Prevalence of urinary incontinence and its relation to occupational status among Egyptian female patients presenting with chronic cough

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However, there is few information about its actual prevalence among women with chronic cough. There are some previous studies that link urinary incontinence to the occupational status. Aim of work : To measure the prevalence of stress urinary incontinence and to identify the relationship between urinary incontinence and occupational status among female patients with chronic cough. Materials and methods: A cross-sectional study was conducted on 80 female patients presented with chronic cough of any cause, all patients were interviewed using a structured questionnaire that included personal, occupational, chronic cough and urinary incontinence questionnaire. General and local examination were done. Results: Out of 80 patients, 55% were found to have stress urinary incontinence. Gastro esophageal reflux disease (GERD) was the most prevalent cause of chronic cough (48.8%) followed by bronchial asthma (22.5%). Most of the studied patients (90.9%) reported that leaking of urine interferes with their quality of life. The frequency of UI among working females was significantly higher than non-workers. Occupations requiring physical activity had significantly higher frequency of UI than those without. Other environmental work conditions as unclean or uncomfortable workplaces had no significant relationship with UI. Menopause patients had 2.9 times higher risk to develop UI. The mean age, mean number of parities, vaginal delivery, median duration of cough, cough severity index and cough visual analogue scale were significantly higher in UI patients. The logistic regression was performed to test effects of different risk factors on UI, Results indicated that age, type of occupations according to physical activity and cough severity index were independently statistically significant risk factors for UI in female patients with chronic cough Conclusion: Urinary Incontinence (UI) is common in female patients with chronic cough (55%). Age, type of occupations according to physical activity and cough severity index were independently significant risk factors for UI in female patients with chronic cough. urinary incontinence chronic cough occupational status and cough severity index Introduction A chronic cough is described as one that lasts more than eight weeks and, even when treated according to published standards, frequently does not improve with medical care. A persistent cough is linked to a lower quality of life, which includes discomfort in the body, sadness, and social isolation ( 1 ). “Complaint of involuntary leakage of urine" is the definition of urinary incontinence. Urge urinary incontinence (UUI), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI) are the three most prevalent forms ( 2 ). Women who are incontinent range from 23–55% ( 3 ). Age, BMI, parity, and hysterectomy are the potential risk factors for UI in women ( 4 ). Cough can affect the patient’s life functionally, physically, emotionally and psychosocially ( 5 ). In Egypt, patient’s awareness of the relationship between chronic chough and urinary incontinence has not been measured ( 6 ). Few studies have related the occupational status of females with urinary incontinence ( 7 ). Different risky work settings, such as dirty and uncomfortable workplaces, hazardous work and accidents, time pressure, extended awkward positions and heavy lifting, have been linked to urinary incontinence ( 8 ). This study aimed to measure the prevalence of stress urinary incontinence among female patients and to determine the relationship between urinary incontinence and occupational status among female patients with chronic cough. The need to measure the community burden of urinary incontinence among Egyptian women presenting with chronic cough and relate it to their occupations, to pave the way for screening and early detection projects for urinary incontinence among Egyptian females for their treatment and health improvement, drove our team to conduct this study. Materials and methods This was a cross-sectional study. With the institutional ethics committee’s approval of Faculty of medicine, Ain Shams University, the research was conducted on 80 female patients with chronic cough who attended the outpatient respiratory clinic of Ain Shams University hospitals from July to December 2023., after consent assignment. Study procedure: 1. Interview questionnaire: First part : Included personal and occupational history: age, marital status, number of parities, comorbidities, menopause, type of occupations, working hours, years of employment, different hazardous exposure, heavy lifting, unclean and uncomfortable workplace, etc. Second part : Included questions about their chronic cough e.g. diagnosed chest disease, duration of cough, severity of cough according to cough severity index (5), and cough visual analogue scale and complications of cough. Third part : Included urinary incontinence questionnaire (9) as leakage of urine during physical activity including coughing and sneezing, level of activity that causes urine leakage, sex life affection, declaration about incontinence without direct question, etc Clinical examination including general examination, calculating BMI and local examination were done. Statistical analysis: SPSS version 23 was used to code, enter, and analyze the data after it had been checked for consistency and completeness. Chi square was used to compare the frequency and percent representations of the qualitative data. The Student t test was used to compare quantitative data. This study used a p-value < 0.05 threshold of significance and a 95% confidence level for adjusted odds ratios. Mann Whitney u test used to compare quantitative non parametric date and represented as median and interquartile range (IQR). The logistic regression was performed to test effects of different risk factors independently on UI. Results A total of 80 female patients with chronic cough were included in the study, out of which 55% (95% CI=40 -70%) were found to have stress urinary incontinence. Mean age of the study group was 41.5+12.5. Mean of BMI was 27.9+ 6.2. The median duration of chronic cough was 6.5 (2.8-44) months. Mean of cough severity index and cough visual analogue scale of the study group were (6.5 (2.8-44), 21.9+ 9.3, 2.9+ 1.3) respectively. GERD was the most common cause of chronic cough (48.8%) followed by bronchial asthma (22.5%). Among UI patients, the majority of the studied patients (90.9%) reported that urinary leakage interfered with their quality of life, 43.1% of UI patients reported that their sexual life was affected. All female patients with UI didn’t declare about incontinence without direct question (100%) . By comparing occupational status in patients with UI and without UI, the frequency of UI among working females was significantly higher than non-workers (p value = 0.03, OR= 3.5, 95% CI=1.1 -10.7). Occupations requiring physical activity had significantly higher frequency of UI than those without (p value=0.001 OR= 5.5, 95% CI=0.8-34.1) as shown in table (1). Other hazardous environmental work conditions as unclean or uncomfortable workplace had no significant relationship with UI. Only lifting heavy objects was significant as all of cleaners reported lifting heavy objects . The mean age, mean number of parity, and vaginal delivery were significantly higher in UI patients. Menopause patients had 2.9 times higher risk to develop UI (table 2). Other risk factors as constipation, associated gynecological disease, recurrent UTI, hysterectomy, comorbidities, nutritional status had no significant relations between female patients with UI and without UI. Patients with UI had significantly longer median cough duration, higher mean cough severity index, and a mean cough visual analogue scale compared to those without UI (p value <0.05) (table 3). The logistic regression was performed to test effects of different risk factors on UI. Results indicated that age, type of occupations according to physical activity and cough severity index were independently statistically significant risk factors for UI in female patients with chronic cough. The Nagelkerke R square indicated that the model accounted for 70.7% of the total variance as shown in table (4). Discussion Chronic cough is common and affects both patients and physicians. Prolonged coughing is linked to a lower quality of life, which includes discomfort in the body, sadness, and social isolation ( 1 ). It is often recognized that women's coughs are frequently linked to urine incontinence (UI); however, little is known regarding the true frequency of this condition among women who have chronic coughs, particularly in the Arab world, such as Egypt ( 10 ). There are some previous studies that link urinary incontinence to the occupational status ( 8 ). A total of 80 female patients with chronic cough were investigated, out of which 55% were found to have stress urinary incontinence. The prevalence rate of UI was shown to vary widely in earlier studies, ranging from 16.1–68.8% ( 11 , 12 ). Our results are in accordance with the study of Yang’s et al., 2022 which investigated the different risk factors for urinary incontinence in female adult patients with chronic cough and found that the frequency of urinary incontinence in female patients with chronic cough was 50.1% ( 13 ) and this is not far from an European study by Hunskaar et al. in 2004 , where in 35% of women reported experiencing any type of involuntary urine loss (UI). Spain had the lowest incidence at 23%, but the UK, France, and Germany had higher rates at 44%, 41%, and 42%, respectively ( 3 ). The most prevalent causes of chronic cough, according to the literature, are upper airway cough syndrome, asthma and GERD ( 12 ). This somewhat agrees with our results where GERD was the most common cause of chronic cough which was found in 48.8% of patients followed by bronchial asthma, which was found in 22.5% of patients. In the current study, the majority of patients (90.9%) reported that urinary leakage interfered with their quality of life and 43.1% of UI patients reported that their sexual life was affected, this was in line with Corrado team study in 2020, which found that UI affects a variety of facets of patients' lives, including relationships at work, with family, and during sexual activity. As a result, UI can lower patients' quality of life ( 14 ). According to Bradaia et al. (2009), who looked into the effects of UI among female patients who had interstitial lung diseases-related chronic cough, the median impact of UI was 3 (minimum = 1, maximal = 5) on a 5-point quality of life scale, while the median impact of chronic cough was 3.5 ( 15 ). According to the current results, 43.1% of UI patients reported that their sexual life was affected and this was not far from what reported by Corrado and his coworkers in 2020 who indicated that UI is often difficult to accept, because it negatively affects their privacy and sexuality ( 14 ). All female patients with UI didn’t declare about incontinence without direct questioning (100%), which is due to the delicate nature of the subject, individuals often underreport their illness. The same reason explains the low medical request rates in the European countries for this issue, for example; about a quarter of those in Spain and the UK had ever visited a physician for their condition ( 3 ) and In 2009, a different European team under the direction of Bradaia found that most patients (64%) thought that incontinence was a normal aging symptom, that all patients felt embarrassed about this symptom, and that 79% of patients were unable to bring it up with the physicians ( 15 ). The present study showed that occupations requiring physical activity (heavy lifting) had significantly higher frequency of UI than non-physical work, which aligns with what was reported in a cross-sectional study by Wang and his colleagues in China, that indicated that manual labor was a risk factor for incontinence in women compared to mental work ( 16 ). Liao et al. (2008) also showed that lifting heavy objects at work was a risk factor for incontinence among Taipei school teachers. ( 17 ). The current study showed that other environmental work conditions as unclean, uncomfortable, accidents, time pressure, awkward positions had no significant relationship with UI and this was in line with Kaya et al.'s study, which examined the relations between various work-related factors and UI in 218 nurses and 63 secretaries and found no significant relationships ( 18 ). However, Kim et al.'s 2017 study produced a different conclusion, stating that urinary incontinence was significantly linked to various work environments, including an unhygienic and uncomfortable workplace, accidents, time constraints, and awkward positions ( 8 ). This diversity may result from varying occupational workplaces and environments. Our study found that older age was an indicator of risk for UI, which is in keeping with other research that found that age was a significant risk factor for UI. This may be explained by the fact that urethral sphincter tension decreases with age ( 19 , 20 ). The same in a European study which conducted by Hunskaar et al., in 2004 , revealed that prevalence increased with age, which adds to our results ( 3 ). We found that more severe cough either by cough severity index or cough visual analogue scale and long duration of cough were significant risk factors for UI, which concurs with Yang’s et al ., 2022 who reported that patients with UI had considerably greater median cough duration and cough visual analogue scores than those without UI ( 13 ). Contrary to our results that deny the significance of BMI as a risk factor for UI, previous studies have shown that high BMI was a significant indicator of the existence of UI in female patients ( 19 , 20 , 21 ). Noblett et al. examined the link between BMI and intra-abdominal and intra-vesical pressure, suggesting that being overweight or obese may result in a persistent condition of elevated pressure in the pelvic floor, increasing the risk of UI ( 22 ). This disparity could result from varying demographics and small sample size in current study. One of the most important environmental factors related to UI is thought to be pregnancy and childbirth. In our research, the mean number of parities, and vaginal delivery were significantly higher in UI patients. Menopause patients had 2.9 times higher risk of developing UI. These results partially match those of Schreiber Pedersen et al., 2017 where age, parity & vaginal deliveries were strongly associated with UI ( 21 ). In contrast to Guin et al.’s study, we didn’t find any association between nutritional status and UI. Guin et al., 2018 reported that stress urine incontinence was found to be more common in those with poor nutritional status; causing weak pelvic support ( 23 ). This discrepancy may be due to the different age groups and nutritional categorizations between studies. Hysterectomy may alter the support of the bladder and urethral neck and impair the complex mechanism of the urethral sphincter by damaging the inferior hypogastric plexus and distal branches of pudendal nerves. However, we found no association between hysterectomy & UI. The results of different studies are controversial, as Singh et al., 2013 reported a significant relation between hysterectomy and different types of incontinence ( 24 ). On the other hand, Burgio et al., 1991 and Samuelsson et al., 1997 reported that urinary incontinence was not significantly associated with hysterectomy ( 25 , 26 ). This controversial may be attributed to the variant hand skills of surgeons. By using logistic regression analysis, our results showed that age, occupational status according to physical activity and cough severity index were independently statistically significant risk factors for UI in female patients with chronic cough which are somehow consistent with Yang et al., 2022 who reported that Patients with UI had significantly higher scores for daytime cough symptoms, night time cough symptoms, and cough visual analogue scores than did patients without UI. However, it was discovered that only the cough VAS score may be an independent risk factor for UI when the three values mentioned above were included in a multivariate logistic regression analysis. Muscle strain from regular exercise, particularly moderate-to-high intensity activity, can raise the pressure inside the abdomen. Furthermore, exercise-induced cough could consistently raise abdominal pressure which increases the risk of UI ( 13 ), which may explain why occupations requiring physical activity had significantly higher frequency of UI than those without. Conclusion Prevalence of UI among female patients with chronic cough was 55%. GERD was the most common cause of chronic cough followed by bronchial asthma. UI interfered with their quality of life. All patients didn’t declare about UI without direct questions. Worker female patients with chronic cough had significantly higher frequency of UI especially those with physical activity. The mean age, number of parities, vaginal delivery, cough severity index and cough visual analogue scale were significantly higher in UI patients. Old age, occupations with physical activities and cough severity index were independently significant risk factors for UI in female patients with chronic cough. Recommendations: We recommend screening and early detection of UI among females with chronic cough and raising awareness about UI for their treatment and improving health. We recommend following international safety standards and guidelines to improve occupational status and environment at workplace for working women in addition, health education for working female patients about UI specially with chronic cough and guidelines standards to lift heavy objects are mandatory. Abbreviations UI..................................... Urinary Incontinence GERD.............................. Gastro esophageal reflux disease BMI.................................. Body Mass Index UUI ………………….. Urge urinary incontinence. SUI .................................. stress urinary incontinence MUI................................. mixed urinary incontinence. IQR................................... interquartile range CI...................................... Confidence interval OR.................................... Odds ratio Declarations Ethics approval and consent to participate This study was approved by the