Prospective questionnaire-based evaluation of the prevalence of urinary incontinence in women with chronic cough

Purpose: Because chronic cough leads to repeated increases in intra-abdominal pressure, it might cause or unmask stress urinary incontinence (SUI). To test this hypothesis, we performed a cross-sectional prospective survey of women with chronic cough and female subjects without cough symptoms.

Methods: A group of women with chronic cough (n = 297) presenting at a specialty asthma/allergy clinic over an 18-month period and a control group (n = 106) completed a self-administered survey that included the Urogenital Distress Inventory (UDI)-6 questionnaire and a global quality of life (QOL) question. Subjects on medication for bladder symptoms (n = 14) or who had undergone prior anti-incontinence surgery (n = 29) were excluded.

Results: 263 patients and 97 control subjects met criteria for analysis. Chronic cough patients were older than control subjects (median 41 versus 35 years; p < 0.001). There was no difference in weight between groups (p = 0.544). The UDI-6 question responses correlated with each other and with the responses to the QOL questions (p values <or=0.002). Chronic cough patients were more bothered by urinary frequency (UDI question 1, 33 vs. 20%, p = 0.018), sense of incomplete emptying (UDI question 5, 10 vs. 3%, p = 0.047). There was no statistical difference in SUI between chronic cough patients and controls (UDI question 3, 24 vs. 15%, p = 0.059).

Conclusions: Based on this exploratory study, we found no statistically significant difference in the prevalence of SUI between patients with or without chronic cough. However, increased urinary frequency may have had a protective effect on SUI, thereby masking a larger difference in SUI.