Depression, anxiety disorders and sexual trauma have all been implicated as risk factors in lower urinary tract symptoms (LUTS) such as incontinence and overactive bladder. The exact nature of these associations is unknown. In a study published online in The Journal of Urology, researchers from the Division of Urology, Virginia Commonwealth University School of Medicine and the Hunter Holmes McGuire Veterans Affairs Hospital, Richmond, Virginia, explored the possible association of LUTS with those factors.
Two questionnaires, the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7, were administered to 121 women referred to a specialized urology clinic for evaluation of lower urinary tract symptoms. These data were then analyzed according to psychiatric comorbidities, history of sexual trauma, age, race and obstetric history. Baseline incidence of psychiatric comorbidity and sexual trauma was also compared to a control population of 1,298 women from the Veterans Affairs primary care clinic.
Women referred for evaluation of lower urinary tract symptoms had higher rates of psychiatric comorbidities (64.5% vs. 25.9%) and sexual trauma (49.6% vs. 20.1%) compared to those in the primary care clinic. Separate analysis showed that women younger than 50 years and with a history of miscarriage had higher Urogenital Distress Inventory-6 scores, while higher Incontinence Impact Questionnaire-7 scores were associated only with psychiatric comorbidities and history of miscarriage.
Writing in the article, Adam P. Klausner, MD, and colleagues state, "This is the first study to our knowledge to characterize the association of psychiatric comorbidities and sexual trauma with the type, severity and quality of life impact of LUTS in women using validated surveys. The prevalence of psychiatric comorbidities and sexual trauma is high in women veterans presenting for evaluation of LUTS." Dr. Klausner is an associate professor and the Director of Neurourology, Female Urology, and Voiding Dysfunction at Virginia Commonwealth University Medical Center.
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