Comparison of stress urinary incontinence between urban women and women of indigenous origin in the Brazilian Amazon

Int Urogynecol J. 2021 Feb;32(2):395-402. doi: 10.1007/s00192-020-04439-6. Epub 2020 Jul 18.

Abstract

Introduction and hypothesis: This study compared two populations in the Brazilian Amazon, one comprising urban women and the other indigenous origin women from a riparian population, to assess the prevalence of and risk factors associated with stress urinary incontinence (SUI).

Methods: Following sample calculation, 120 indigenous and 260 urban women underwent evaluations including medical history, UI-oriented physical examination, pelvic organ prolapse, and functional assessment of the pelvic floor. Women with complaints of SUI underwent a urodynamic study and completed a quality of life questionnaire (King's Health Questionnaire). Univariate ORs were calculated, and multiple logistic regression models were then built using the stepwise backward method.

Results: The prevalence of SUI was similar in both groups (25.8% in indigenous origin women and 20.4% in the urban group (P > 0.05). The parity and number of spontaneous deliveries and home births were higher in the indigenous origin group. Multivariate analysis showed a decreased prevalence of SUI in patients with modified Oxford Scale scores ≥ 3. Women with homebirths had a 3.45-fold higher likelihood of having SUI than women with hospital deliveries (OR 3.45 -CI 1.78-6.70). Quality of life was worse in the domains of SUI impact, hindering daily and physical activities as well as jeopardizing personal and emotional relationships in urban women.

Conclusions: No significant difference in SUI was observed between the groups, despite significantly higher risk factors for SUI in the indigenous origin group.

Keywords: Indigenous, Amazon; Pelvic floor disorders, quality of life; Stress urinary incontinence.

MeSH terms

  • Brazil / epidemiology
  • Female
  • Humans
  • Pelvic Floor
  • Pelvic Organ Prolapse*
  • Pregnancy
  • Quality of Life
  • Urinary Incontinence, Stress* / epidemiology