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1763 ARE URINARY STORAGE SYMPTOMS RELATED WITH SMOKING? A POPULATION-BASED STUDY IN WOMEN
e682
THE JOURNAL OF UROLOGY姞
CONCLUSIONS: Obesity and Type 2 DM was associated with significantly lower PN activity in uninjured animals and impaired EUS guarding response recovery after PN injury. Obesity alone was associated with lower EUS activity and impaired PN recovery. This suggests obesity may impact sphincter function and nerve recovery, while Type 2 DM may contribute to nerve dysfunction. Source of Funding: National Institutes of Health grant RO1 HD38679-08, Department of Veterans Affairs Rehabilitation Research and Development Service, AUA Foundation Research Scholars Program, Society for Urodynamics and Female Urology
Vol. 183, No. 4, Supplement, Tuesday, June 1, 2010
Symptoms
Frequency
Bivariate analyses Former smokers Current smokers OR 95% CI OR 95% CI 1.69 1.01-2.85 3.43 2.14-5.49
Nocturia
1.06
0.70-1.62
1.34
0.88-2.05
SUI
1.49
1.01-2.19
0.97
0.62-1.51
Urgency
1.78
1.15-2.75
2.73
1.81-4.13
UUI
1.92
Frequency
0.86-4.26 2.24 0.99-5.06 Multivariate analyses Former smokers Current smokers OR 95% CI OR 95% CI 1.75 1.00-3.06 2.97 1.77-4.97
1763
Nocturia
0.96
0.61-1.51
1.15
0.72-1.83
ARE URINARY STORAGE SYMPTOMS RELATED WITH SMOKING? A POPULATION-BASED STUDY IN WOMEN
SUI
1.41
0.94-2.14
0.77
0.47-1.26
Urgency
1.85
1.16-2.93
2.69
1.73-4.18
UUI 1.81 0.77-4.29 Never smokers were regarded as referent.
1.47
0.57-3.77
Theodore M. Johnson, II*, Atlanta, GA; Riikka M. Ta¨htinen, Anssi Auvinen, Teuvo L. J. Tammela, Tampere, Finland; Rufus Cartwright, Twickenham, United Kingdom; Kari A. O. Tikkinen, Helsinki, Finland INTRODUCTION AND OBJECTIVES: To explore the association between smoking and urinary storage symptoms in women. METHODS: Questionnaires were mailed to 3,000 women aged 18-79 years randomly selected from the national population register. Subjects were classified as never/former/current smokers using questions: “Have you ever smoked?”, “Do you still smoke?”. Information on urinary storage symptoms was collected using the DAN-PSS with an additional AUA-SI nocturia question. Urinary urgency, urgency incontinence (UUI) and stress urinary incontinence (SUI) were defined as abnormal if reported often or always (scale: never/seldom/often/always). Urinary frequency was defined as abnormal if longest interval between each urination was reported as ⬍2 hours (scale: ⬎3h, 2-3h, 1-2h, ⬍1h) and nocturia as at least 2 voids/night. Information on self-reported physician-diagnosed comorbidity (33 conditions), prescribed medication (26 ATC groups), sociodemographic, lifestyle (BMI, coffee, alcohol) and reproductive factors were treated as potential confounders. Based on comorbidity and medications, Confounder Scores were calculated. Odds ratios (OR) were calculated for each symptom with age adjustment (B, bivariate). All factors associated with (particular) symptom in the age-adjusted analysis were entered as potential confounders into multivariate model. At each step, the covariate that caused the smallest change in the exposure effect estimates (compared with full model estimates) upon deletion was removed. The process was stopped when deletion of each of the remaining variables caused ⬎10% relative change (M, multivariate). RESULTS: 2,002 (67%) women took part; 114 were excluded due to pregnancy, puerperium or urinary tract infection. Of the women, 52.7% never smoked, 24.1% were former and 23.2% current smokers. Urinary frequency, nocturia, SUI, urgency and UUI were reported by 7.1%, 12.6%, 11.2%, 9.7% and 3.1% of women (age-standardized). Current (and former) smoking were associated with urinary urgency and frequency but not with nocturia or incontinence in multivariate analyses. (Table) CONCLUSIONS: Urinary urgency and frequency were associated with smoking whereas nocturia and stress incontinence was not. Strengths of this analysis include high response rate, representative study population, and adjustment for major confounders.
Source of Funding: Unrestricted grants from Pirkanmaa Hospital District and Pfizer - work independent of the funders.
