American Journal of Obstetrics & Gynecology
Volume 202, Issue 6 , Pages 584.e1-584.e12, June 2010

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

Presented at the 30th Annual Scientific Meeting of the American Urogynecologic Society, Hollywood, FL, Sept. 24-26, 2009, and received the Best Oral Presentation Award.

  • John O.L. DeLancey, MD

      Affiliations

    • Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI
    • Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI
    • Corresponding Author InformationCorresponding author
    • ,
  • Dee E. Fenner, MD

      Affiliations

    • Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI
    • Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI
    • ,
  • Ken Guire, MS

      Affiliations

    • Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI
    • Department of Biostatistics, University of Michigan, Ann Arbor, MI
    • ,
  • Divya A. Patel, PhD

      Affiliations

    • Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI
    • Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI
    • ,
  • Denise Howard, MD

      Affiliations

    • Peachtree Gynecology, Atlanta, GA
    • ,
  • Janis M. Miller, PhD, ANP-BC, RN

      Affiliations

    • Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI
    • Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI
    • School of Nursing, University of Michigan, Ann Arbor, MI

Received 3 August 2009; received in revised form 2 February 2010; accepted 14 April 2010.

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 H2O, 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.

Key words: epidemiology, prevalence, racial differences, urethral axis, urethral closure pressure, urinary incontinence

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 Reprints not available from the authors.

 Supported by National Institute of Childhood Diseases and National Institute on Aging R01HD/AG41123. Additional investigator support was provided by Office for Research on Women's Health's Special Center of Research on Sex and Gender Factors Affecting Women's Health and the National Institute of Child Health and Human Development through Grant P50 HD044406.

 Cite this article as: DeLancey JOL, Fenner DE, Guire K, et al. Differences in continence system between community-dwelling black and white women with and without urinary incontinence in the EPI study. Am J Obstet Gynecol 2010;202:584.e1-12.

PII: S0002-9378(10)00457-6

doi:10.1016/j.ajog.2010.04.027

American Journal of Obstetrics & Gynecology
Volume 202, Issue 6 , Pages 584.e1-584.e12, June 2010

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