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Is the occurrence of storage and voiding dysfunction affected by menopausal transition or associated with the normal aging process?

Chen, Yi-Ching MS, PT1; Chen, Gin-Den MD2; Hu, Suh-Woan DDS, PhD3; Lin, Tzu-Li RN4; Lin, Long-Yau MD, DSc2,5


Objectives To evaluate whether the increasing occurrence of urinary and voiding dysfunction is independently influenced by the transition from pre- to postmenopause or by the interactive and additive effects of age-associated changes in bladder and urethral function.

Design Of the 1,584 women randomly sampled from a community-based health population, 1,253 (79.1%) were successfully interviewed. The participants were asked to reply to the Bristol Female Urinary Tract Symptoms Questionnaire regarding various storage symptoms and voiding dysfunction. The χ2 test and Cochran-Armitage trend test were used for analysis.

Results The prevalence of storage symptoms such as frequency, urgency, nocturia, and urge incontinence in premenopausal and menopausal groups was 18.0% versus 29.8%, 9.8% versus 20.7%, 21.2% versus 38.2%, and 6.8% versus 15.7%, respectively (all P < 0.05). In premenopausal and menopausal groups, the prevalence of hesitancy, poor stream, incomplete emptying, voiding with abdominal straining, discontinuous urine flow, and dribbling was also significantly different (17.2% v 22.9%, 17.8% v 25.7%, 12.7% v 21.9%, 4.9% v 11.6%, 16.2% v 24.5%, and 9.4% v 17.6%, respectively; all P < 0.05). However, the occurrences of various storage symptoms, namely, frequency, urgency, nocturia, and urge incontinence, as well as voiding symptoms such as incomplete emptying, discontinuous urine flow, and dribbling, were also significantly associated with the normal aging process (P < 0.05).

Conclusions Our results imply that the increasing occurrences of storage and voiding dysfunctions are not only affected by pre- and postmenopausal transition but are also closely associated with aging changes.

From the 1School of Physical Therapy, 2Department of Obstetrics and Gynecology, 3Institute of Stomatology, Dental School, 4School of Nursing, and the 5Department of Epidemiology, Chung Shan Medical University and Hospital, Taichung, Taiwan.

Received July 11, 2002; revised and accepted September 26, 2002.

This study was supported in part by a grant from the National Science Council in Taiwan (NSC-89-2314-b-040-046).

Address reprint requests to Gin-Den Chen, MD, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital 110, Section 1, Chien-Kuo N. Road, Taichung 40201 Taiwan. E-mail:

©2003The North American Menopause Society