Urinary incontinence and urinary tract infection: temporal relationships in postmenopausal women.
OBJECTIVE
To estimate the temporal relationship between self-reported urine loss and incident, symptomatic, microbiologically confirmed urinary tract infection (UTI).


METHODS
We used daily diaries to collect information on incontinent episodes during a 2-year prospective study of incident UTI among 913 healthy postmenopausal health maintenance organization enrollees. We calculated the monthly rate of urine loss to assess for association with incident UTI. We also estimated the basal rate of urinary incontinence among women who experienced a UTI (excluding the 14-day time period pre- and post-UTI) and compared this to urine loss during the 3-day time period after UTI, to evaluate changes after infection.


RESULTS
Sixty percent of women reported urinary incontinence, at a mean rate of 4.7 times per month. The monthly mean rate of urine loss was 2.64 times per month among women who did not experience a UTI compared with 4.60 times per among women who developed a UTI (P=.04). Among women who developed a UTI (n=78), the rate of urine loss during the 3 days after UTI onset was 1.5 times higher than the basal rate (0.23 compared with 0.15 reports per day, P=.26).


CONCLUSIONS
After eliminating episodes of incontinence surrounding a UTI, the basal rate of urine loss was higher among women who experienced UTIs compared with those who did not. Additionally, among women who experienced a UTI, an increase in urine loss occurred in the immediate 3-day time period post-UTI, compared with infection-free periods. Urinary incontinence characterizes women who experience UTIs, both intercurrently and during an acute episode.


METHODS
III.
Moore
Elya E
EE
Health Services Research & Development Center of Excellence, VA Puget Sound Health Care System, Department of Medicine, University of Washington, Seattle, USA. elya.moore@mcri.edu.au
Jackson
Sara L
SL
Boyko
Edward J
EJ
Scholes
Delia
D
Fihn
Stephan D
SD
D000368:Aged; D001437:Bacteriuria / Q000175:diagnosis / Q000453:epidemiology*; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006306:Health Surveys; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000502:physiology; D013997:Time Factors; D014549:Urinary Incontinence / Q000453:epidemiology*; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology