title: Urge incontinence: estimating environmental and obstetrical risk factors using an identical twin study.
abstract: OBJECTIVE
  The objective of this study was to determine risk factors for urge urinary incontinence (UUI).
  
  
  METHODS
  A multi-item survey was administered to a community sample of identical twin sisters from 2002-2008. Generalized estimating equations accounting for co-twin correlation were used to perform three different regression models on the outcome: UUI (yes vs. no).
  
  
  RESULTS
  Mean age, median parity, and BMI were 41.4 +/- 16.4 (18-85), 1.0, and 26.0 +/- 6.5 (13.5-55.8), respectively. Thirty-five percent of women were post-menopausal, and 27.5% had UUI. Urge urinary incontinence was reported in 40.1% of parous versus 14.1% among nulliparous women (p < .0001). The rate of UUI was 40.6% after vaginal delivery, 36.7% after cesarean delivery, and 14.1% in nulliparous women (p < .0001). Obesity, age >40, and chronic constipation were also identified as risk factors for urge urinary incontinence.
  
  
  CONCLUSIONS
  Risk factors for UUI include parity, age, obesity, and chronic constipation. There was a 2.5-fold increased risk of UUI after one or more births, regardless of type of delivery.
authors.affiliation: NorthShore University HealthSystem, Division of Urogynecology, Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of Medicine, Evanston, IL 60201, USA. tgamble7@gmail.com
authors.forename: Tondalaya L
authors.initials: TL
authors.lastname: Gamble
authors.forename: Hongyan
authors.initials: H
authors.lastname: Du
authors.forename: Peter K
authors.initials: PK
authors.lastname: Sand
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Botros
authors.forename: Magdalena
authors.initials: M
authors.lastname: Rurak
authors.forename: Roger P
authors.initials: RP
authors.lastname: Goldberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003248:Constipation / Q000150:complications*; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D010298:Parity; D011247:Pregnancy; D012044:Regression Analysis; D012307:Risk Factors; D014430:Twins, Monozygotic; D053202:Urinary Incontinence, Urge / Q000453:epidemiology*; D055815:Young Adult
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