Urgency incontinence travelled with vascular disease and erectile dysfunction

Design

Secondary analysis of two prospective cohorts

Population

2,118 adults: urgency incontinence, urgency alone and controls

Primary outcome

Vascular comorbidity and erectile dysfunction by urgency phenotype

Effect

Vascular disease OR 3.2 (1.7 to 6.2); ED 64% vs 29% in men

A secondary analysis of two US lower urinary tract cohorts compared 2,118 people: 1,241 with urgency incontinence, 609 with urgency without leakage and 268 controls.

Those with urgency syndromes had three times the odds of vascular disease such as angina, heart failure, stroke or peripheral vascular disease (OR 3.2, 95% CI 1.7 to 6.2). Among men, erectile dysfunction affected 64% with urgency incontinence, 41% with urgency alone and 29% of controls. Vascular disease did not predict improvement at 12 months.

The association supports a vascular contribution to urgency in some patients. It does not mean treating vascular risk will improve bladder symptoms, but it gives a reason to look at cardiovascular risk in these patients.

• Ask about erectile function in men presenting with urgency incontinence
• Check blood pressure, glucose and lipids in patients with urgency syndromes
• Share cardiovascular risk findings with the patient's GP
• Do not expect vascular disease to predict response to bladder treatment

Why it matters

Urgency incontinence may be a window onto vascular disease that would otherwise go unchecked.

Don't overread it

Cross-sectional associations; they do not show vascular disease causes urgency.

The statistics, in plain English

An OR of 3.2 is a strong association, but the interval (1.7 to 6.2) is wide because there were only 268 controls. Vascular disease was self-reported.

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