BACKGROUND Bladder health encompasses total bladder well-being and not merely the absence of urinary symptoms. While much is known about the prevalence of urinary symptoms in women, little is known about the distribution of bladder health (e.g., optimal to poor). OBJECTIVE We report the distributions of multiple dimensions of bladder health and function in a population-based sample of community-dwelling women, overall and separately in women without urinary symptoms to begin to explore bladder health dimensions that may precede the onset of symptoms. STUDY DESIGN RISE FOR HEALTH is a regionally-representative cohort study of US women aged 18 and older. Baseline surveys included the validated Bladder Health Scales/Bladder Function Indices, the 10-item Symptoms of Lower Urinary Tract Dysfunction Research Network Symptom Index, and additional study items. Bladder well-being was assessed across 10 scales and bladder function across six indices. Bladder Health Scale scores were adjusted for adaptive/coping behaviors (e.g., using/carrying pads, staying close to a toilet) to account for the perceived impact of urinary symptoms on well-being. Scores for scales and indices ranged from 0 (poor well-being/function) to 100 (optimal well-being/function). We calculated summary statistics for each scale (with and without adaptive behavior adjustment) and each index in the full study population and subset of women without urinary symptoms. RESULTS The mean age of 3,027 eligible participants was 49.8 years (SD 17.9). The median global Bladder Health Scale score was 72 (IQR: 56, 84) before adjustment for adaptive/coping behaviors and 55 (IQR: 34, 78) after adjustment. Median scores for the other scales ranged from 75-100 before and 61-72 after adjustment. Sixty-nine percent of participants reported using adaptive/coping behaviors, including using pads (40%), toilet mapping (58%), and staying close to a toilet (3%). The median overall Bladder Function Index score was 77 (IQR: 63, 89); individual median scores ranged from 63-68 for frequency, sensation, continence, and emptying indices to 100 for biosis/urinary tract infection and comfort indices. Among participants without reported urinary symptoms (n=700), scores were higher across all scales (unadjusted medians=88-100 and adjusted medians=82-100) and indices (medians=93-100), indicating better, but not optimal health; however, 38% of asymptomatic women reported using adaptive/coping behaviors: 11% using pads, 30% toilet mapping, and 2% staying close to a toilet. CONCLUSION We observed a wide range of bladder well-being and function in RISE participants, and high utilization of adaptive/coping behaviors. Bladder health variability and utilization of adaptive/coping behaviors was also observed in women without urinary symptoms, highlighting bladder health dimensions not captured by traditional urinary symptom tools and potentially identifying a group of women with "sub-clinical" symptoms who may be at greater risk of developing urinary symptoms. Future prospective analyses should investigate this novel group of women further.

中文翻译：

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美国女性的膀胱健康：来自 RISE FOR HEALTH 研究的基于人群的估计。


背景 膀胱健康包括膀胱的整体健康，而不仅仅是没有泌尿系统症状。虽然对女性泌尿系统症状的患病率了解很多，但对膀胱健康状况的分布知之甚少（例如，从最佳到不良）。目的 我们报告了社区居民妇女总体样本中膀胱健康和功能的多个维度的分布，总体和单独分布在没有泌尿系统症状的妇女中，以开始探索可能在症状出现之前出现的膀胱健康维度。研究设计 RISE FOR HEALTH 是一项针对 18 岁及以上美国女性的具有区域代表性的队列研究。基线调查包括经过验证的膀胱健康量表/膀胱功能指数、10 项下尿路功能障碍症状研究网络症状指数和其他研究项目。通过 10 个量表评估膀胱健康状况，通过 6 个指标评估膀胱功能。膀胱健康量表评分根据适应性/应对行为（例如，使用/携带护垫、靠近马桶）进行调整，以解释泌尿系统症状对健康的感知影响。量表和指数的分数范围从 0（健康状况/功能不佳）到 100（最佳幸福感/功能）。我们计算了整个研究人群和无泌尿系统症状的女性子集中每个量表（有和没有适应性行为调整）和每个指数的汇总统计数据。结果 3,027 名符合条件的参与者的平均年龄为 49.8 岁 （SD 17.9）。调整适应/应对行为前，总体膀胱健康量表评分中位数为 72 （IQR： 56， 84），调整后为 55 （IQR： 34， 78）。其他量表的中位数分数在调整前 75-100 分和调整后 61-72 分之间。 69% 的参与者报告使用适应性/应对行为，包括使用垫子 （40%）、厕所映射 （58%） 和靠近厕所 （3%）。膀胱功能指数总体评分中位数为 77 （IQR： 63， 89）;个体中位数评分范围从频率、感觉、节制和排空指数的 63-68 到 BIOSIS/尿路感染和舒适度指数的 100。在未报告泌尿系统症状的参与者 （n=700） 中，所有量表 （未调整的中位数 = 88-100 和调整后的中位数 = 82-100） 和指数 （中位数 = 93-100） 的分数都较高，表明健康状况更好，但不是最佳;然而，38% 的无症状女性报告使用了适应性/应对行为：11% 使用护垫，30% 使用厕所映射，2% 靠近厕所。结论 我们观察到 RISE 参与者的膀胱健康和功能范围很广，并且适应性/应对行为的利用率很高。在没有泌尿系统症状的女性中还观察到膀胱健康的变异性和适应性/应对行为的利用，突出了传统泌尿系统症状工具无法捕捉的膀胱健康维度，并可能识别出一组具有“亚临床”症状的女性，这些女性可能更容易出现泌尿系统症状。未来的前瞻性分析应进一步调查这一新的女性群体。