Association of age, hospitalizations, and physical activity with urinary incontinence in cystic fibrosis: a multicenter cross-sectional study

Background: Females with cystic fibrosis (fwCF) are at increased risk of urinary incontinence (UI), likely due to chronic coughing and elevated intra-abdominal pressure. Prevalence rates reported in the literature vary widely, and no large multicenter study has been carried out to date. Objective: To estimate the prevalence and severity of UI in fwCF and to investigate clinical variables associated with UI. Design: A multicenter, cross-sectional study conducted across 21 Italian CF centers. Methods: UI prevalence and severity were assessed using two validated questionnaires. A multivariable fractional polynomial approach was used to select variables for inclusion in the final logistic regression model to identify relevant associations with UI. Results: UI was present in 218/542 females (40.2%, 95% Confidence Interval (CI): 36.1-44.5). Among children and adolescents, the prevalence was 12/160 (7.5%, 95% CI: 4.1-13), whereas among adults it was 206/382 (53.9%, 95% CI: 48.8-59). FwCF with UI showed a BMI of 0.2 Z score higher (95% CI: 0.1-0.4) than fwCF without UI; however, the overall prevalence of UI in fwCF overweight was 41% (95% CI: 30.2-52.7) compared to 40.1% (95%CI: 35.6-44.7) in fwCF with normal weight. Age (interquartile range-odds ratio (IQR-OR) 4.19, 95% CI: 2.80-6.28), days of hospitalization (IQR-OR 1.72, 95% CI: 1.42-2.08), and physical activity (OR 0.66, 95% CI: 0.53-0.82) were the only factors statistically associated with UI. Conclusion: UI affects mostly adult fwCF and is associated with older age and longer hospitalization. Physical activity of ⩾150 min per week was also associated with a reduced probability of UI. (the CrISP Study Group)