Urinary incontinence as a novel and underrecognized clinical manifestation of prolactinoma in women

Abstract

Objective: Prolactin exerts numerous pleiotropic effects on various tissues, including smooth muscle. Urinary incontinence, particularly the urge subtype, is primarily associated with detrusor overactivity-the involuntary contractions of the bladder's smooth muscle. The aim of this study is to investigate the potential impact of prolactinoma on urinary incontinence (UI) in women.

Methods: This cross-sectional study included 64 patients with prolactinoma and 80 controls. UI was assessed using the International Consultation on Incontinence Questionnaire-Short Form. Based on this instrument, incontinence was categorized into three subtypes: urge urinary incontinence (UUI), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI).

Results: The overall rate of UI was significantly higher in prolactinoma patients, with 20 cases (31.3%), compared to 6 cases (7.5%) in the control group (p < 0.001). Compared to the control group, prolactinoma patients exhibited higher rates of UUI and MUI, while no difference was found in SUI rates (p = 0.012, p = 0.008, and p = 0.839; respectively). Incontinent patients had a higher mean age, a greater frequency of macroadenoma, and a longer disease duration compared to continent patients (p = 0.015, p = 0.038, and p < 0.001; respectively). The logistic regression analysis suggested that the disease duration was the only independent predictor of UI in the prolactinoma patients.

Conclusion: Prolactinoma, particularly in the later stages of the disease, may influence detrusor muscle activity in female patients and contribute to an increased prevalence of UI.

Keywords: Prolactin; Prolactinoma; Stress incontinence; Urge incontinence; Urinary incontinence.