SAN FRANCISCO—Major depression, hypertension, and prostatic enlargement are independently associated with moderate to severe urinary incontinence (UI) in men aged 40 years and older, according to researchers.
Elucidation of these factors may improve clinicians’ ability to identify men who may be suffering from the condition, said lead investigator Alayne D. Markland, DO, MS, an assistant professor in the Division of Gerontology and Geriatric Medicine at the University of Alabama in Birmingham.
Dr. Markland and her colleagues analyzed data from 5,297 men aged 20 years and older who participated in the National and Nutrition Examination Survey, a cross-sectional nationally representative survey of the U.S. noninstitutionalized population. Men were interviewed in their homes and then underwent standardized physical examinations in a mobile examination center. The investigators defined UI as a score of 3 or higher on the Incontinence Severity Index (moderate to severe UI).
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In the cohort overall, major depression and hypertension were associated with a 2.6 and 1.3 times increased risk of moderate to severe UI, respectively, after adjusting for numerous potential confounders, Dr. Markland reported at the American Urological Association annual meeting. Each 10-year increment in age was associated with a 1.8 times increased risk.
Among men aged 40 years and older, major depression, hypertension, and prostatic enlargement were associated with a 2.5, 1.5, and 1.2 times increased risk of moderate to severe UI, respectively. In addition, each 10-year increment in age was associated with a 1.5 times increased risk.
The prevalence of moderate to severe UI in the cohort overall was 4.5%. Urge UI was the most common type (48.6% of cases). The prevalence of mixed and stress UI was 15.4% and 12.5%, respectively. The prevalence of moderate to severe UI increased with decade of life and ranged from 0.7% among men aged 20-34 years to 16% among men aged 75 years and older. The prevalence of moderate to severe UI did not differ by race or ethnicity.
It is unclear how hypertension might play a role in UI, Dr. Markland said, but one possibility is that the drugs used to treat hypertension, such as diuretics, may affect urine volume that may be linked with urine leakage
