Association between urgency urinary incontinence and cause-specific mortality: a population-based analysis

Abstract

Purpose: Urgency urinary incontinence (UUI) is a prevalent condition with significant implications for quality of life, yet its association with mortality was less examined by a few studies. Using data from representative U.S. population, this study aims to investigate the relationship between UUI and cause-specific mortality.

Methods: We utilized data from the NHANES collected between 2005 and 2014, comprising 21,973 patients (median age 49, 50.3% male). All data were combined with the National Death Index (NDI), which assessed mortality in December 2019. UUI was characterized by at least one incident of involuntary urination before reaching a toilet within a year. The Cox regression analysis was applied to compute the adjusted hazard ratios for mortality, with further subgroup and cause-specific analyses to assess the differential risk of mortality associated with UUI.

Results: Of the participants, 21.8% (4781/21,973) reported experiencing UUI over the year. The average duration of follow-up was 9.3 years, during which 2968 (13.5%) subjects passed away. Controlling for potential confounders, individuals with UUI exhibited an elevated mortality risk. Interaction analyses did not show statistical interactions between UUI and age- and sex-stratified subgroups. However, the findings were consistently indicative of an increased risk of mortality from cardiovascular disease, cancer and other causes. CONCLUSIONS: UUI presents a significant burden across all ages and sexes, being associated with various conditions and an increased risk of overall mortality including cardiovascular disease and cancer-related death. The causal relationship between UUI and mortality can provide a basis for understanding the mechanism.

Keywords: Lower urinary tract symptoms; Mortality; Nutrition surveys; Urinary bladder; Urinary incontinence.