86 Saudi Med J 2010; Vol. 31 (1) www.smj.org.sa Characteristics of women attending a urogynecology clinic in Riyadh Ahmed H. Al-Badr, FRCS(c), FACOG, Aneela G. Kamil, MCPS, FCPS, Ehab F. Wahbah, MBBS, SSCOG, Valerie A. Zimmerman, MS, PhD, Mohamad A. Al-Tannir, DMD, MPH. E pidemiological population based trials from the western world identiied many factors associated with urinary incontinence (UI) in women. 1 hese include increasing age, parity, obesity, and chronic cough. he median UI prevalence in women is 27.6% (range: 4.8-58.4%). Stress urinary incontinence (SUI) comprises 50% of all UI cases, followed by mixed urinary incontinence (MUI, 32%) and urge urinary incontinence (UUI, 14%). 1 According to a regional survey, the mean number of children for a Saudi woman is 7, compared with reports that the mean number of children per woman in the Western world ranges from 0.98-2.1. 2 he prevalence of obesity in Saudi women was reported as 20.3%, while 25.2% are overweight. 3 herefore, common characteristics in Saudi women include grand multiparity and obesity that put them at risk for developing UI. he objective of this study was to determine the distribution of lower urinary tract symptoms (LUTS) and associated factors in women presenting at our urogynecology clinic during the speciied study period. A retrospective chart review was performed for all patients attending the urogynecology clinic at Security Forces Hospital, Riyadh, KSA (a tertiary care hospital) from August 2003 to January 2005. Institutional Review Board approval was sought before data collection and analysis. All patients underwent standard evaluation, medical, surgical, and obstetrical history, as well as general physical and urogynecological examination. Observations included age, body mass index (BMI), and parity. he BMI was calculated using the formula as weight (kg)/height 2 (meter 2 ). Further evaluations, including laboratory tests and imaging, were carried out as required. Lower urinary tract symptoms were deined according to revised International Continence Society (ICS) recommendations. 4 Assessments at irst visit included pelvic organ prolapse (POP), SUI, over active bladder (OAB-wet; OAB with UUI), MUI, urinary tract infection (UTI), and OAB-dry (OAB without UUI). Enquiries made by a specialized urogynecologist with the assistance of residents and interns. Assessments were based on patient symptoms. Pelvic organ prolapse stage was documented using the POP-Q system. 4 Data were evaluated using the appropriate tests for signiicance. Proportions of categorical variables were compared using Chi square, Fisher’s exact test, or McNemar’s test as appropriate. A p-value ≤0.05 was considered signiicant. Characteristics of 153 women were included. he mean age was 45 years (SD ± 8.3). Of 102 patients for whom BMI data were available, 97.1% (n=99) were at least overweight, 3 were underweight, and no patients had normal BMI. he majority of patients were premenopausal (71.8%) and grand multiparous (79.1%, parity ≥5). Table 1 shows clinical and demographic characteristics of continent and incontinent women. Urinary incontinence, afecting 128 women (83.6%), was the predominant LUTS, primarily presenting as SUI (n=118; 77.1%). Almost half (n=73; 47.7%) of women complained of POP. Almost three-fourths Brief Communication Table 1- Clinical and demographic characteristics. Characteristics Continent Incontinent Total P-value (n=25) (n=128) (N=153) Age (years), mean±SD 39.1±7.4 46.1±9.1 45.0±8.3 0.370 BMI kg/m 2 , mean±SD 29.4±5.6 33.8±7.2 33.0±6.8 (102 total)* 0.163 Parity, mean±SD 0-4, n (%) >4, n (%) 5.6±3.6 11 (44) 14 (56) 7.1±2.9 21 (16.4) 107 (83.6) 6.8±3.0 32 (20.9) 121 (79.1) 0.002 POP, n (%) 5 (20) 68 (53.1) 73 (47.7) 0.002 Nocturia, n (%) 11 (44) 77 (60.2) 88 (57.0) 0.325 Anal incontinence, n (%) 2 (8) 11 (8.69) 13 (8.5) 0.812 DM, n (%) 0 (0) 21 (16.4) 21 (13.7) 0.029 Asthma, n (%) 2 (8) 38 (29.7) 40 (26.1) 0.024 *missing data on BMI - body mass index, POP - pelvic organ prolapse, DM - diabetes mellitus, SD - standard deviation