Lack of association of joint hypermobility with urinary incontinence subtypes and pelvic organ prolapse

作者：Derpapas Alex^*; Cartwright Rufus; Upadhyaya Purnima; Bhide Alka A; Digesu Alex G; Khullar Vik

来源：BJU International, 2015, 115(4): 639-643.

DOI：10.1111/bju.12823

• pelvic floor disorders
• joint hypermobility
• urinary incontinence
• pelvic organ prolapse
• urodynamics

Objective
To test the hypothesis that joint hypermobility (JHM) is associated with specific urinary incontinence (UI) subtypes and uterovaginal prolapse.
Patients and 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).
Conclusion
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.

• 出版日期2015-4