Advertisement

Prevalence of lower urinary tract symptoms and social determinants in primary care users in Brazil

  • Mônica Oliveira Batista Oriá
  • Emma McKim Mitchell
  • Camila Teixeira Moreira Vasconcelos
  • Tamires Dayanne Araújo de Oliveira
  • Lia Gomes Lopes
  • Purdenciana Ribeiro de Menezes
  • Marli Terezinha Gimeniz Galvão
Original Article
  • 41 Downloads

Abstract

Introduction and hypothesis

Although lower urinary tract symptoms (LUTS) have considerable clinical relevance, few propose evaluating its association with social conditions. Our study aimed to evaluate LUTS prevalence in primary care and its association with the social determinants of health (SDH).

Methods

This is a cross-sectional study conducted with 322 females in the period of June to October 2016 that carried out consultations and screening to prevent gynecological cancer in a primary care unit.

Results

The ages ranged from 18 to 85 years (M = 40.53). Storage symptoms had a higher overall prevalence (64.6%), highlighting nocturia (n = 186, 57.8%) and urinary incontinence (n = 120, 37.3%). Storage symptoms were associated with three layers of SDH. The voiding and postmicturition symptoms were only related to operative vaginal delivery.

Conclusions

The findings of this study suggest a relationship between SDH and LUTS. It is important to emphasize that the results not only imply a causal relationship, but also point to the social inequalities existing at a population level.

Keywords

Lower urinary tract symptoms Social determinants of health Women 

Notes

Acknowledgements

We thank CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) and FUNCAP (Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico), Brazilian agencies, for funding the scholarships of the master’s students.

Compliance with ethical standards

Conflicts of interest

None.

