Nav: Home

New genomic analysis promises benefit in female urinary incontinence

May 28, 2017

Copenhagen, Denmark: Urinary incontinence in women is common, with almost 50% of adult women experiencing leakage at least occasionally. Genetic or heritable factors are known to contribute to half of all cases, but until now studies had failed to identify the genetic variants associated with the condition. Speaking at the annual conference of the European Society of Human Genetics today (Monday), Dr Rufus Cartwright, MD, a visiting researcher in the Department of Epidemiology and Biostatistics, Imperial College, London, UK, will say that his team's investigations hold out the promise that drugs already used for the treatment of other conditions can help affected women combat this distressing problem.

Pelvic floor disorders, including urinary incontinence, but also faecal incontinence and pelvic organ prolapse, have a devastating effect on quality of life. Most commonly they occur after childbirth, or at menopause, though some women report incontinence dating from childhood. Of the 25% who are affected sufficiently for it to affect their daily lives, most suffer from stress incontinence - the loss of small amounts of urine associated with laughing, coughing, sneezing, exercising or other movements that increase pressure on the bladder. Isolated urgency incontinence - where a sudden pressing need to urinate causes the leakage of urine - affects only around 5% of women, and 5-10% have a combination of both forms.

"25% of adult women will experience incontinence severe enough to impact on their quality of life," says Dr Cartwright. "Finding a genetic cause and a potential treatment route is therefore a priority."

The researchers undertook a genome-wide association study (GWAS) in just under 9,000 women from three groups in Finland and the UK, confirming their findings in six further studies. Genome-wide association studies work by scanning markers across the complete sets of DNA of large numbers of people in order to find genetic variants associated with a particular disease.

Analysis of the study data yielded a risk locus for urinary incontinence close to the endothelin gene, known to be involved in the ability of the bladder to contract. Drugs that work on the endothelin pathway are already used in the treatment of pulmonary hypertension and Raynaud's syndrome, a condition where spasm of the arteries causes reduced blood flow, most usually to the fingers.

"Previous studies had failed to confirm any genetic causes for incontinence. Although I was always hopeful that we would find something significant, there were major challenges involved in finding enough women to participate, and then collecting the information about incontinence. It has taken more than five years of work, and has only been possible thanks to the existence of high quality cohort studies with participants who were keen to help," says Dr Cartwright.

Current treatment for urinary incontinence in women includes pelvic floor and bladder training, advice on lifestyle changes (for example, reducing fluid intake and losing weight), drugs to reduce bladder contraction, and surgery.

However, as the number of identified risk variants for urinary incontinence grows, there will be potential to introduce genetic screening for the condition, and improve advice to pregnant women about the likely risks of incontinence in order that they may make an informed choice about delivery method. "We know that a caesarean section offers substantial protection from incontinence. However, across Europe there are efforts to reduce caesarean section rates, and establishing such a screening programme during pregnancy may run against current political objectives in many maternity care systems.

"Clearly this will need further debate and an analysis, not just of the cost to healthcare systems, but also of the benefit to women who may be spared the distress of urinary incontinence," Dr Cartwright will conclude.

Chair of the ESHG conference, Professor Joris Veltman, Director of the Institute of Genetic Medicine at Newcastle University, Newcastle, United Kingdom, said: "This work reveals the first links between urinary incontinence and genetic factors. It provides important insight into the biological mechanisms for incontinence and suggests the potential of identifying women at risk."
-end-
Abstract no: C18.4.

European Society of Human Genetics

Related Incontinence Articles:

Does adding therapy before, after surgery for urinary incontinence help?
Adding behavioral and physical therapy before and after surgery for women with stress and urgency urinary incontinence resulted in a small improvement in symptoms compared to women who just had surgery but that difference in symptoms may not be clinically important.
Study shows advantages for stress urinary incontinence surgery
One of the most commonly performed surgeries to treat stress urinary incontinence in women may have better long-term results than another common surgical technique, according to a study led by Mayo Clinic researchers.
Childbirth delivery methods and risk of incontinence, overactive bladder
Pelvic floor disorders such as urinary incontinence and pelvic organ prolapse (when one or more of the pelvic organs drop from their normal position) are associated with childbirth and affect millions of women in the United States.
Poll: Half of women over 50 experience incontinence, but most haven't talked to a doctor
Nearly half of women over 50 say they sometimes leak urine according to a new national poll.
Getting relief from sexual dysfunction and incontinence caused by menopause
Microablative fractional CO2 lasers are energy-based devices designed to help manage troublesome menopause symptoms such as painful sex, dryness, itching/burning, urinary frequency, and incontinence.
Overweight and obesity linked to higher risk of urinary incontinence for women
Being overweight or obese is linked with an increased risk of developing urinary incontinence for young to mid-aged women, according to an Obesity Reviews analysis of all relevant published studies.
WPSI says screen all women annually for urinary incontinence
All women should be screened annually for urinary incontinence, according to new guidelines from the Women's Preventive Services Initiative (WPSI).
Men tolerate stress incontinence years before seeking help
Men often tolerate stress urinary incontinence for more than two years before seeking medical help -- and one-third put up with it for more than five years, making it important for doctors to check for this problem, a new study from UT Southwestern researchers advises.
Chronic medical conditions are common in women with urinary incontinence
New research published in BJU International indicates that women with urinary incontinence often have other chronic conditions.
Urinary incontinence may have negative effects on sexual health
In a new BJU International study, women with urinary incontinence reported declines in sexual activity and arousal over the last year, and they expressed increased concern about their frequency of sexual activity and ability to become sexually aroused.
More Incontinence News and Incontinence Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.