Risk Factors for Overactive Bladder and Urinary Incontinence

Risk Factors for OAB and UI

RISK FACTORS FOR OVERACTIVE BLADDER AND URINARY INCONTINENCE
	Men	Women
Age	Prevalence of OAB with urge incontinence increased with age from 0.3% to 8.9% in men, with a marked increase after 64yrs of age. In men 65yrs of age and older, the prevalence increased to 8.2% (65–74yrs) and 10.2% (≥75yrs) [NOBLE study].	Prevalence of OAB with urge incontinence increased with age from 2% (18–24yrs) to 19.1% (65–74yrs) in women, with a marked increase after 44yrs of age [NOBLE study].
Chronic medical conditions	MS, spinal cord injury, diabetes, Parkinson’s disease, stroke, dementia, impaired mobility, UTIs, smoking and obesity may cause bladder symptoms.	Same for women.
Medications	Diuretics, antidepressants, alpha-agonists, beta-antagonists, sedatives, anti-cholinergics, and analgesics can all cause urinary tract symptoms.	Same for women.
Menopause and estrogen depletion	N/A	Menopause has been associated with a decrease in urethralmucosa vascularity and thickness, as a result of diminished estrogen production.
Pelvic surgery	Incontinence has been seen in men following surgical treatment for prostate cancer.	Hysterectomy may increase a woman’s risk of incontinence.
Pregnancy and childbirth	N/A	Pregnancy and vaginal childbirth increase the risk of incontinence. Post-childbirth incontinence has been associated with the use of forceps, vacuum extraction, episiotomy, and pudendal anesthesia.
Prostate-related conditions	BPH, and prostatic obstruction secondary to BPH. Prostate cancer may also cause symptoms.	N/A
Race	The prevalence of OAB is 33.3% in African American (AA) men, 28% in Hispanic, 27% in Asian, and 26.3% in white men (EpiLUTS study). Similar trends were seen from the OAB-POLL study, with the highest prevalence in AA men (20.2%) compared to Hispanic (18.1%) or white (14.6%) men.	The prevalence of OAB is 45.9% in AA women, 43.4% in white, 42% in Hispanic, and 26.6% in Asian women (EpiLUTS study). Data from the OAB-POLL study showed a prevalence of 32.6% in AA women compared to 29.4% in white and 29% in Hispanic women. NHANES data on UI supports that AA women report the highest prevalence of urge-UI (11%) over white (7.5%) and Mexican-American (7.5%) women.
NOTES
Key: AA = African-American; MS = multiple sclerosis; NOBLE = National Overactive Bladder Evaluation; OAB = overactive bladder; UI = urinary incontinence; UTIs = urinary tract infections
REFERENCES
1) Milsom I, Stewart W, Thuroff J. The Prevalence of Overactive Bladder. American Journal of Managed Care. 2000 Jul; 6 (11 suppl) S565-73. 2) Newman DK. Managing and Treating Urinary Incontinence. Baltimore, MD: Health Professions Press; 2002. 3) Reynolds WS, Fowke J, Dmochowski R. The Burden of Overactive Bladder on US Public Health; Curr Bladder Dysfunct Rep. 2016 Mar; 11(1): 8-13. 4) Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and Burden of Overactive Bladder in US. World J Urol. (2003) 20:327-336. (Rev. 12/2018)

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