title: Lack of association of joint hypermobility with urinary incontinence subtypes and pelvic organ prolapse.
abstract: OBJECTIVE
  To test the hypothesis that joint hypermobility (JHM) is associated with specific urinary incontinence (UI) subtypes and uterovaginal prolapse.
  
  
  METHODS
  In all, 270 women scheduled to undergo urodynamic investigations were invited to self-complete a validated five-item JHM questionnaire. Women underwent history taking, symptoms assessing via the King's Health Questionnaire and clinical examination using the Pelvic Organ Prolapse Quantification system. Associations between JHM and pelvic floor disorders in univariate and multivariate ordinal regression were reported using odds ratios (ORs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  The prevalence of JHM was 31.1%. JHM had a negative association with age (OR 0.98/year, P = 0.04). There was no association between JHM and either urodynamic (P = 0.41), or symptomatic stress UI (P = 0.48). Nor was there association with detrusor overactivity or symptomatic urgency UI. Multivariate ordinal regression of JHM with maximum prolapse stage, adjusting for age, showed a significant relationship (OR 1.26/stage, 95% CI 1.06-1.46, P < 0.05).
  
  
  CONCLUSIONS
  Although JHM is highly prevalent amongst women with lower urinary tract symptoms (LUTS), there is no strong association of JHM with any UI subtype. There is a trend towards higher prolapse staging in women with JHM, which becomes significant only after adjustment for the confounding negative association between age and JHM.
authors.affiliation: Department of Urogynaecology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, Merseyside, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Derpapas
authors.forename: Rufus
authors.initials: R
authors.lastname: Cartwright
authors.forename: Purnima
authors.initials: P
authors.lastname: Upadhyaya
authors.forename: Alka A
authors.initials: AA
authors.lastname: Bhide
authors.forename: Alex G
authors.initials: AG
authors.lastname: Digesu
authors.forename: Vik
authors.initials: V
authors.lastname: Khullar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000150:complications / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000150:complications / Q000503:physiopathology*; D014563:Urodynamics; D055815:Young Adult
keywords: joint hypermobility; pelvic floor disorders; pelvic organ prolapse; urinary incontinence; urodynamics