Differences in continence system between community-dwelling black and white women with and without urinary incontinence in the EPI study

• Published in: American journal of obstetrics and gynecology 2010-06, Vol.202 (6), p.584.e1-584.e12
• Main Authors: DeLancey, John O.L., MD, Fenner, Dee E., MD, Guire, Ken, MS, Patel, Divya A., PhD, Howard, Denise, MD, Miller, Janis M., PhD, ANP-BC, RN
• Format: Article
• Language: English
• Subjects: Adult; African Americans; Biological and medical sciences; Chi-Square Distribution; Cross-Sectional Studies; epidemiology; European Continental Ancestry Group; Female; Gynecology. Andrology. Obstetrics; Humans; Interviews as Topic; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Obstetrics and Gynecology; Pelvic Floor - physiopathology; Prevalence; racial differences; Surveys and Questionnaires; Urethra - physiopathology; urethral axis; urethral closure pressure; urinary incontinence; Urinary Incontinence, Stress - ethnology; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Urge - ethnology; Urinary Incontinence, Urge - physiopathology; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Urodynamics
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.04.027

Objective We sought to compare continence system function of black and white women in a population-based sample. Study Design As part of a cross-sectional population-based study, black and white women ages 35-64 years were invited to have pelvic floor testing to achieve prespecified groups of women with and without urinary incontinence. We analyzed data collected from 335 women classified as continent (n = 137) and stress (n = 102) and urge (n = 96) incontinent based on full bladder stress test and symptoms. Continence system functions were compared across racial and continence groups. Results Comparing black to white women, maximal urethral closure pressure (MUCP) was 22% higher in blacks than whites (68.0 vs 55.8 cm H2 O, P < .0001). White and black women with stress incontinence had MUCP 19% and 23% lower than continent women. MUCP in urge incontinent white women was as low as stress incontinent whites, but blacks with urge had normal urethral function. Conclusion Black women have higher urethral closure pressures than white women. White women with urge incontinence, but not black women, have reduced MUCP.