1, the more clearly related factors
(1) Age.
The prevalence of female urinary incontinence gradually increases with age, with a high prevalence age of 45 to 55 years. The correlation between age and urinary incontinence may be related to the relaxation of the pelvic floor with age, estrogen reduction and degenerative changes in the urethral sphincter. Some common diseases of the elderly, such as chronic pulmonary disorders and diabetes mellitus, can also contribute to the progression of urinary incontinence. However, the incidence of stress incontinence tends to slow down in the elderly, which may be related to their lifestyle changes, such as reduced daily activities.
(2) Childbirth.
The number of births, the age at first birth, the mode of delivery, the size of the fetus and the incidence of urinary incontinence during pregnancy are significantly correlated with the occurrence of postpartum urinary incontinence, and the number of births is positively correlated with the occurrence of urinary incontinence.
Women who had their first birth between 20 and 34 years of age had a higher correlation between the occurrence of urinary incontinence and childbirth than other age groups; those who gave birth at an older age were more likely to have urinary incontinence; women who delivered vaginally were more likely to have urinary incontinence than those who delivered by cesarean section; women who had a cesarean section had a greater risk of urinary incontinence than women who did not have a child; the use of birth assistants such as forceps, suction devices, and contractions to speed up the labor process The use of midwifery techniques such as forceps, suction devices and contractions to speed up labor also increases the likelihood of urinary incontinence; mothers with large fetuses are also at greater risk of urinary incontinence.
(3) Pelvic organ prolapse.
Pelvic organ prolapse and stress incontinence seriously affect the health and quality of life of middle-aged and older women. Stress urinary incontinence and pelvic organ prolapse are closely related, and both are often present together. The thinning and disorganization of smooth muscle fibers, connective tissue fibrosis and muscle fiber atrophy in the pelvic floor support tissue of patients with pelvic organ prolapse may be associated with the development of stress urinary incontinence.
(4) Obesity.
Obese women are significantly more likely to develop stress urinary incontinence, and weight loss may reduce the incidence of urinary incontinence.
(5) Ethnic and genetic factors.
Genetic factors have a clearer correlation with stress urinary incontinence. The prevalence of patients with stress incontinence is significantly correlated with the prevalence of their immediate family members. The prevalence of urinary incontinence is higher in white women than in blacks.
2. Possible associated risk factors
(1) Estrogen.
Declining estrogen has long been thought to be associated with female stress urinary incontinence, and clinical treatment with estrogen has been advocated. However, recent data have questioned the role of estrogen, arguing that there is no correlation between changes in estrogen levels and the prevalence of stress urinary incontinence. It has even been suggested that estrogen replacement therapy may aggravate urinary incontinence symptoms.
(2) Hysterectomy.
If stress urinary incontinence occurs after hysterectomy, it is usually six months to one year postoperatively. Surgical technique and the extent of surgical resection may have a relationship with the occurrence of urinary incontinence. However, there is not enough evidence-based medical evidence to confirm a definite correlation between hysterectomy and the occurrence of stress urinary incontinence.
(3) Smoking.
The correlation between smoking and the occurrence of stress urinary incontinence is controversial. Some data suggest that urinary incontinence occurs at a higher rate in smokers than in nonsmokers and may be related to smoking-induced chronic cough and decreased collagen fiber synthesis. There are also data that smoking is not associated with the occurrence of urinary incontinence.
(4) Physical activity.
High-intensity physical activity may induce or exacerbate urinary incontinence, but there is a lack of sufficient evidence-based medical evidence.
Other possible associated factors are constipation, bowel dysfunction, caffeine intake, and chronic cough.