ethics committee of Ain Shams University, Faculty of Medicine, ethical approval no. FMASU R 124/2023. The subject participant provided written consent. Consent for publication Not applicable. Availability of data and materials The data used during study are available from authors on reasonable request. Conflict of Interest None Funding None Acknowledgements The study's participants are all thanked by the authors for their assistance. Contributions The study's conception, design, preparation of the materials, data collection, and analysis were all done by the authors. The final manuscript was read and approved by all writers. References Morice A, Millqvist E, Bieksiene K, Surinder S. et al. (2020): “ERS guidelines on the diagnosis and treatment of chronic cough in adults and children,” Eur. Respir. J., vol. 55, no. Abrams P, Cardozo M, Fall M, et al. (2003): The standardisation of terminology in lower urinary tract function: Report from the standardisation sub-committee of the International Continence Society, Urology, vol. 61, no. 1, pp. 37–49, Jan. 2003 . Hunskaar S, Lose G, Sykes D, and Voss S. (2009): The prevalence of urinary incontinence in women in four European countries,” BJU Int., vol. 93, no. 3, pp. 324–330. Danforth KN, Townsend MK, Lifford K, Curhan GC, Resnick NM, and Grodstein F. (2006): “Risk factors for urinary incontinence among middle-aged women,” Am. J. Obstet. Gynecol., vol. 194, no. 2, pp. 339–345 . Shembel, AC, Rosen CA, Zullo TG, and Gartner-Schmidt JL. (2013): “Development and validation of the cough severity index: a severity index for chronic cough related to the upper airway,” Laryngoscope, vol. 123, no. 8, pp. 1931–1936 . Soliman SSA, Mbbch HHH, Azab A, Ali H, and Zarzour. 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Kaplan AG. (2019): Chronic Cough in Adults: Make the Diagnosis and Make a Difference. Pulm Ther.;5(1):11-21 . Yang C, Feng Z, Chen Z, Xu D, Li Y, Lai K, Yi F. (2022): The risk factors for urinary incontinence in female adults with chronic cough. BMC Pulmonary Medicine. 18;22(1):276 . Corrado B, Giardulli B, Polito F, Aprea S, Lanzano M, Dodaro C. (2020): The Impact of Urinary Incontinence on Quality of Life: A Cross-Sectional Study in the Metropolitan City of Naples. Geriatrics (Basel). 2020 Nov 20;5(4):96 . Bradaia F, Lazor R, Khouatra, C Poissonnier L, Cottin,V and Cordier JF. (2009): “Urinary incontinence due to chronic cough in interstitial lung disease],” Rev. Mal. Respir., vol. 26, no. 5, pp. 499–504 . Wang Y , Xu K , Hu H , et al . (2011): Prevalence, risk factors, and impact on health related quality of life of overactive bladder in China. Neurourol Urodyn ;30:1448–55. Liao Y-M , Dougherty MC , Biemer PP , et al . (2008): Factors related to lower urinary tract symptoms among a sample of employed women in Taipei. Neurourol Urodyn ;27:52–9. Kaya Y , Kaya C , Baseskioglu B , et al . (2016): Effect of work-related factors on lower urinary tract symptoms in nurses and secretaries. Low Urin Tract Symptoms ;8:49–54. Xie X, Chen Y, Khan A, Long T, Li S, Xie M. (2021): Risk factors for urinary incontinence in Chinese women: a cross-sectional survey. Urogynecology. 2021 Jun 1;27(6):377-81 . Lamerton TJ, Torquati L, Brown WJ. (2018): Overweight and obesity as major, modifiable risk factors for urinary incontinence in young to mid‐aged women: a systematic review and meta‐analysis. Obesity Reviews. 2018 Dec;19(12):1735-45 . Schreiber Pedersen L, Lose G, Høybye MT, Elsner S, Waldmann A, Rudnicki M. (2017): Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark. Acta obstetricia et gynecologica Scandinavica.;96(8):939-48 . 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Tables Table (1): Relation between urinary incontinence and occupational status of the studied patients: Variables Patient with SUI(n=44) Patient without SUI(n=36) Test of significance P value Odds ratio 95% CI Working patients Non-working patients 38 (86.4%) 6 (13.6%) 23(63.9%) 13(36.1%) X 2 =0.019 0.033* 3.5 1.1-10.7 Type of occupations: -Occupations with physical activity** -Occupations without physical activity*** 23 (52.3%) 15 (34.1%) 4 (11.1%) 19 (52.8%) X 2 =10.8 0.003* 5.5 0.8-34.1 *Statistically significant at p- value <0.05 X 2 means chi-square value CI: confidence interval (95%) ** Occupations with physical activity (lifting heavy objects) as cleaners *** Occupations without physical activity as employees Table (2): Relation between urinary incontinence and associated risk factors: Variables Patient with SUI (n=44) Patient without SUI(n=36) Test of significance P value Odds ratio 95% CI Age (years) 47.6 + 9.2 34.1 + 12 t=5.6 0.001* BMI (kg|m2) 28.6+5.8 26.9+6.6 t=1.2 0.22 Number of parity 3+1.5 1.6+1.7 t=3.8 0.001* Number of vaginal delivery 2.6+1.6 1.3+1.7 t=3.45 0.001* Menopause 18(40.9%) 7 (19.4%) X 2 =4.24 0.039* 2.8 1.03-7.9 *Statistically significant at p- value <0.05 t= independent sample t test CI: confidence interval (95%) **Other risk factors as constipation, associated gynecological disease, recurrent UTI, hysterectomy, comorbidities, nutritional status had no significant relations between female patients with UI and without UI. Table (3): Relation between urinary incontinence and cough status (cough duration of cough, cough severity index, cough visual analogue scale and causes of chronic cough among studied patients: Variables Patient with SUI (n=44) Patient without SUI(n=36) Test of significance P value Duration of chronic cough (months) 12 (3-82.5) 3.5(3.5-15) Mann Whitney ** 0.031* -Cough severity index 25.8+8.2 17.1+8.2 t=4.7 0.001* -Cough visual analogue scale 3.34+1.2 2.4+1.1 t=3.6 0.001* *Statistically significant at p- value <0.05 ** Mann Whitney u test used Table (4): Relation between different risk factors & stress urinary incontinence: Chronic cough patients with UI and without UI ** Independent factor Β p-value Odds ratio 95% Confidence Interval Lower Upper Age 0.227 0.003* 1.25 1.07 1.47 Menopause 1.55 0.162 0.211 0.024 1.87 Number of parity 0.316 0.507 1.37 0.54 3.48 Number of vaginal delivery 0.234 0.538 0.791 0.37 1.66 Type of occupations according to physical activity 2.171 0.037* 8.7 1.1 67.1 cough severity index 0.126 0.032* 1.13 1.01 1.27 cough visual analogue scale 0.131 0.77 1.1 0.47 2.7 Duration of cough per month 0.00 0.969 1.00 0.99 1.01 *Statistically significant at p- value <0.05 **Dependent Variable: Chronic cough patients with UI and without UI R square= 0.707 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4803847","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":338300839,"identity":"cd76bcae-2f03-430b-8193-9c888fd70520","order_by":0,"name":"Ragy Mamdouh Ghaly","email":"data:image/png;base64,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","orcid":"","institution":"Ain Shams University","correspondingAuthor":true,"prefix":"","firstName":"Ragy","middleName":"Mamdouh","lastName":"Ghaly","suffix":""},{"id":338300840,"identity":"a8cba83a-d2f9-4dc0-b542-e1c366688f81","order_by":1,"name":"Alaa Mohamed Atef Karim Eldin","email":"","orcid":"","institution":"Ain Shams University","correspondingAuthor":false,"prefix":"","firstName":"Alaa","middleName":"Mohamed Atef Karim","lastName":"Eldin","suffix":""},{"id":338300841,"identity":"ff56d75d-6b0b-4664-90ed-9fc1c37ec57b","order_by":2,"name":"Dina Abbas Mohamed AbdelRahman","email":"","orcid":"","institution":"Ain Shams University","correspondingAuthor":false,"prefix":"","firstName":"Dina","middleName":"Abbas Mohamed","lastName":"AbdelRahman","suffix":""},{"id":338300842,"identity":"1f9f714e-ee6d-4d43-a9d7-6d1703ff78f1","order_by":3,"name":"Marwa Hussein Elassal","email":"","orcid":"","institution":"Ain Shams University","correspondingAuthor":false,"prefix":"","firstName":"Marwa","middleName":"Hussein","lastName":"Elassal","suffix":""}],"badges":[],"createdAt":"2024-07-25 19:02:35","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4803847/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4803847/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":63014444,"identity":"90d8a75d-559f-4dc7-8c06-de66695d6df9","added_by":"auto","created_at":"2024-08-22 06:25:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":960436,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4803847/v1/66773edf-d5d8-4cf5-9262-309768a24f1c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of urinary incontinence and its relation to occupational status among Egyptian female patients presenting with chronic cough","fulltext":[{"header":"Introduction","content":"\u003cp\u003eA chronic cough is described as one that lasts more than eight weeks and, even when treated according to published standards, frequently does not improve with medical care. A persistent cough is linked to a lower quality of life, which includes discomfort in the body, sadness, and social isolation (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e\u0026ldquo;Complaint of involuntary leakage of urine\" is the definition of urinary incontinence. Urge urinary incontinence (UUI), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI) are the three most prevalent forms (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Women who are incontinent range from 23\u0026ndash;55% (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Age, BMI, parity, and hysterectomy are the potential risk factors for UI in women (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCough can affect the patient\u0026rsquo;s life functionally, physically, emotionally and psychosocially (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In Egypt, patient\u0026rsquo;s awareness of the relationship between chronic chough and urinary incontinence has not been measured (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFew studies have related the occupational status of females with urinary incontinence (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Different risky work settings, such as dirty and uncomfortable workplaces, hazardous work and accidents, time pressure, extended awkward positions and heavy lifting, have been linked to urinary incontinence (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study aimed to measure the prevalence of stress urinary incontinence among female patients and to determine the relationship between urinary incontinence and occupational status among female patients with chronic cough.\u003c/p\u003e \u003cp\u003eThe need to measure the community burden of urinary incontinence among Egyptian women presenting with chronic cough and relate it to their occupations, to pave the way for screening and early detection projects for urinary incontinence among Egyptian females for their treatment and health improvement, drove our team to conduct this study.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eThis was a cross-sectional study. With the institutional ethics committee\u0026rsquo;s approval of Faculty of medicine, Ain Shams University, the research was conducted on 80 female patients with chronic cough who attended the outpatient respiratory clinic of Ain Shams University hospitals from July to December 2023., after consent assignment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy procedure:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1. Interview questionnaire:\u003c/strong\u003e \u003c/p\u003e\n\u003col style=\"list-style-type: upper-alpha;\"\u003e\n \u003cli\u003e\u003cstrong\u003eFirst part\u003c/strong\u003e: Included personal and occupational history: age, marital status, number of parities, comorbidities, menopause, type of occupations, working hours, years of employment, different hazardous exposure, heavy lifting, unclean and uncomfortable workplace, etc.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSecond part\u003c/strong\u003e: Included questions about their chronic cough e.g. diagnosed chest disease, duration of cough, severity of cough according to cough severity index (5), and cough visual analogue scale and complications of cough.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eThird part\u003c/strong\u003e: Included urinary incontinence questionnaire (9) as leakage of urine during physical activity including coughing and sneezing, level of activity that causes urine leakage, sex life affection, declaration about incontinence without direct question, etc\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eClinical examination including general examination, calculating BMI and local examination were done.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSPSS version 23 was used to code, enter, and analyze the data after it had been checked for consistency and completeness. Chi square was used to compare the frequency and percent representations of the qualitative data. The Student t test was used to compare quantitative data. This study used a p-value \u0026lt; 0.05 threshold of significance and a 95% confidence level for adjusted odds ratios. \u0026nbsp;Mann Whitney u test used to compare quantitative non parametric date and represented as median and interquartile range (IQR). The logistic regression was performed to test effects of different risk factors independently on UI.\u003c/p\u003e"},{"header":"Results","content":"\u003cp style=\"text-align: left;\"\u003eA total of 80 female patients with chronic cough were included in the study, out of which 55% (95% CI=40 -70%) were found to have stress urinary incontinence. Mean age of the study group was 41.5+12.5. \u0026nbsp;Mean of BMI was 27.9+ 6.2. The median duration of chronic cough was 6.5 (2.8-44) months. Mean of cough severity index and cough visual analogue scale of the study group were (6.5 (2.8-44), 21.9+ 9.3, 2.9+ 1.3) respectively. GERD was the most common cause of chronic cough (48.8%) followed by bronchial asthma (22.5%). Among UI patients, the majority of the studied patients (90.9%) reported that urinary leakage interfered with their quality of life, 43.1% of UI patients reported that their sexual life was affected. All female patients with UI didn\u0026rsquo;t declare about incontinence without direct question \u003cspan dir=\"RTL\"\u003e(100%)\u003c/span\u003e.\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cspan dir=\"LTR\"\u003eBy comparing occupational status in patients with UI and without UI, the frequency of UI among working females was significantly higher than non-workers (p value = 0.03, OR= 3.5, 95% CI=1.1 -10.7). Occupations requiring physical activity had significantly higher frequency of UI than those without (p value=0.001 OR= 5.5, 95% CI=0.8-34.1) as shown in table (1). Other hazardous environmental work conditions as unclean or uncomfortable workplace had no significant relationship with UI. Only lifting heavy objects was significant as all of cleaners reported lifting heavy objects\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e.\u003c/span\u003e\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cspan dir=\"LTR\"\u003eThe mean age, mean number of parity, and vaginal delivery were significantly higher in UI patients. Menopause patients had 2.9 times higher risk to develop UI\u003c/span\u003e\u003cspan dir=\"LTR\"\u003e\u0026nbsp;(table 2). Other risk factors as constipation, associated gynecological disease, recurrent UTI, hysterectomy, comorbidities, nutritional status had no significant relations between female patients with UI and without UI.\u003c/span\u003e\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cspan dir=\"LTR\"\u003ePatients with UI had significantly longer median cough duration, higher mean cough severity index, and a mean cough visual analogue scale compared to those without UI (p value \u0026lt;0.05) (table 3).\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eThe logistic regression was performed to test effects of different risk factors on UI. Results indicated that age, type of occupations according to physical activity and cough severity index were independently statistically significant risk factors for UI in female patients with chronic cough. The Nagelkerke R square indicated that the model accounted for 70.7% of the total variance as shown in table (4).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eChronic cough is common and affects both patients and physicians. Prolonged coughing is linked to a lower quality of life, which includes discomfort in the body, sadness, and social isolation (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). It is often recognized that women's coughs are frequently linked to urine incontinence (UI); however, little is known regarding the true frequency of this condition among women who have chronic coughs, particularly in the Arab world, such as Egypt (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). There are some previous studies that link urinary incontinence to the occupational status (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA total of 80 female patients with chronic cough were investigated, out of which 55% were found to have stress urinary incontinence. The prevalence rate of UI was shown to vary widely in earlier studies, ranging from 16.1\u0026ndash;68.8% (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur results are in accordance with the study of \u003cb\u003eYang\u0026rsquo;s et al., 2022\u003c/b\u003e which investigated the different risk factors for urinary incontinence in female adult patients with chronic cough and found that the frequency of urinary incontinence in female patients with chronic cough was 50.1% (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) and this is not far from an European study by \u003cb\u003eHunskaar et al. in 2004\u003c/b\u003e, where in 35% of women reported experiencing any type of involuntary urine loss (UI). Spain had the lowest incidence at 23%, but the UK, France, and Germany had higher rates at 44%, 41%, and 42%, respectively (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe most prevalent causes of chronic cough, according to the literature, are upper airway cough syndrome, asthma and GERD (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). This somewhat agrees with our results where GERD was the most common cause of chronic cough which was found in 48.8% of patients followed by bronchial asthma, which was found in 22.5% of patients.\u003c/p\u003e \u003cp\u003eIn the current study, the majority of patients (90.9%) reported that urinary leakage interfered with their quality of life and 43.1% of UI patients reported that their sexual life was affected, this was in line with Corrado team study in 2020, which found that UI affects a variety of facets of patients' lives, including relationships at work, with family, and during sexual activity. As a result, UI can lower patients' quality of life (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). According to \u003cb\u003eBradaia et al.