Childhood dysfunctional voiding is differentially associated with urinary incontinence subtypes in women

Abstract

Purpose: To estimate the relationship between the history of childhood dysfunctional voiding and urinary incontinence (UI) in adult women with and without clinical UI and to estimate its relationship with stress, urge, and mixed UI.

Materials and methods: Using a case-control study, we surveyed adult women with or without UI using a validated dysfunctional voiding questionnaire. Cases were clinically classified as stress, urge, or mixed UI. Patient characteristics were compared using Student's t-test, chi-square test, and Fisher's exact test. Confounders were controlled through logistic regression. We compared the history of childhood dysfunctional voiding status among the three UI subtypes using multinomial logistic regression.

Results: We recruited 267 cases (120 stress, 37 urge, 98 mixed, and 12 other UI) and 107 controls. Mean age of cases and controls were 58 and 52 years and BMI 26 and 23 kg/m², respectively. Fifty-six percent of cases (48% stress, 65% urge, and 62% mixed UI) had a prevalence of childhood dysfunctional voiding compared to controls (40%) (P = 0.06). After adjusting for confounders, women with adult UI had a twofold increased odds (95% CI = 1.2-3.4, P = 0.006) of childhood dysfunctional voiding compared with controls. The highest prevalence of dysfunctional voiding was with urge UI (OR = 4.4, 95% CI = 1.8-10.7) followed by mixed UI (OR = 2.7, 95% CI = 1.5-5.2), and finally stress UI (OR = 1.4, 95% CI = 0.8-2.5).

Conclusion: Childhood dysfunctional voiding may predict adult bladder control problems. This association is strongest in women with urge UI followed by mixed UI, but not different between women with stress UI and controls.