References

  1. 1.
    Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21:5–26.  https://doi.org/10.1007/s00192-009-0976-9.CrossRefPubMedGoogle Scholar
  2. 2.
    Zhang C, Hai T, Yu L, Wang X. Association between occupational stress and risk of overactive bladder and other lower urinary tract symptoms: a cross-sectional study of female nurses in China. Neurourol Urodyn. 2013;32(3):254–60.  https://doi.org/10.1002/nau.22290.CrossRefPubMedGoogle Scholar
  3. 3.
    Abrams P, Cardozo L, Khoury S, Wein A. Incontinence. Tokyo: ICS/ICUD; 2016.Google Scholar
  4. 4.
    Bavendam TG, Norton JM, Kirkali Z, Mullins C, Kusek JW, Star RA, et al. Advancing a comprehensive approach to the study of lower urinary tract symptoms. J Urol. 2016;196(5):1342–9.  https://doi.org/10.1016/j.juro.2016.05.117.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Zhang L, Zhu L, Xu T, Lang J, Li Z, Gong J, et al. A population-based survey of the prevalence, potential risk factors, and symptom-specific bother of lower urinary tract symptoms in adult Chinese women. Eur Urol. 2015;68(1):97–112.  https://doi.org/10.1016/j.eururo.2014.12.012.CrossRefPubMedGoogle Scholar
  6. 6.
    Wang Y, Hu H, Xu K, Kang X. Prevalence, risk factors and the bother of lower urinary tract symptoms in China: a population-based survey. Int Urogynecol J. 2015;26:911–9.  https://doi.org/10.1007/s00192-015-2626-8.CrossRefPubMedGoogle Scholar
  7. 7.
    Agarwal A, Eryuzlu LN, Cartwright R, Thorlund K, Tammela TL, Guyatt GH, et al. What is the most bothersome lower urinary tract symptom? Individual- and population-level perspectives for both men and women. Eur Urol. 2014;65(6):1211–7.  https://doi.org/10.1016/j.eururo.2014.01.019.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Cormio L, Mancini V, Liuzzi G, d’Altilia N, Carrieri G. Surgical management of female pelvic organ prolapse with and without urinary incontinence: a single center experience. Medicine (Baltimore). 2017;96(39):e7914.  https://doi.org/10.1097/MD.0000000000007914.CrossRefGoogle Scholar
  9. 9.
    Barbiani R, Nora CRD, Schaefer R. Nursing practices in the primary health care context: a scoping review. Rev Latino-Am Enferm. 2016;24:e2721.  https://doi.org/10.1590/1518-8345.0880.2721.CrossRefGoogle Scholar
  10. 10.
    Abbott LS, Elliot LT. Eliminating health disparities through action on the social determinants of health: a systematic review of home visiting in the United States, 2005–2015. Public Health Nurs. 2016;34(1):2–300737.  https://doi.org/10.1111/phn.12268.CrossRefPubMedGoogle Scholar
  11. 11.
    World Health Organization-WHO (2010) Closing the Gap on a Generation: Health Equity Through Action on the Social Determinants of Health. Commission on Social Determinants of Health (CSDH). Geneva, 2010. http://apps.who.int/iris/bitstream/10665/43943/1/9789241563703_eng.pdf Accessed 30 Sept 2017.
  12. 12.
    da Rocha PR, David HMSL. Determination or determinants? A debate based on the theory on the social production of health. Rev Esc Enferm USP. 2015;49(1):129–35.  https://doi.org/10.1590/S0080-623420150000100017.CrossRefPubMedGoogle Scholar
  13. 13.
    Dahlgren G, Whitehead M (2007) Policies and strategies to promote social equity in health. Background document to WHO-Strategy paper for Europe. Stockholm: Stockholm Institute for Further Studies https://pdfs.semanticscholar.org/2537/7200786dcbdb7889cf4123bfeab5377c13d1.pdf. Accessed 30 Sept 2017.
  14. 14.
    Berzuk K, Shay B. Effect of increasing awareness of pelvic floor muscle function on pelvic floor dysfunction: a randomized controlled trial. Int Urogynecol J. 2015;26(6):837–44.  https://doi.org/10.1007/s00192-014-2599-z.CrossRefPubMedGoogle Scholar
  15. 15.
    Associação Brasileira de Empresas de Pesquisa – ABEP (2015) Critério de Classificação Econômica Brasil. file:///C:/Users/Ibyte/Downloads/01_cceb_2016_11_04_16_final.pdf. Accessed 30 Sept 2017.Google Scholar
  16. 16.
    Pålsson M, Stjerndahl JH, Granåsen G, Löfgren M, Sundfeldt K. Patient-reported lower urinary tract symptoms after hysterectomy or hysteroscopy: a study from the Swedish quality register for gynecological surgery. Int Urogynecol J. 2017;28:1341–9.  https://doi.org/10.1007/s00192-017-3268-9.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    van Breda HMK, Bosch JLHR, Kort LMO. Hidden prevalence of lower urinary tract symptoms in healthy nulligravid young women. Int Urogynecol J. 2015;26:1637–43.  https://doi.org/10.1007/s00192-015-2754-1.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Moreira ED Jr, Neves RCS, Neto AF, Duarte FG, Moreira TL, Lobo CFL, et al. Population-based survey of lower urinary tract symptoms (LUTS) and symptom-specific bother: results from the Brazilian LUTS epidemiology study (BLUES). World J Urol. 2013;31(6):1451–8.  https://doi.org/10.1007/s00345-013-1057-8.CrossRefPubMedGoogle Scholar
  19. 19.
    Silva JCP, Soler ZASG, Wysocki AD. Associated factors to urinary incontinence in women undergoing urodynamic testing. Rev Esc Enferm USP. 2017;51:e03209.  https://doi.org/10.1590/S1980-220X2015048003209.PubMedGoogle Scholar
  20. 20.
    Crane AK, Geller EJ, Bane H, Ju R, Myers E, Matthews CA. Evaluation of pelvic floor symptoms and sexual function in Primiparous women who underwent operative vaginal delivery versus cesarean delivery for second-stage arrest. Female Pelvic Med Reconstr Surg. 2013;19(1):13–6.  https://doi.org/10.1097/SPV.0b013e31827bfd7b.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Zizzi PT, Trevisan KF, Leister N, Cruz CS, Riesco MLG. Women’s pelvic floor muscle strength and urinary and anal incontinence after childbirth: a cross-sectional study. Rev Esc Enferm USP. 2017;51:e03214.  https://doi.org/10.1590/S1980-220X2015039203214.CrossRefPubMedGoogle Scholar
  22. 22.
    Svihrova V, Svihra J, Luptak J, Hudeckova H, Kliment J. The prevalence of lower urinary tract symptoms in slovak women with pelvic organ prolapse. Eur Urol. 2013;12(4):e1135.  https://doi.org/10.1016/S1569-9056(13)61875-8.CrossRefGoogle Scholar
  23. 23.
    Irwin DE, Abrams P, Milsom I, Kopp Z, Reilly K. EPIC study group understanding the elements of overactive bladder: questions raised by the EPIC study. BJU Int. 2008;101(11):1381–7.  https://doi.org/10.1111/j.1464-410X.2008.07573.x.CrossRefPubMedGoogle Scholar
  24. 24.
    Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog A, Corey R, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20(6):327–36.  https://doi.org/10.1007/s00345-002-0301-4.PubMedGoogle Scholar
  25. 25.
    Coyne KS, Sexton CC, Vats V, Thompson C, Kopp ZS, Milsom I. National community prevalence of overactive bladder in the United States stratified by sex and age. Urology. 2011;77(5):1081–7.  https://doi.org/10.1016/j.urology.2010.08.039.CrossRefPubMedGoogle Scholar
  26. 26.
    Milsom I, Abrams P, Cardozo L, Roberts RG, Thüroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population based prevalence study. BJU Int. 2001;87(9):760–6.  https://doi.org/10.1046/j.1464-410x.2001.02228.x.CrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2018

Authors and Affiliations

  • Mônica Oliveira Batista Oriá
    • 1
  • Emma McKim Mitchell
    • 2
  • Camila Teixeira Moreira Vasconcelos
    • 1
  • Tamires Dayanne Araújo de Oliveira
    • 1
  • Lia Gomes Lopes
    • 1
  • Purdenciana Ribeiro de Menezes
    • 1
  • Marli Terezinha Gimeniz Galvão
    • 1
  1. 1.Nursing DepartmentFederal University of Ceará (UFC)FortalezaBrazil
  2. 2.School of NursingUniversity of Virginia (UVa)CharlottesvilleUSA

Personalised recommendations