1764 COMPARATIVE STUDY OF PELVIC FLOOR MUSCLE EVALUATION IN NULIPAROUS AND PRIMIPAROUS WOMEN. A PROSPECTIVE TRIAL Joao Amaro*, Monica Gameiro, Vanessa Sousa, Luciana Miraglia, Rosana Muchailh, Paulo Kawano, Botucatu, Brazil INTRODUCTION AND OBJECTIVES: The aim of this study was to assess pelvic floor muscle (PFM) strength in nulliparous and primiparous using subjective and objective evaluation. METHODS: 100 women were prospectively divided into 2 groups: Group G1 (n ⫽ 50) composed by voluntary healthy nulliparous women without urinary complaints; Group G2 (n ⫽ 50) by primiparous women. Demographic data, such as physical activity, was obtained using clinical questionnaire. Subjective evaluation of pelvic floor muscle (PFM) was performed using transvaginal digital palpation (TDP) into 2 positions (anterior and posterior). Objective evaluation of PFM strength was assessed using a portable perineometer (DM 01 Dynamed) in three different positions: in lying position with straight limbs (P1), with bent limbs (P2) and sitting (P3). These parameters were recorded at one moment in group G1 and in G2, at 20th and 36th weeks of pregnancy and after 45 days of childbirth. RESULTS: In G2, 14 women were excluded due to the lost follow-up. The median of age was 23 years in G1 and 22, in G2 (p⬎ 0.05). The sexual activity was significantly higher in G2 (97%) as compared to G1 (84%)(p⬍ 0.05). In anterior position, the TDP evaluation of PFM contraction was considered normal in 52% of nuliparous (G1),and in 39%, 22% and 25%, at 20th and 36th week of pregnancy and 45 days after childbirth, respectively, in G2. There was a significant difference between all moments of evaluation in G2 as compared to G1, except when compared 20th week of pregnancy and nuliparous (p⬎ 0.05). In posterior position, the TDP was normal in 76% of G1, and in 67%, 36% and 44%, at 20th and 36th week of pregnancy and 45 days after childbirth, respectively, in G2. There was statistical difference between all moments of evaluation in G2 as compared to G1. In the objective evaluation of PFM, there was no statistical difference between both groups at different moments, except in all positions (P1, P2 and P3) wich were significantly lower after 45 days of vaginal delivery in G2 as compared to healthy nuliparous (Graph 1). CONCLUSIONS: The subjective evaluation of PFM showed significant decrease in musculature strength during pregnancy and 45 days after childbirth. In objective evaluation there was a significant decrease of PFM strength in all positions after 45 days of vaginal delivery as compared to healthy nuliparous.
THE JOURNAL OF UROLOGY姞
CONCLUSIONS: Obesity and Type 2 DM was associated with significantly lower PN activity in uninjured animals and impaired EUS guarding response recovery after PN injury. Obesity alone was associated with lower EUS activity and impaired PN recovery. This suggests obesity may impact sphincter function and nerve recovery, while Type 2 DM may contribute to nerve dysfunction. Source of Funding: National Institutes of Health grant RO1 HD38679-08, Department of Veterans Affairs Rehabilitation Research and Development Service, AUA Foundation Research Scholars Program, Society for Urodynamics and Female Urology
Vol. 183, No. 4, Supplement, Tuesday, June 1, 2010
Symptoms
Frequency
Bivariate analyses Former smokers Current smokers OR 95% CI OR 95% CI 1.69 1.01-2.85 3.43 2.14-5.49
Nocturia
1.06
0.70-1.62
1.34
0.88-2.05
SUI
1.49
1.01-2.19
0.97
0.62-1.51
Urgency
1.78
1.15-2.75
2.73
1.81-4.13
UUI
1.92
Frequency
0.86-4.26 2.24 0.99-5.06 Multivariate analyses Former smokers Current smokers OR 95% CI OR 95% CI 1.75 1.00-3.06 2.97 1.77-4.97
1763
Nocturia
0.96
0.61-1.51
1.15
0.72-1.83
ARE URINARY STORAGE SYMPTOMS RELATED WITH SMOKING? A POPULATION-BASED STUDY IN WOMEN
SUI
1.41
0.94-2.14
0.77
0.47-1.26
Urgency
1.85
1.16-2.93
2.69
1.73-4.18
UUI 1.81 0.77-4.29 Never smokers were regarded as referent.
