LUTS In PSRI
Prevalence of lower urinary tract symptoms among lady employees of a tertiary care hospital
Rajesh Taneja, M.B.B.S., M.S., M.Ch. F.G.S.I
(Sr. Consultant Urology and Andrology, Andrologist surgical division)
Birbala Rai, M.B.B.S., M.S. (Senior Consultant Gynaecology)
Shikha Sharma MSc. Biotechnology (Research Assistant)
Urinary incontinence, stress urinary incontinence, overactive bladder.
To assess the prevalence of Lower Urinary Tract Symptoms (LUTS) in lady employees of a tertiary care hospital in New Delhi.
A cross sectional survey of 123 healthy women employees of a tertiary care hospital was conducted. A questionnaire, developed jointly by urologist and gynecologist of the hospital, covering demographic characteristics, lower urinary tract symptoms and co-morbid diseases was administered.
Lower urinary tract symptoms are usually perceived as trivial and perhaps inevitable by most women suffering from them and their treating clinicians. It has been documented that almost all women have had involuntary loss of urine at some time or the other during their lifetime. Due to temporary nature of this problem this may never attract serious attention from their health care providers. However a minority continue to suffer and look for the solutions only when urinary symptoms become distressing enough so as to interfere with their day to day life. Lower urinary tract symptoms range from frequency, urgency, urge precipitancy (urge incontinence), stress incontinence to painful urination. Some of these are commonly seen as part of lower urinary tract infection and respond very well to usual short course antibiotics.
However when lower urinary tract symptoms are present without documented urinary tract infection, they become a matter of distress as they persist or gradually increase in intensity despite empirical treatment. At this stage many women tend to accept this as their fate and therefore stop seeking medical advice. The aim of our study was to unearth any such urinary symptoms being prevalent among otherwise healthy women employees at our institution. The questionnaire designed for use in this study attempted to quantify the prevalence of urinary symptoms and capture the demographic data of this population. Urinary incontinence is defined as any involuntary leakage of urine. It includes stress urinary incontinence (SUI), urge incontinence (UI), overactive bladder (OAB) and mixed incontinence (MI).SUI is the most common form of urinary incontinence and is defined as involuntary loss of urine on effort or exertion as on sneezing or coughing. Based on severity, SUI is categorized as mild when there is minimal loss of urine on undue abdominal straining; moderate when there is significant loss of urine on usual straining and severe when there is incontinence on change of posture from supine to erect as in getting up from bed. UI is a common form of incontinence. It involves a strong, sudden need to urinate, followed by a bladder contraction, which results in leakage.
This is commonly seen in association with urinary tract infections. OAB is defined as urgency, with or without urge incontinence, usually with frequency and nocturia . It is not uncommon to come across women who have a mixed type of incontinence i.e. both stress urinary incontinence and urge incontinence. Incontinence of any kind has an adverse effect on the quality of life of women including the physical, mental and sexual health. Apart from the typical odor that they have to bear, there are features of ammonia dermatitis visible on the perineum and inner thighs. These women suffer from lack of self esteem, and are usually withdrawn socially. Despite the impact of urinary incontinence on lives of women, these kinds of studies have not been initiated in India. We undertook a survey on World’s Women Day, 8 March 2007, to determine the prevalence of lower urinary tract symptoms (LUTS) in women employees of our hospital.
Only 94 subjects returned the filled questionnaire. The responses were analyzed. The overall prevalence of lower urinary symptoms was 9.5%,which took the form of stress urinary incontinence in 3.1% and Overactive bladder symptoms in 6.4%.Out of the nine symptomatic women ,four were nulliparous ,three had vaginal deliveries and two had Cesarean section in past.
A significant percentage (9.5%) of adult women employed at a hospital were found to be suffering from otherwise unreported lower urinary tract symptoms .Larger community based studies must be done to evaluate their true prevalence.