\u003c/b\u003e (2009), who looked into the effects of UI among female patients who had interstitial lung diseases-related chronic cough, the median impact of UI was 3 (minimum\u0026thinsp;=\u0026thinsp;1, maximal\u0026thinsp;=\u0026thinsp;5) on a 5-point quality of life scale, while the median impact of chronic cough was 3.5 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccording to the current results, 43.1% of UI patients reported that their sexual life was affected and this was not far from what reported by \u003cb\u003eCorrado and his coworkers in 2020\u003c/b\u003e who indicated that UI is often difficult to accept, because it negatively affects their privacy and sexuality (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAll female patients with UI didn\u0026rsquo;t declare about incontinence without direct questioning (100%), which is due to the delicate nature of the subject, individuals often underreport their illness. The same reason explains the low medical request rates in the European countries for this issue, for example; about a quarter of those in Spain and the UK had ever visited a physician for their condition (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) and In 2009, a different European team under the direction of Bradaia found that most patients (64%) thought that incontinence was a normal aging symptom, that all patients felt embarrassed about this symptom, and that 79% of patients were unable to bring it up with the physicians (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe present study showed that occupations requiring physical activity (heavy lifting) had significantly higher frequency of UI than non-physical work, which aligns with what was reported in a cross-sectional study by \u003cb\u003eWang and his colleagues\u003c/b\u003e in China, that indicated that manual labor was a risk factor for incontinence in women compared to mental work (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). \u003cb\u003eLiao et al. (2008)\u003c/b\u003e also showed that lifting heavy objects at work was a risk factor for incontinence among Taipei school teachers. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe current study showed that other environmental work conditions as unclean, uncomfortable, accidents, time pressure, awkward positions had no significant relationship with UI and this was in line with Kaya et al.'s study, which examined the relations between various work-related factors and UI in 218 nurses and 63 secretaries and found no significant relationships (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). However, \u003cb\u003eKim et al.'s 2017\u003c/b\u003e study produced a different conclusion, stating that urinary incontinence was significantly linked to various work environments, including an unhygienic and uncomfortable workplace, accidents, time constraints, and awkward positions (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). This diversity may result from varying occupational workplaces and environments.\u003c/p\u003e \u003cp\u003eOur study found that older age was an indicator of risk for UI, which is in keeping with other research that found that age was a significant risk factor for UI. This may be explained by the fact that urethral sphincter tension decreases with age (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). The same in a European study which conducted by \u003cb\u003eHunskaar et al., in 2004\u003c/b\u003e, revealed that prevalence increased with age, which adds to our results (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWe found that more severe cough either by cough severity index or cough visual analogue scale and long duration of cough were significant risk factors for UI, which concurs with \u003cb\u003eYang\u0026rsquo;s et al\u003c/b\u003e., \u003cb\u003e2022\u003c/b\u003e who reported that patients with UI had considerably greater median cough duration and cough visual analogue scores than those without UI (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eContrary to our results that deny the significance of BMI as a risk factor for UI, previous studies have shown that high BMI was a significant indicator of the existence of UI in female patients (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). \u003cb\u003eNoblett et al.\u003c/b\u003e examined the link between BMI and intra-abdominal and intra-vesical pressure, suggesting that being overweight or obese may result in a persistent condition of elevated pressure in the pelvic floor, increasing the risk of UI (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). This disparity could result from varying demographics and small sample size in current study.\u003c/p\u003e \u003cp\u003eOne of the most important environmental factors related to UI is thought to be pregnancy and childbirth. In our research, the mean number of parities, and vaginal delivery were significantly higher in UI patients. Menopause patients had 2.9 times higher risk of developing UI. These results partially match those of \u003cb\u003eSchreiber Pedersen et al., 2017\u003c/b\u003e where age, parity \u0026amp; vaginal deliveries were strongly associated with UI (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn contrast to Guin et al.\u0026rsquo;s study, we didn\u0026rsquo;t find any association between nutritional status and UI. \u003cb\u003eGuin et al., 2018\u003c/b\u003e reported that stress urine incontinence was found to be more common in those with poor nutritional status; causing weak pelvic support (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). This discrepancy may be due to the different age groups and nutritional categorizations between studies.\u003c/p\u003e \u003cp\u003eHysterectomy may alter the support of the bladder and urethral neck and impair the complex mechanism of the urethral sphincter by damaging the inferior hypogastric plexus and distal branches of pudendal nerves. However, we found no association between hysterectomy \u0026amp; UI. The results of different studies are controversial, as \u003cb\u003eSingh et al., 2013\u003c/b\u003e reported a significant relation between hysterectomy and different types of incontinence (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). On the other hand, \u003cb\u003eBurgio et al., 1991 and Samuelsson et al., 1997\u003c/b\u003e reported that urinary incontinence was not significantly associated with hysterectomy (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). This controversial may be attributed to the variant hand skills of surgeons.\u003c/p\u003e \u003cp\u003eBy using logistic regression analysis, our results showed that age, occupational status according to physical activity and cough severity index were independently statistically significant risk factors for UI in female patients with chronic cough which are somehow consistent with \u003cb\u003eYang et al., 2022\u003c/b\u003e who reported that Patients with UI had significantly higher scores for daytime cough symptoms, night time cough symptoms, and cough visual analogue scores than did patients without UI. However, it was discovered that only the cough VAS score may be an independent risk factor for UI when the three values mentioned above were included in a multivariate logistic regression analysis. Muscle strain from regular exercise, particularly moderate-to-high intensity activity, can raise the pressure inside the abdomen. Furthermore, exercise-induced cough could consistently raise abdominal pressure which increases the risk of UI (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), which may explain why occupations requiring physical activity had significantly higher frequency of UI than those without.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePrevalence of UI among female patients with chronic cough was 55%. GERD was the most common cause of chronic cough followed by bronchial asthma. UI interfered with their quality of life. All patients didn\u0026rsquo;t declare about UI without direct questions. Worker female patients with chronic cough had significantly higher frequency of UI especially those with physical activity. The mean age, number of parities, vaginal delivery, cough severity index and cough visual analogue scale were significantly higher in UI patients. Old age, occupations with physical activities and cough severity index were independently significant risk factors for UI in female patients with chronic cough.\u003c/p\u003e\n\u003ch3\u003eRecommendations:\u003c/h3\u003e\n\u003cp\u003eWe recommend screening and early detection of UI among females with chronic cough and raising awareness about UI for their treatment and improving health. We recommend following international safety standards and guidelines to improve occupational status and environment at workplace for working women in addition, health education for working female patients about UI specially with chronic cough and guidelines standards to lift heavy objects are mandatory.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cem\u003eUI.....................................\u0026nbsp;Urinary Incontinence\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eGERD..............................