Urinary incontinence as a novel and underrecognized clinical manifestation of prolactinoma in women.

OBJECTIVE

Prolactin exerts numerous pleiotropic effects on various tissues, including smooth muscle. Urinary incontinence, particularly the urge subtype, is primarily associated with detrusor overactivity-the involuntary contractions of the bladder's smooth muscle. The aim of this study is to investigate the potential impact of prolactinoma on urinary incontinence (UI) in women.

METHODS

This cross-sectional study included 64 patients with prolactinoma and 80 controls. UI was assessed using the International Consultation on Incontinence Questionnaire-Short Form. Based on this instrument, incontinence was categorized into three subtypes: urge urinary incontinence (UUI), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI).

RESULTS

The overall rate of UI was significantly higher in prolactinoma patients, with 20 cases (31.3%), compared to 6 cases (7.5%) in the control group (p < 0.001). Compared to the control group, prolactinoma patients exhibited higher rates of UUI and MUI, while no difference was found in SUI rates (p = 0.012, p = 0.008, and p = 0.839; respectively). Incontinent patients had a higher mean age, a greater frequency of macroadenoma, and a longer disease duration compared to continent patients (p = 0.015, p = 0.038, and p < 0.001; respectively). The logistic regression analysis suggested that the disease duration was the only independent predictor of UI in the prolactinoma patients.

CONCLUSION

Prolactinoma, particularly in the later stages of the disease, may influence detrusor muscle activity in female patients and contribute to an increased prevalence of UI.