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:

Mixed results on effectiveness of acupuncture to treat stress urinary incontinence, infertility
Electroacupuncture improved stress urinary incontinence -- that's when a woman can experience an involuntary loss of urine such as when sneezing or coughing -- but acupuncture did not increase the likelihood of childbirth among women with infertility, according to two studies published by JAMA.
New genomic analysis promises benefit in female urinary incontinence
Urinary incontinence in women is common, with almost 50 percent of adult women experiencing leakage at least occasionally.
Majority of incontinence treatments deliver poor results
Surgery is the most reliable method of treatment for incontinence -- curing the condition in just over eight in ten cases; other types of treatment, meanwhile, do not deliver the same kind of success.
Body composition may affect older women's risk of urinary incontinence
In a study of older women, the prevalence of stress- and urgency urinary incontinence (SUI and UUI) was at least two-fold higher among women in the highest category of body mass index (BMI) or fat mass compared with women in the lowest category.
ATOMS device effectively treats male incontinence with high patient satisfaction
In the largest study yet to assess the long-term safety and efficacy of the adjustable transobturator male system (ATOMS) to treat incontinence in men following invasive prostate treatment, the overall success and dry rates were 90% and 64%, respectively, after a median of 31 months.
Stress urinary incontinence drug's benefits do not outweigh harms
A new study indicates that the benefits of duloxetine, a drug used in Europe to treat stress incontinence in women, do not outweigh the harms.
Weethinking the role of bacteria in incontinence
We have much to learn about the bladder, bacteria in the urinary tract, and their relationship to incontinence.
Botox may beat neural stimulation for urge incontinence, but has risks
A head-to-head comparison of sacral neuromodulation and botulinum toxin led by a Duke Health researcher shows that Botox provides more daily relief for women suffering from urgency urinary incontinence, but might also be associated with more adverse events.
Mayo clinic first to implant device to solve fecal incontinence
JACKSONVILLE, Fla. -- A clinical team on Mayo Clinic's Florida campus is the first to offer four patients with long-term fecal incontinence a new and potentially long-lasting treatment -- a small band of interlinked magnetic titanium beads on a titanium string that successfully mimics the function of the anal sphincter.
New soft material could reduce complications for women suffering from urinary incontinence
Researchers at the University of Sheffield have developed a novel implantable material which could reduce the number of debilitating side-effects that occur as a result of using a material that is too rigid for surgical treatment of incontinence.

Related Incontinence Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Changing The World
What does it take to change the world for the better? This hour, TED speakers explore ideas on activism—what motivates it, why it matters, and how each of us can make a difference. Guests include civil rights activist Ruby Sales, labor leader and civil rights activist Dolores Huerta, author Jeremy Heimans, "craftivist" Sarah Corbett, and designer and futurist Angela Oguntala.
Now Playing: Science for the People

#520 A Closer Look at Objectivism
This week we broach the topic of Objectivism. We'll be speaking with Keith Lockitch, senior fellow at the Ayn Rand Institute, about the philosophy of Objectivism as it's taught through Ayn Rand's writings. Then we'll speak with Denise Cummins, cognitive scientist, author and fellow at the Association for Psychological Science, about the impact of Objectivist ideology on society. Related links: This is what happens when you take Ayn Rand seriously Another Critic Who Doesn’t Care What Rand Thought or Why She Thought It, Only That She’s Wrong Quote is from "A Companion to Ayn Rand"