They present with predominant overactive bladder symptoms. Detrusor overactivity and a reduced urethral closure pressure are the associated urodynamic findings. Stress urinary incontinence is not associated with pad usage. Lifestyle factors like weight (BMI), antidepressant use and smoking appear to contribute to pad usage. These findings have implications for further research and interventions to benefit women who use pads for managing their urinary incontinence.