\u0026nbsp;Gastro esophageal reflux disease\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eBMI..................................\u0026nbsp;Body Mass Index\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eUUI\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;\u0026hellip;..\u003c/em\u003e \u003cem\u003eUrge urinary incontinence.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSUI\u003c/em\u003e\u003cem\u003e..................................\u0026nbsp;stress urinary incontinence\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMUI.................................\u0026nbsp;mixed urinary incontinence.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIQR...................................\u0026nbsp;interquartile range\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCI......................................\u0026nbsp;\u003c/em\u003e\u003cem\u003eConfidence interval\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOR.................................... Odds ratio\u003c/em\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e This study was approved by the ethics committee of Ain Shams University, Faculty of Medicine, ethical approval no. FMASU R 124/2023. The subject participant provided written consent. \u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e Not applicable. \u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eAvailability of data and materials\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cspan dir=\"LTR\"\u003eThe data used during study are available from authors on reasonable request.\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eNone\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eNone\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eAcknowledgements\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eThe study\u0026apos;s participants are all thanked by the authors for their assistance.\u003cspan dir=\"LTR\"\u003e \u003c/span\u003e\u003c/p\u003e\n\u003cp dir=\"RTL\" style=\"text-align: left;\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eContributions\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left;\"\u003eThe study\u0026apos;s conception, design, preparation of the materials, data collection, and analysis were all done by the authors. The final manuscript was read and approved by all writers.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eMorice A, Millqvist E, Bieksiene K, Surinder S. et al. (2020): \u0026ldquo;ERS guidelines on the diagnosis and treatment of chronic cough in adults and children,\u0026rdquo; Eur. Respir. J., vol. 55, no.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eAbrams P, Cardozo M, Fall M, et al. (2003): The standardisation of terminology in lower urinary tract function: Report from the standardisation sub-committee of the International Continence Society, Urology, vol. 61, no. 1, pp. 37\u0026ndash;49, Jan. 2003\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eHunskaar S, Lose G, Sykes D, and Voss S. (2009): \u0026nbsp;The prevalence of urinary incontinence in women in four European countries,\u0026rdquo; BJU Int., vol. 93, no. 3, pp. 324\u0026ndash;330.\u003c/li\u003e\n \u003cli\u003eDanforth KN, Townsend MK, Lifford K, Curhan GC, Resnick NM, and Grodstein F. (2006): \u0026ldquo;Risk factors for urinary incontinence among middle-aged women,\u0026rdquo; Am. J. Obstet. Gynecol., vol. 194, no. 2, pp. 339\u0026ndash;345\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eShembel, AC, Rosen CA, Zullo TG, and Gartner-Schmidt JL. (2013): \u0026ldquo;Development and validation of the cough severity index: a severity index for chronic cough related to the upper airway,\u0026rdquo; Laryngoscope, vol. 123, no. 8, pp. 1931\u0026ndash;1936\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eSoliman SSA, Mbbch HHH, Azab A, Ali H, and Zarzour. (2021): \u0026ldquo;Urinary Incontinence among Women Attending Primary Health Center at El-Kharaga City, New Valley, Egypt,\u0026rdquo;\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eFultz N, Girts T, Kinchen K, Nygaard I, Pohl G, Sternfeld B. (2005): Prevalence, management and impact of urinary incontinence in the workplace. Occup Med (Lond) ;55(7):552-7.\u003c/li\u003e\n \u003cli\u003eKim Y, Kwak Y. (2017): Urinary incontinence in women in relation to occupational status. Women Health.;57(1):1-18,2017.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eBradley CS, Brown JS, Van Den Eeden SK, Schembri M, Ragins A, Thom DH. (2011): Urinary incontinence self-report questions: reproducibility and agreement with bladder diary. Int Urogynecol J ;22(12):1565-71, Dec 2011.\u003cspan dir=\"LTR\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eShariat, SF. Zimmern PE, Hilton, and Gruchalla RS. (2009): \u0026ldquo;Prospective Questionnaire-Based Evaluation of the Prevalence of Urinary Incontinence in Women with Chronic Cough,\u0026rdquo; Urol. Int., vol. 83, no. 2, pp. 181\u0026ndash;186\u003cspan dir=\"RTL\"\u003e.\u003cspan dir=\"LTR\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eDicpinigaitis PV. (2021): Prevalence of stress urinary incontinence in women presenting for evaluation of chronic cough. ERJ Open Research. 1;7.\u003c/li\u003e\n \u003cli\u003eKaplan AG. (2019): Chronic Cough in Adults: Make the Diagnosis and Make a Difference. Pulm \u0026nbsp;Ther.;5(1):11-21\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eYang C, Feng Z, Chen Z, Xu D, Li Y, Lai K, Yi F. (2022): The risk factors for urinary incontinence in female adults with chronic cough. BMC Pulmonary Medicine. 18;22(1):276\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eCorrado B, Giardulli B, Polito F, Aprea S, Lanzano M, Dodaro C. (2020): The Impact of Urinary Incontinence on Quality of Life: A Cross-Sectional Study in the Metropolitan City of Naples. Geriatrics (Basel). 2020 Nov 20;5(4):96\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eBradaia F, Lazor R, Khouatra, C Poissonnier L, Cottin,V and Cordier JF. (2009): \u0026ldquo;Urinary incontinence due to chronic cough in interstitial lung disease],\u0026rdquo; Rev. Mal. Respir., vol. 26, no. 5, pp. 499\u0026ndash;504\u003cspan dir=\"RTL\"\u003e.\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eWang Y , Xu K , Hu H , et al . (2011): Prevalence, risk factors, and impact on health related quality of life of overactive bladder in China. Neurourol Urodyn ;30:1448\u0026ndash;55.\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eLiao Y-M , Dougherty MC , Biemer PP , et al . (2008): Factors related to lower urinary tract symptoms among a sample of employed women in Taipei. Neurourol Urodyn ;27:52\u0026ndash;9.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKaya Y , Kaya C , Baseskioglu B , et al . (2016): Effect of work-related factors on lower urinary tract symptoms in nurses and secretaries. Low Urin Tract Symptoms ;8:49\u0026ndash;54.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eXie X, Chen Y, Khan A, Long T, Li S, Xie M. (2021): Risk factors for urinary incontinence in Chinese women: a cross-sectional survey. Urogynecology. 2021 Jun 1;27(6):377-81\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eLamerton TJ, Torquati L, Brown WJ. (2018): Overweight and obesity as major, modifiable risk factors for urinary incontinence in young to mid‐aged women: a systematic review and meta‐analysis. Obesity Reviews. 2018 Dec;19(12):1735-45\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eSchreiber Pedersen L, Lose G, H\u0026oslash;ybye MT, Elsner S, Waldmann A, Rudnicki M. (2017): Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark. Acta obstetricia et gynecologica Scandinavica.;96(8):939-48\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eNoblett KL, Jensen JK, Ostergard DR. (1997): The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry. Int Urogynecol J Pelvic Floor Dysfunct.;8(6):323\u0026ndash;6\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eGuin G, Choudhary A, Dadhich R. (2018): Prevalence of stress urinary incontinence and its associated risk factors amongst females attending tertiary referral centre. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 1;7(6):2115-20\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eSingh U, Agarwal P, Verma ML, Dalela D, Singh N, Shankhwar P. (2013): Prevalence and risk factors of urinary incontinence in Indian women: A hospital-based survey. Indian journal of urology. 1;29(1):31-6\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eBurgio KL, Matthews KA, Engel BT. (1991): Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women. The Journal of urology. 1;146(5):1255-9\u003cspan dir=\"RTL\"\u003e.