Journal
JOURNAL OF WOMENS HEALTH
Volume 30, Issue 8, Pages 1171-1181Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/jwh.2020.8624
Keywords
LUTS; constipation; urinary incontinence; women's health; ALSPAC
Categories
Funding
- United Kingdom Medical Research Council
- Wellcome [217065/Z/19/Z]
- University of Bristol
- Medical Research Council (MRC) [MR/M009351/1]
- Avon Longitudinal Study of Parents and Children
- Research Council of Norway through its Centers of Excellence funding scheme [262700]
- MRC [MC_PC_19009] Funding Source: UKRI
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This study found a prospective association between constipation and an increased risk of urgency and hesitancy among parous middle-aged women. The results suggest that treating constipation may help reduce the risk of developing these Lower Urinary Tract Symptoms (LUTS) in women.
Objective: To examine the prospective association between constipation and risk of developing lower urinary tract symptoms (LUTS) in parous middle-aged women. Materials and Methods: The study uses data from 3,729 women from the Avon Longitudinal Study of Parents and Children who provided self-reports of medication intake for constipation at two time points (Baseline): 2001-2003 and 2003-2005. Women with LUTS at baseline were excluded. After 10 years of follow-up, women provided self-reports of LUTS using an adapted version of the International Consultation on Incontinence Questionnaire on Female LUTS. LUTS were categorized according to International Continence Society definitions as stress urinary incontinence (UI), urgency UI, mixed UI, nocturia, increased daytime frequency, urgency, hesitancy, and intermittency. LUTS were considered present if symptoms were reported to occur at least sometimes for all subtypes, except for increased daytime frequency (>= 9 times) and nocturia (>= 2 times nightly). Results: At follow-up, the prevalence of any LUTS was 40%. Women (mean age 43.3 years, standard deviation 0.5), who took medication for constipation at either time point had increased risks of urgency (adjusted relative risks [RRs] = 1.35; 95% confidence interval [CI] 1.04-1.95) and hesitancy (adjusted RR = 1.72; 95% CI 1.04-3.01) compared with women who reported not using medication for constipation at either time point. The risk of urgency (adjusted RR = 1.94; 95% CI 1.15-3.29) and hesitancy (adjusted RR = 1.78; 95% CI 1.03-4.19) was greater for women who reported taking medication for constipation at both time points. There was no evidence that constipation was associated with stress UI, urgency UI, mixed UI, nocturia, increased daytime frequency, and intermittency. Conclusion: Constipation is prospectively associated with an increased risk of urgency and hesitancy among parous middle-aged women. If further research finds evidence that this association is causal, this implies that women should seek treatment to alleviate constipation to reduce their consequent risk of developing these LUTS.
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