Does Sexual Abuse Cause Urinary Problems?

Over 25% of the United States adult population report either physical or sexual lifetime abuse. Medically, abuse is strongly associated with a range of gastroenterologic and genitourinary symptoms. Even paternal rejection and hostility has been associated with somatization in irritable bowel syndrome patients (Behaviour Research and Therapy 42 (2004) 41-46).

Carol Link and colleagues from the New England Research Institutes in Massachusetts and the University of Virginia analyzed data from the Boston Area Community Health (BACH) survey a community-based epidemiologic study of many different urologic symptoms and risk factors with regard to urinary frequency (33% of BACH population), urgency (12%), and nocturia (28%).

They sought to determine whether sexual, physical, or emotional abuse experienced either as a child or as an adolescent/adult is associated with these symptoms, and the extent to which the association might be causal.

They found that the prevalence of various types of abuse are comparable (about 20% overall) to the limited available information from other population-based US surveys. The prevalence of urinary frequency, urgency, and nocturia was significantly higher in the group that had experienced abuse. This was consistent for each urologic symptom and regardless of whether the abuse was sexual, physical, or emotional. Childhood and adult emotional abuse and gender were associated with urinary frequency. The prevalence of all three urologic symptoms increases with the frequency of each type of abuse.

The authors conclude that current symptoms of urinary frequency, urgency, and nocturia are associated with previously experienced sexual, physical, and emotional abuse for both men and women and for three race/ethnic groups. The associations appear to meet several criteria suggesting a causal relationship.

Reference:
European Urology. 52(2): 397-406, August 2007
doi:10.1016/j.eururo.2007.03.024
Link CL, Lutfey KE, Steers WD, McKinlay JB

Reviewed by Philip M. Hanno, MD, a Contributing Editor with UroToday.

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