女性應力性尿失禁與生物電阻抗分析定義之肌少症的關係

江長和¹、范玉華 ^1,2、林登龍^1,2、林志杰^1,2、程威銘³、黃志賢^1,2

¹臺北榮民總醫院泌尿部

²國立陽明交通大學醫學院泌尿學科 書田泌尿科學研究中心

³臺北市立聯合醫院忠孝院區泌尿科

Association with Female Stress Urinary Incontinence and Sarcopenia Defined by Bioelectrical Inpedance Analysis

Chang-Ho Chiang¹, Yu-Hua Fan^1,2, Teng-Lung Lin^1,2,Chih-Chieh Lin ^1,2,

Wei-Ming Cheng³, William J. Huang^1,2

¹Department of Urology, Taipei Veterans General Hospital

²Department of Urology, College of Medicine and Shu-Tien Urological Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

³ Division of Urology, Department of Surgery, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan

Purpose:

Sarcopenia is defined as an age associated decline in skeletal muscle mass. Sarcopenia at the level of the pelvic floor muscles is of special importance in the aging woman as it may contribute to stress urinary incontinence (SUI). Nevertheless, limited literature investigated the association between SUI and sarcopenia and reported conflicting results. This study aimed to investigate the association between sarcopenia and SUI.

Materials and Methods:

We prospectively enrolled the female patients with lower urinary tract symptoms who visited urological outpatient clinic at Taipei Veterans General Hospital and Taipei City Hospital Zhongxiao Branch from January 2021 to February 2022. SUI symptoms and quality of life were assessed using the Symptom Severity Index and Symptom Impact Index for Stress Incontinence questionnaire. Body composition analysis through bioelectrical impedance analysis (BIA) was performed with InBody 770 (Biospace, Seoul, Korea). Sarcopenia was defined as percentage of skeletal muscle mass obtained from BIA in relation to body weight <27.6%. Additionally, data regarding demographic characteristics and comorbidities were collected. Multivariate logistic regression analyses were conducted to assess the predictive factors of SUI.

Results

In total, 113 patients were enrolled. Among them, 31 patients had at least grade 1 SUI (Grade 1, n= 4; Grade 2, n= 16; Grade 3, n= 8; Grade 4, n= 3). The number of deliveries was significantly higher in patients with SUI(p= 0.013). Moreover, having a history of hysterectomy was more prevalent in SUI patients(p= 0.033). Regarding the BIA variables, the prevalence of sarcopenia(p= 0.03), leg muscle mass index (p= 0.045), fat mass index were significantly higher in patients with SUI(p= 0.031).

Multivariate logistic regression analyses reported that part of aforementioned variables, including the number of deliveries ( OR= 1.85, 95% CI: 1.113-3.075, p= 0.018 ), leg muscle index (OR= 2.684, 95% CI: 1.071-6.724, p= 0.029) and fat mass index( OR= 0.281, 95% CI: 1.023-1.714, p= 0.033) remained significantly associated with the occurrence of SUI. Furthermore, old age( OR= 2.331, 95% CI: 2.251-47.001, p= 0.003) was an independent predictor of SUI.

Conclusions