Mixed incontinence: comparing definitions in women having stress incontinence surgery
Linda Brubaker, Anne Stoddard, Holly Richter, Philippe Zimmern, Pamela Moalli, Stephen R Kraus, Peggy Norton, Emily Lukacz, Larry Sirls, Harry Johnson, Urinary Incontinence Treatment Network, William Steers, Ananias Diokno, Veronica Mallett, Linda Brubaker, MaryPat FitzGerald, Holly E Richter, L Keith Lloyd, Michael Albo, Charles Nager, Toby C Chai, Harry W Johnson, Halina M Zyczynski, Wendy Leng, Philippe Zimmern, Gary Lemack, Stephen Kraus, Thomas Rozanski, Peggy Norton, David Lesser, Sharon Tennstedt, Anne Stoddard, Debuene Chang, John W Kusek, Leroy M Nyberg, Anne M Weber, Rowell S Ashford, Jan Baker, Diane Borello-France, Kathryn L Burgio, Seine Chiang, Ash Dabbous, Patricia S Goode, Lee N Hammontree, Kimberly Kenton, Salil Khandwala, Karl Luber, Emily Lukacz, Shawn Menefee, Pamela Moalli, Kenneth Peters, Elizabeth Sagan, Joseph Schaffer, Amanda Simsiman, Larry Sirls, Robert Starr, R Edward Varner, Rosemary Bradt, Karen Debes, Rosanna Dinh, Judy Gruss, Lynn Hall, Alice Howell, Kathy Jesse, D Lynn Kalinoski, Kathryn Koches, Barbara Leemon, Karen Mislanovich, Shelly O'Meara, Janese Parent, Norma Pope, Caren Prather, Terry Rogers, Sylvia Sluder, Mary Tulke, Kimberly J Dandreo, Corinne J Leifer, Susan M McDermott, Anne Stoddard, Sharon Tennstedt, Liane Tinsley, Lisa Wruck, Yan Xu, Elizabeth A Gormley, Paul Abrams, Diedre Bland, J Quentin Clemens, John Connett, William Henderson, Dee Fenner, Sheryl Kelsey, Deborah Myers, Jacek Mostwin, Bassem Wadie, Linda Brubaker, Anne Stoddard, Holly Richter, Philippe Zimmern, Pamela Moalli, Stephen R Kraus, Peggy Norton, Emily Lukacz, Larry Sirls, Harry Johnson, Urinary Incontinence Treatment Network, William Steers, Ananias Diokno, Veronica Mallett, Linda Brubaker, MaryPat FitzGerald, Holly E Richter, L Keith Lloyd, Michael Albo, Charles Nager, Toby C Chai, Harry W Johnson, Halina M Zyczynski, Wendy Leng, Philippe Zimmern, Gary Lemack, Stephen Kraus, Thomas Rozanski, Peggy Norton, David Lesser, Sharon Tennstedt, Anne Stoddard, Debuene Chang, John W Kusek, Leroy M Nyberg, Anne M Weber, Rowell S Ashford, Jan Baker, Diane Borello-France, Kathryn L Burgio, Seine Chiang, Ash Dabbous, Patricia S Goode, Lee N Hammontree, Kimberly Kenton, Salil Khandwala, Karl Luber, Emily Lukacz, Shawn Menefee, Pamela Moalli, Kenneth Peters, Elizabeth Sagan, Joseph Schaffer, Amanda Simsiman, Larry Sirls, Robert Starr, R Edward Varner, Rosemary Bradt, Karen Debes, Rosanna Dinh, Judy Gruss, Lynn Hall, Alice Howell, Kathy Jesse, D Lynn Kalinoski, Kathryn Koches, Barbara Leemon, Karen Mislanovich, Shelly O'Meara, Janese Parent, Norma Pope, Caren Prather, Terry Rogers, Sylvia Sluder, Mary Tulke, Kimberly J Dandreo, Corinne J Leifer, Susan M McDermott, Anne Stoddard, Sharon Tennstedt, Liane Tinsley, Lisa Wruck, Yan Xu, Elizabeth A Gormley, Paul Abrams, Diedre Bland, J Quentin Clemens, John Connett, William Henderson, Dee Fenner, Sheryl Kelsey, Deborah Myers, Jacek Mostwin, Bassem Wadie
Abstract
Objective: To develop an empirically derived definition of mixed urinary incontinence (MUI) for use in incontinence outcomes research.
Methods: Participants in a randomized trial comparing the fascial sling and. Burch colposuspension were assessed using standardized measures including the Medical, Epidemiologic and Social Aspects of Aging (MESA), UI questionnaire, the Urogenital Distress Inventory (UDI), 3-day urinary diary and urodynamic studies (UDS). Participants were required to have stress incontinence with a MESA stress subscale score > MESA urge subscale score. Several definitions of MUI were considered. Logistic and linear regression analysis methods were used to predict clinical outcomes based on the different MUI definitions. Analyses were carried out using SAS (SAS Institute, Inc., Cary, NC, Version 9.1). Statistical significance was defined at P-value <0.05.
Results: In 655 participants, the proportion of women with MUI varied from 8.3% to 93.3% depending on the MUI definition All definitions were associated with severity as measured by the frequency of incontinence episodes at baseline; however little of the variability was explained by any single definition. No strict cut-off value for these baseline measures was identified to predict clinical outcomes.
Conclusions: These MUI definitions do not adequately categorize clinically relevant UI subgroups. For research reporting, MUI subcomponents of stress and urge UI should be described separately rather than as a single dimension.
Trial registration: ClinicalTrials.gov NCT00064662.
(c) 2009 Wiley-Liss, Inc.
Source: PubMed