\u0026nbsp;\u003c/span\u003e\u003c/li\u003e\n \u003cli\u003eSamuelsson E, Victor A, Tibblin G. (1997): A population study of urinary incontinence and nocturia among women aged 20‐59 years. Acta obstetricia et gynecologica Scandinavica.;76(1):74-80\u003cspan dir=\"RTL\"\u003e. \u003c/span\u003e\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable (1): Relation between urinary incontinence and occupational status of the studied patients:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"585\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.17808219178082%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.80821917808219%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient with SUI(n=44)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.095890410958905%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient without SUI(n=36)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.383561643835616%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest of significance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931506849315069%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.301369863013699%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOdds ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.301369863013699%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.17808219178082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eWorking patients\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNon-working patients\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.80821917808219%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e38 (86.4%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e6 (13.6%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.095890410958905%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e23(63.9%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e13(36.1%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.383561643835616%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eX\u003csup\u003e2\u003c/sup\u003e=0.019\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931506849315069%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.033*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.301369863013699%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e3.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.301369863013699%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1.1-10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.17808219178082%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of occupations:\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e-Occupations with physical activity**\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Occupations without physical activity***\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.80821917808219%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e23 (52.3%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e15 (34.1%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.095890410958905%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e4 (11.1%)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e19 (52.8%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.383561643835616%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eX\u003csup\u003e2\u003c/sup\u003e=10.8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931506849315069%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.003*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.301369863013699%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e5.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.301369863013699%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.8-34.1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Statistically significant at p- value \u0026lt;0.05\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e means chi-square value \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; CI: confidence interval (95%)\u003c/p\u003e\n\u003cp\u003e** Occupations with physical activity (lifting heavy objects) as cleaners\u003c/p\u003e\n\u003cp\u003e*** Occupations without physical activity as employees \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (2): Relation between urinary incontinence and associated risk factors:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.02728731942215%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient with SUI\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=44)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.13804173354735%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient without SUI(n=36)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest of significance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOdds ratio\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.248796147672552%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.02728731942215%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e47.6\u003cu\u003e+\u003c/u\u003e9.2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.13804173354735%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e34.1\u003cu\u003e+\u003c/u\u003e12\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003et=5.6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.248796147672552%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.02728731942215%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBMI (kg|m2)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e28.6+5.8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.13804173354735%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e26.9+6.6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003et=1.2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.22\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.248796147672552%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.02728731942215%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of parity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e3+1.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.13804173354735%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.6+1.7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003et=3.8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.248796147672552%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.02728731942215%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of vaginal delivery\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.6+1.6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.13804173354735%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.3+1.7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003et=3.45\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.248796147672552%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.02728731942215%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMenopause\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e18(40.9%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.13804173354735%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e7 (19.4%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.199036918138042%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eX\u003csup\u003e2\u003c/sup\u003e=4.24\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.039*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.593900481540931%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.8\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.248796147672552%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.03-7.9\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;*Statistically significant at p- value \u0026lt;0.05\u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;t= independent sample t test\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; CI: confidence interval (95%)\u003c/p\u003e\n\u003cp\u003e**Other risk factors as constipation, associated gynecological disease, recurrent UTI, hysterectomy, comorbidities, nutritional status had no significant relations between female patients with UI and without UI.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (3): Relation between urinary incontinence and cough status (cough duration of cough, cough severity index, cough visual analogue scale and causes of chronic cough among studied patients:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"547\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.948811700182816%\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.539305301645339%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient with SUI\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=44)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.012797074954296%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient without SUI(n=36)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.95978062157221%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest of significance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.539305301645339%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.948811700182816%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Duration of chronic cough (months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.539305301645339%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e12 (3-82.5)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.012797074954296%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.5(3.5-15)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.95978062157221%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMann Whitney **\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.539305301645339%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.031*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.948811700182816%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e-Cough severity index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.539305301645339%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e25.8+8.2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.012797074954296%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e17.1+8.2\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.95978062157221%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003et=4.7\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.539305301645339%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"23.948811700182816%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e-Cough