1.47
0.57-3.77
Theodore M. Johnson, II*, Atlanta, GA; Riikka M. Ta¨htinen, Anssi Auvinen, Teuvo L. J. Tammela, Tampere, Finland; Rufus Cartwright, Twickenham, United Kingdom; Kari A. O. Tikkinen, Helsinki, Finland INTRODUCTION AND OBJECTIVES: To explore the association between smoking and urinary storage symptoms in women. METHODS: Questionnaires were mailed to 3,000 women aged 18-79 years randomly selected from the national population register. Subjects were classified as never/former/current smokers using questions: “Have you ever smoked?”, “Do you still smoke?”. Information on urinary storage symptoms was collected using the DAN-PSS with an additional AUA-SI nocturia question. Urinary urgency, urgency incontinence (UUI) and stress urinary incontinence (SUI) were defined as abnormal if reported often or always (scale: never/seldom/often/always). Urinary frequency was defined as abnormal if longest interval between each urination was reported as ⬍2 hours (scale: ⬎3h, 2-3h, 1-2h, ⬍1h) and nocturia as at least 2 voids/night. Information on self-reported physician-diagnosed comorbidity (33 conditions), prescribed medication (26 ATC groups), sociodemographic, lifestyle (BMI, coffee, alcohol) and reproductive factors were treated as potential confounders. Based on comorbidity and medications, Confounder Scores were calculated. Odds ratios (OR) were calculated for each symptom with age adjustment (B, bivariate). All factors associated with (particular) symptom in the age-adjusted analysis were entered as potential confounders into multivariate model. At each step, the covariate that caused the smallest change in the exposure effect estimates (compared with full model estimates) upon deletion was removed. The process was stopped when deletion of each of the remaining variables caused ⬎10% relative change (M, multivariate). RESULTS: 2,002 (67%) women took part; 114 were excluded due to pregnancy, puerperium or urinary tract infection. Of the women, 52.7% never smoked, 24.1% were former and 23.2% current smokers. Urinary frequency, nocturia, SUI, urgency and UUI were reported by 7.1%, 12.6%, 11.2%, 9.7% and 3.1% of women (age-standardized). Current (and former) smoking were associated with urinary urgency and frequency but not with nocturia or incontinence in multivariate analyses. (Table) CONCLUSIONS: Urinary urgency and frequency were associated with smoking whereas nocturia and stress incontinence was not. Strengths of this analysis include high response rate, representative study population, and adjustment for major confounders.
Source of Funding: Unrestricted grants from Pirkanmaa Hospital District and Pfizer - work independent of the funders.
1764 COMPARATIVE STUDY OF PELVIC FLOOR MUSCLE EVALUATION IN NULIPAROUS AND PRIMIPAROUS WOMEN. A PROSPECTIVE TRIAL Joao Amaro*, Monica Gameiro, Vanessa Sousa, Luciana Miraglia, Rosana Muchailh, Paulo Kawano, Botucatu, Brazil INTRODUCTION AND OBJECTIVES: The aim of this study was to assess pelvic floor muscle (PFM) strength in nulliparous and primiparous using subjective and objective evaluation. METHODS: 100 women were prospectively divided into 2 groups: Group G1 (n ⫽ 50) composed by voluntary healthy nulliparous women without urinary complaints; Group G2 (n ⫽ 50) by primiparous women. Demographic data, such as physical activity, was obtained using clinical questionnaire. Subjective evaluation of pelvic floor muscle (PFM) was performed using transvaginal digital palpation (TDP) into 2 positions (anterior and posterior). Objective evaluation of PFM strength was assessed using a portable perineometer (DM 01 Dynamed) in three different positions: in lying position with straight limbs (P1), with bent limbs (P2) and sitting (P3). These parameters were recorded at one moment in group G1 and in G2, at 20th and 36th weeks of pregnancy and after 45 days of childbirth. RESULTS: In G2, 14 women were excluded due to the lost follow-up. The median of age was 23 years in G1 and 22, in G2 (p⬎ 0.05). The sexual activity was significantly higher in G2 (97%) as compared to G1 (84%)(p⬍ 0.05). In anterior position, the TDP evaluation of PFM contraction was considered normal in 52% of nuliparous (G1),and in 39%, 22% and 25%, at 20th and 36th week of pregnancy and 45 days after childbirth, respectively, in G2. There was a significant difference between all moments of evaluation in G2 as compared to G1, except when compared 20th week of pregnancy and nuliparous (p⬎ 0.05). In posterior position, the TDP was normal in 76% of G1, and in 67%, 36% and 44%, at 20th and 36th week of pregnancy and 45 days after childbirth, respectively, in G2. There was statistical difference between all moments of evaluation in G2 as compared to G1. In the objective evaluation of PFM, there was no statistical difference between both groups at different moments, except in all positions (P1, P2 and P3) wich were significantly lower after 45 days of vaginal delivery in G2 as compared to healthy nuliparous (Graph 1). CONCLUSIONS: The subjective evaluation of PFM showed significant decrease in musculature strength during pregnancy and 45 days after childbirth. In objective evaluation there was a significant decrease of PFM strength in all positions after 45 days of vaginal delivery as compared to healthy nuliparous.