The Influence of Psychiatric Comorbidities and Sexual Trauma on Lower Urinary Tract Symptoms in Female Veterans

PurposeWe characterized the association of psychiatric comorbidities and sexual trauma with lower urinary tract symptoms in women.Materials and MethodsConsecutive women (121) referred for evaluation of lower urinary tract symptoms to a specialized urology clinic were given validated questionnaires including the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7. These data were then analyzed according to psychiatric comorbidities, history of sexual trauma, age, race and obstetric history. Baseline incidence of psychiatric comorbidity and sexual trauma was also compared to a control population (1,298) from which all patients were referred.ResultsWomen referred for evaluation of lower urinary tract symptoms had higher rates of psychiatric comorbidities (64.5% vs 25.9%, p <0.001) and sexual trauma (49.6% vs 20.1%, p <0.001) compared to those in the primary care clinic. Total survey scores for the Incontinence Impact Questionnaire-7 were significantly higher for patients with psychiatric comorbidities and sexual trauma (11.05 ± 0.84) compared to scores of patients with neither of these conditions (7.6 ± 1.02, p = 0.010). Stepwise multivariate regression analyses demonstrated that higher Urogenital Distress Inventory-6 scores were associated only with age younger than 50 years and history of miscarriage, and that higher Incontinence Impact Questionnaire-7 scores were associated only with psychiatric comorbidities and history of miscarriage.ConclusionsPsychiatric comorbidities and sexual trauma are prevalent in female veterans presenting for evaluation of lower urinary tract symptoms and psychiatric comorbidities are associated with greater quality of life impact.