Military Sexual Trauma's Association with Lower Urinary Tract Symptoms (LUTS) and Fecal Incontinence (FI) Among U.S. Female Veterans.

Abstract

Importance: Military Sexual Trauma (MST) affects a large number of female veterans and is associated with various adverse physical and mental health conditions. Sexual trauma can lead to pelvic floor dysfunction, contributing to lower urinary tract symptoms (LUTS), a common urological concern, and fecal incontinence (FI). LUTS and FI may have a higher prevalence among female veterans with MST.

Objectives: This study aimed to evaluate the prevalence and treatment of LUTS/FI among female veterans with a history of MST compared to those without.

Study design: A retrospective cohort analysis was conducted using data from the Veterans Health Administration's (VHA) Corporate Data Warehouse. Baseline demographic data, International Classification of Diseases (ICD-9) codes, and medication use were analyzed, with logistic regression models controlling for confounders.

Results: Of the 416,137 female veterans analyzed, 103,877 (25%) reported a history of MST. Veterans with MST were more likely to be diagnosed with LUTS and FI, including a 22% (aOR 1.215; 95% CI 1.133, 1.302) increase in voiding issues and 17% (aOR 1.163; 95% CI 1.132, 1.194) increase in storage difficulties; 26% (aOR 1.260; 95% CI 1.136, 1.397) increase in interstitial cystitis/bladder pain syndrome (IC/BPS), and 34% (aOR 1.338; 95% CI 1.224,1.462) increase in FI. MST was associated with increased odds of undergoing diagnostic procedures for LUTS, such as cystoscopy (aOR 1.221; 95% CI 1.159, 1.287) and urodynamics (aOR 1.241; 95% CI 1.158,1.331). Veterans with MST were 15% more likely to receive pharmacological treatment for overactive bladder (aOR 1.152; 95% CI 1.122, 1.182).

Conclusions: Female veterans with MST have a higher prevalence of LUTS and FI and are more likely to undergo diagnostic and therapeutic interventions.