Urinary incontinence is common among people attending pulmonary rehabilitation, yet pulmonary rehabilitation has a small effect on urinary symptoms: A multicenter prospective cohort study

INTRODUCTION: Urinary incontinence (UI) is common among individuals with chronic respiratory diseases (CRDs) and may limit attendance, completion, and response to pulmonary rehabilitation (PR). This study aims to assess what is the prevalence of UI among individuals attending PR, and how does PR affect UI and other clinical outcomes, and if UI is associated with PR completion and response. METHODS: A multicenter prospective cohort study was conducted. UI was assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) questionnaire before and after an 8-week program. Completion was defined as attending at least 70% of sessions. Response was defined as achieving minimum clinically important differences (MCIDs) in any clinical outcome. RESULTS: Among 341 individuals with CRDs 48% female, mean age of 63 (SD 10)), UI prevalence was 38% (95% CI 32 to 44) and remained unchanged following PR. PR led to a positive effect on urinary symptoms (ICIQ-UI-SF mean change -1.8, 95% CI -2.5 to -1.1), although the magnitude of change was below the established MCID of 4 points. PR also led to a positive improvement on the Saint George's Respiratory Questionnaire total score (-4, 95% CI -7 to -2). The associations between UI and PR completion and response were imprecise due to wide confidence intervals. CONCLUSIONS: UI is common among individuals attending PR, yet PR has a small effect on urinary symptoms. Despite this, individuals with UI may still achieve improvements from the program. Our findings suggest that UI should not delay PR initiation but should be screened and managed as part of the multidisciplinary care that defines PR.