visual analogue scale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.539305301645339%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.34+1.2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.012797074954296%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.4+1.1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.95978062157221%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003et=3.6\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.539305301645339%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; *Statistically significant at p- value \u0026lt;0.05\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;** Mann Whitney u test used\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (4): Relation between different risk factors \u0026amp; stress urinary incontinence:\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"108%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.21212121212121%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"78.78787878787878%\" colspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic cough patients with UI and without UI\u003c/strong\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003e\u0026nbsp; \u0026nbsp; Independent factor\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026Beta;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; Odds ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.632653061224488%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e95% Confidence Interval\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"35.483870967741936%\" valign=\"top\"\u003e\n \u003cp\u003eLower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"64.51612903225806%\" valign=\"top\"\u003e\n \u003cp\u003eUpper\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eAge\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" valign=\"top\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\"\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMenopause\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" valign=\"top\"\u003e\n \u003cp\u003e1.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.162\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" valign=\"top\"\u003e\n \u003cp\u003e0.211\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eNumber of parity\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.507\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" valign=\"top\"\u003e\n \u003cp\u003e1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e3.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eNumber of vaginal delivery\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" valign=\"top\"\u003e\n \u003cp\u003e0.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.538\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" valign=\"top\"\u003e\n \u003cp\u003e0.791\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;1.66\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eType of occupations according to physical activity\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" valign=\"top\"\u003e\n \u003cp\u003e2.171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.037*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" valign=\"top\"\u003e\n \u003cp\u003e8.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e67.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003ecough severity index\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.032*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" valign=\"top\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003ecough visual analogue scale\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;0.131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.77\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" valign=\"top\"\u003e\n \u003cp\u003e1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.428571428571427%\" valign=\"top\"\u003e\n \u003cp dir=\"RTL\"\u003e\u003cstrong\u003e\u003cspan dir=\"LTR\"\u003eDuration of cough per month\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.204081632653061%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.969\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.3265306122449%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.224489795918368%\" valign=\"top\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.408163265306122%\" valign=\"top\"\u003e\n \u003cp\u003e1.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e*Statistically significant at p- value \u0026lt;0.05 \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e**Dependent Variable: Chronic cough patients with UI and without UI\u003c/p\u003e\n\u003cp\u003eR square= 0.707 \u003cspan dir=\"LTR\"\u003e\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"the-egyptian-journal-of-bronchology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [The Egyptian Journal of Bronchology](https://ejb.springeropen.com/)","snPcode":"43168","submissionUrl":"https://submission.nature.com/new-submission/43168/3","title":"The Egyptian Journal of Bronchology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"urinary incontinence, chronic cough, occupational status and cough severity index","lastPublishedDoi":"10.21203/rs.3.rs-4803847/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4803847/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Coughing is frequently linked to urinary incontinence (UI) in women. However, \u0026nbsp;there is few information about its actual prevalence among women with chronic cough. There are some previous studies that link urinary incontinence to the occupational status.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAim of work\u003c/strong\u003e: To measure the prevalence of stress urinary incontinence and to identify the relationship between urinary incontinence and occupational status among female patients with chronic cough.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and\u003c/strong\u003e \u003cstrong\u003emethods: \u003c/strong\u003eA cross-sectional study was conducted on 80 female patients presented with chronic cough of any cause, all patients were interviewed using a structured questionnaire that included personal, occupational, chronic cough and urinary incontinence questionnaire. General and local examination were done.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eOut of 80 patients, 55% were found to have stress urinary incontinence. Gastro esophageal reflux disease (GERD) was the most prevalent cause of chronic cough (48.8%) followed by bronchial asthma (22.5%). Most of the studied patients (90.9%) reported that leaking of urine interferes with their quality of life. The frequency of UI among working females was significantly higher than non-workers. Occupations requiring physical activity had significantly higher frequency of UI than those without. Other environmental work conditions as unclean or uncomfortable workplaces had no significant relationship with UI. Menopause patients had 2.9 times higher risk to develop UI. The mean age, mean number of parities, vaginal delivery, median duration of cough, cough severity index and cough visual analogue scale were significantly higher in UI patients. The logistic regression was performed to test effects of different risk factors on UI, Results indicated that age, type of occupations according to physical activity and cough severity index were independently statistically significant risk factors for UI in female patients with chronic cough\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Urinary Incontinence (UI) is common in female patients with chronic cough (55%). Age, type of occupations according to physical activity and cough severity index were independently significant risk factors for UI in female patients with chronic cough.\u003c/p\u003e","manuscriptTitle":"Prevalence of urinary incontinence and its relation to occupational status among Egyptian female patients presenting with chronic cough","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-22 06:17:52","doi":"10.21203/rs.3.rs-4803847/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-08-09T18:54:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-07-30T04:36:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-07-26T12:17:32+00:00","index":"","fulltext":""},{"type":"submitted","content":"The Egyptian Journal of Bronchology","date":"2024-07-25T19:01:07+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"the-egyptian-journal-of-bronchology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [The Egyptian Journal of Bronchology](https://ejb.springeropen.com/)","snPcode":"43168","submissionUrl":"https://submission.nature.com/new-submission/43168/3","title":"The Egyptian Journal of Bronchology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f05518d9-2f6e-4503-a19b-1e46766592de","owner":[],"postedDate":"August 22nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-01-30T20:53:12+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-22 06:17:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4803847","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4803847","identity":"rs-4803847","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}