Assessing the Impact of Low Testosterone Levels and Frailty on Urinary Incontinence in Elderly Women: A Prospective Cross-Sectional Study

This study examines the relationship between low testosterone levels, frailty, and urinary incontinence (UI), specifically stress urinary incontinence (SUI) and urgency urinary incontinence (UUI), in elderly women. Conducted at the Yokosuka Urogynecology and Urology Clinic, Japan, this prospective cross-sectional study enrolled 2,721 women aged 60 and above. We classified 1,328 participants into frailty and no-frailty groups, with equal representation. Our investigation revealed that 36.2% of participants reported SUI, and 28.7% reported UUI. After adjusting for age discrepancies using ANCOVA, significant associations were found between low total testosterone levels and both forms of UI, particularly in the frailty group. Multivariate analysis showed that low testosterone levels, diabetes, and cerebral infarction were significantly associated with SUI in the no-frailty group, while factors such as age, low testosterone, diabetes, and vaginal deliveries were linked to UUI in the frailty group. These findings underscore the importance of considering frailty and low testosterone levels in the therapeutic approach to UI in elderly women. The study suggests a novel perspective on the pathophysiology of UI, highlighting the need for specific treatment strategies targeting these risk factors.