Persistent Urinary Incontinence in Female Patients with Chronic Cough: A 6-month Longitudinal Analysis

Urinary incontinence (UI) is common among female patients with chronic cough; however, factors associated with persistent UI and related clinical outcomes remain insufficiently defined.

Longitudinal data were analyzed from female patients with chronic cough enrolled in the Korean Chronic Cough Registry. Study participants received cough guideline-based management. Cough-associated UI status and patient-reported outcome (PRO) measures were evaluated at baseline and at 6 months. UI status was categorized as persistent, resolved, or absent based on findings at both time points. Baseline clinical characteristics were compared across groups, and regression analyses were conducted to identify factors associated with persistent UI and to estimate longitudinal changes in PROs.

Among 206 female study participants, 24.3% had persistent UI, 22.3% showed improvement, and 50% had no UI. At the 6-month assessment, 11 (16.7%) subjects with minimal cough severity (cough Visual Analog Scale [VAS] < 20) continued to report UI. Patients with persistent UI were older than those without UI (57.8 ± 11.1 vs. 51.6 ± 14.9 years, P = 0.026) and had a higher body mass index (BMI) (24.8 [22.2-27.4] vs. 23.0 [20.8-25.2] kg/m², P = 0.018). Multiple correspondence analysis showed that age ≥ 60 years and BMI ≥ 25 kg/m² were associated with persistent UI. Regression analyses indicated that improvements in Cough Hypersensitivity Questionnaire scores at 6 months were significantly smaller in the persistent UI group than in the resolved UI group after adjustment for confounders, including cough severity VAS.

UI may persist in one-quarter of female patients despite treatment for chronic cough. Persistent UI was associated with older age, higher BMI, and less improvement in cough hypersensitivity symptom scores. These findings indicate heterogeneity in UI outcomes during chronic cough management and underscore the need for clinical attention to patients with persistent UI.