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You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction I (PD31)1 Apr 2019

PD31-07 INTERPERSONAL TRAUMA: AN UNDER-RECOGNIZED RISK FACTOR FOR SYMPTOMATIC URINARY TRACT DYSFUNCTION IN MIDLIFE AND OLDER WOMEN

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    INTRODUCTION AND OBJECTIVES:

    Interpersonal trauma, including physical and emotional abuse, has the potential to contribute to urinary tract dysfunction through multiple mechanisms. We examined associations between interpersonal trauma exposures, post-traumatic stress disorder (PTSD) symptoms, and urinary tract symptoms in a community-based population of ethnically-diverse midlife and older women.

    METHODS:

    We analyzed data from a multiethnic, community-based cohort study of 2,016 women aged 40-80 years enrolled in an integrated healthcare system in California (the Reproductive Risks of Incontinence Study at Kaiser). Lifetime history of traumatic exposures, current PTSD symptoms, and current urinary tract symptoms were assessed using structured questionnaires in 2008-2012. Multivariable-adjusted logistic regression models examined associations between interpersonal trauma exposures and PTSD symptoms with: 1) any weekly incontinence, 2) weekly stress-type incontinence, 3) weekly urgency-type incontinence, and 4) nocturia ≥2 times/night.

    RESULTS:

    Of the 1,999 participants analyzed, 36% were Caucasian, 22% Black, 23% Latina, and 20% Asian. Twenty-seven percent reported at least one lifetime interpersonal trauma exposure, and 23% reported clinically significant PTSD (by PTSD Checklist-Civilian Version score ≥30). Overall, 45% reported any weekly incontinence, 23% weekly stress-type incontinence, 23% weekly urgency-type incontinence, and 35% nocturia. In multivariable models adjusting for age, race/ethnicity, education, body mass index, parity, menopausal status, pelvic surgery, and selected medications, women with a history of emotional abuse were more likely to report any weekly incontinence (adjusted odds ratio [AOR]=1.3, 95% confidence interval [CI]=1.0-1.7) and nocturia (AOR=1.7, CI=1.4-2.2). Physical abuse was associated with nocturia (AOR=1.4, CI=1.0-1.8) but not incontinence. PTSD was associated with any weekly incontinence (AOR=1.5, CI=1.2-1.9), stress-type incontinence (AOR=1.7, CI=1.3-2.2), urgency-type incontinence (AOR=1.6, CI=1.2-2.1), and nocturia (AOR=2.0, CI-1.6-2.5).

    CONCLUSIONS:

    Over 20% of midlife and older women in this community-based cohort had a history of physical or emotional interpersonal trauma, which contributed to their risk of urinary tract symptoms. Findings point to interpersonal trauma as a potentially under-recognized risk factor for urinary tract dysfunction and highlight the need for trauma-informed care of women presenting with urinary symptoms in community settings.

    Source of Funding:

    Funding was provided by the UCSF-Kaiser Permanente Grants Program for Delivery Science, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (Grant #DK53335 and 2K24DK080775-06), and the Office of Research on Women’s Health Specialized Center of Research (Grant #P50 DK064538).

    San Francisco, CA;

    Oakland, CA;

    Palo Alto, CA;

    San Francisco, CA

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