Urgency incontinence travels with vascular disease and erectile dysfunction

Design

Secondary cross-sectional and longitudinal analysis of LURN cohorts

Population

2118 adults: 1241 urgency incontinence, 609 urgency only, 268 controls

Primary outcome

Vascular comorbidity and erectile dysfunction

Effect

Vascular comorbidity OR 3.2 (95% CI 1.7 to 6.2); ED 64% UUI vs 29% controls

A secondary analysis of the US Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) cohorts compared 2118 adults: 1241 with urgency urinary incontinence, 609 with urgency without incontinence, and 268 controls.

Both urgency groups had about three times the odds of vascular comorbidity — angina, heart failure, myocardial infarction, stroke or peripheral vascular disease — after adjusting for age, sex and other illness. Among 762 men, erectile dysfunction was present in 64% with urgency incontinence, 41% with urgency alone and 29% of controls. Differences in cardiometabolic blood proteins did not survive adjustment. Vascular disease did not predict whether symptoms improved over a year.

The findings support a vascular contribution to some urgency symptoms, particularly urgency incontinence. Practically, new urgency incontinence — especially with erectile dysfunction in a man — is a reasonable prompt to check blood pressure, glucose, lipids and smoking. The data are cross-sectional and self-reported, so they show association, not that vascular disease causes urgency.

• Ask about erectile dysfunction in men presenting with urgency incontinence; nearly two-thirds had it.
• Check cardiovascular risk factors — blood pressure, HbA1c, lipids, smoking — in patients with urgency incontinence.
• Refer or coordinate with primary care when urgency symptoms reveal untreated vascular risk.
• Do not withhold standard overactive bladder treatment; vascular comorbidity did not predict poorer symptom improvement.

Why it matters

A urology visit for bladder symptoms may be the first chance to pick up unrecognised vascular disease.

Don't overread it

This cross-sectional analysis shows association; it does not establish that vascular disease causes urgency or that treating it improves the bladder.

The statistics, in plain English

An odds ratio of 3.2 (95% CI 1.7 to 6.2) for vascular comorbidity is a substantial association. The wide interval reflects the small control group of 268 people.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.