title: The interaction of stress and urgency urinary incontinence and its effect on quality of life.
abstract: OBJECTIVE
  The objective was to estimate the impact of stress and urgency urinary incontinence (UI) on the quality of life (QOL), and to determine whether the impact varies according to UI severity.
  
  
  METHODS
  We used data from the General Longitudinal Overactive Bladder Evaluation-UI study in women. Stress and urgency UI symptom severity scores ranged from 0 to 8. We used logistic regression to test the relation among different severity levels of stress and urgency UI, and their interaction with the Incontinence Impact Questionnaire (IIQ-7). This was categorized according to percentage ranges as 0-40% (reference), 41-80%, and 81-100%.
  
  
  RESULTS
  Both stress and urgency UI were significantly associated with IIQ-7. Higher scores had higher odds ratios (ORs). The OR for urgency vs stress UI was greater at the same severity level. For instance, comparing IIQ-7 quintiles (0-40% vs 41-80%), the OR for an association with an urgency UI score of 5-6 was 5.27 (95% CI = 3.78-7.33) vs 2.76 (95% CI = 2.07-3.68) for a stress UI score of 5-6. Both UI subtypes were more strongly related to the upper (81-100%) than the to the lower (41-80%) quintiles. There was a strong positive urgency UI and stress UI interaction with the upper (i.e., 81-100%) but not the two next lower (41-80%) quintiles.
  
  
  CONCLUSIONS
  The impact of UI subtypes on QOL varies according to the score of IIQ-7, stress and urgency UI, and their interaction. Urgency vs stress UI has a stronger impact. The effect is greatest for high IIQ-7 scores with a significant share mediated by the interaction of the two UI subtypes.
authors.affiliation: Brigham and Women's Hospital, Boston, MA, USA, vminassian@partners.org.
authors.forename: Vatché A
authors.initials: VA
authors.lastname: Minassian
authors.forename: Haiyan
authors.initials: H
authors.lastname: Sun
authors.forename: Xiaowei S
authors.initials: XS
authors.lastname: Yan
authors.forename: Deseraé N
authors.initials: DN
authors.lastname: Clarke
authors.forename: Walter F
authors.initials: WF
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000150:complications* / Q000523:psychology; D053202:Urinary Incontinence, Urge / Q000150:complications* / Q000523:psychology