Urinary Incontinence and Overactive Bladder Symptoms in Women with Breast Cancer Being Treated with Oral Hormone Therapy

Abstract

Objective The objective of the present study is to observe the frequency and severity of urinary symptoms in women with breast cancer (BC) being treated with oral hormone therapy, associating them to drug adherence.

Methods The participants were interviewed once from June to October 2016. The evaluation of urinary symptoms was performed by two questionnaires: International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB). Adherence was evaluated by the Morisky-Green method. Statistical analysis was performed by the Mann-Whitney test, linear regression, and Spearman correlation.

Results Fifty-eight women were interviewed: 42 treated with tamoxifen and 16 with aromatase inhibitor. Twenty-seven women (46.5%) presented urinary incontinence symptoms and 15 (25.8%) presented stress urinary incontinence (SUI). Fourteen (24.1%) women had symptoms of overactive bladder (OAB). There was no statistical difference in symptoms between both treatments and duration of treatments. Higher scores in the ICIQ-SF questionnaire were associated with low/medium adherence and advanced age. Higher scores in the ICIQ-OAB questionnaire were associated with low/medium adherence.

Conclusion The present study showed a high prevalence of urinary symptoms, such as urinary incontinence and OAB, associated with low/medium adherence and older age in women with BC being treated with oral hormone therapy. Health professionals should be alert to these symptoms since it could influence life quality and adherence to treatment.

Resumo

Objetivo O objetivo do presente estudo foi observar a frequência e a gravidade dos sintomas urinários em mulheres com câncer de mama em uso de terapia hormonal oral, associando estes com a adesão ao tratamento.

Métodos As pacientes foram entrevistadas uma única vez, entre junho e outubro de 2016. A avaliação dos sintomas urinários foi realizada por dois questionários: International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF, na sigla em inglês) e o Questionário Sobre Bexiga Hiperativa (ICIQ-OAB, na sigla em inglês). A adesão foi avaliada pelo método Morisky-Green. A análise estatística foi realizada pelo teste de Mann-Whitney, regressão linear e correlação de Spearman.

Resultados Foram entrevistadas 58 mulheres: 42 tratadas com tamoxifeno e 16 com inibidor de aromatase. Vinte e sete mulheres (46,5%) apresentaram sintomas de incontinência urinária (IU) e 15 (25,8%) apresentaram incontinência urinária por estresse (IUS). Quatorze (24,1%) das mulheres tinham sintomas de bexiga hiperativa. Não houve diferença estatística nos sintomas entre os tratamentos e a duração dos tratamentos. Os escores mais elevados no questionário ICIQ-SF estiveram associados à baixa/média adesão e à idade avançada. Os escores mais elevados no questionário da ICIQ-OAB foram associados à baixa/média adesão.

Conclusão O presente estudo mostrou alta prevalência de sintomas urinários, como IU e bexiga hiperativa, associadas à baixa/média adesão e à idade mais avançada em mulheres com câncer de mama em tratamento com hormonioterapia oral. Os profissionais de saúde devem estar atentos a esses sintomas, pois eles podem influenciar a qualidade de vida e a adesão ao tratamento.

Keywords

hormone replacement therapy - urinary incontinence - urinary bladder overactive - medication adherence

Palavras-chave

terapia de reposição hormonal - incontinência urinária - bexiga hiperativa - adesão ao tratamento

Contributors

All of the authors participated in the concept and design of the present study; analysis and interpretation of data; drafting or revising of the manuscript, and they have approved the manuscript as submitted. All authors are responsible for the reported research.

Publikationsverlauf

Eingereicht: 01. April 2020

Angenommen: 10. August 2020

Artikel online veröffentlicht:
30. November 2020

• References

• 1 Ferlay J, Soerjomataram I, Ervik M. et al. GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012 v1.0 [Internet]. Lyon: IARC; 2013. [cited 2019 Jun 19]. Available from: https://publications.iarc.fr/Databases/Iarc-Cancerbases/GLOBOCAN-2012-Estimated-Cancer-Incidence-Mortality-And-Prevalence-Worldwide-In-2012-V1.0-2012
• 2 União Internacional Contra o Câncer. Manual de oncologia clínica da UICC. 8a ed.. São Paulo: Fundação Oncocentro de São Paulo; 2006
• 3 Burstein HJ, Temin S, Anderson H, Buchholz TA, Davidson NA, Gelmon KE. et al. Adjuvant endocrine therapy for women with hormone receptor-positive breast cancer: american society of clinical oncology clinical practice guideline focused update. J Clin Oncol 2014; 32 (21) 2255-2269
• 4 Osborne CK. Tamoxifen in the treatment of breast cancer. N Engl J Med 1998; 339 (22) 1609-1618
• 5 Cuzick J, Sestak I, Forbes JF, Dowsett M, Knox J, Cawthorn S. et al; IBIS-II investigators. Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial. Lancet 2014; 383 (9922): 1041-1048
• 6 Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U. et al; Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21 (02) 167-178
• 7 Juliato CR, Baccaro LF, Pedro AO, Costa-Paiva L, Lui-Filho J, Pinto-Neto AM. Subjective urinary urgency in middle age women: A population-based study. Maturitas 2016; 85: 82-87
• 8 Baumgart J, Nilsson K, Stavreus-Evers A, Kask K, Villman K, Lindman H. et al. Urogenital disorders in women with adjuvant endocrine therapy after early breast cancer. Am J Obstet Gynecol 2011; 204 (01) 26.e1-26.e7
• 9 Cheng CL, Li JR, Lin CH, de Groat WC. Positive association of female overactive bladder symptoms and estrogen deprivation: A nationwide population-based cohort study in Taiwan. Medicine (Baltimore) 2016; 95 (28) e4107
• 10 Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 2005; 365 (9472): 1687-1717
• 11 Haylen BT, Maher CF, Barber MD. et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J Pelvic Floor Dysfunct 2016; 27 (02) 165-194
• 12 Pereira SB, Thiel RdoR, Riccetto C, Silva JM, Pereira LC, Herrmann V, Palma P. [Validation of the International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB) for Portuguese]. Rev Bras Ginecol Obstet 2010; 32 (06) 273-278
• 13 Tamanini JTN, Dambros M, D'Ancona CAL, Palma PCR, Rodrigues Netto Jr N. [Validation of the “International Consultation on Incontinence Questionnaire–Short Form” (ICIQ-SF) for Portuguese]. Rev Saude Publica 2004; 38 (03) 438-444
• 14 Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986; 24 (01) 67-74
• 15 Reigota RB, Pedro AO, de Souza Santos Machado V, Costa-Paiva L, Pinto-Neto AM. Prevalence of urinary incontinence and its association with multimorbidity in women aged 50 years or older: A population-based study. Neurourol Urodyn 2016; 35 (01) 62-68
• 16 Soler R, Gomes CM, Averbeck MA, Koyama M. The prevalence of lower urinary tract symptoms (LUTS) in Brazil: Results from the epidemiology of LUTS (Brazil LUTS) study. Neurourol Urodyn 2018; 37 (04) 1356-1364