Traumatic brain injury increases the risk of female urinary incontinence§


  • Conflict of interest: none.

  • Eric Rovner led the peer-review process as the Associate Editor responsible for the paper.

  • §

    Joseph Keller and Shih-Ping Liu have equal contribution to this manuscript.



According to our knowledge, no study has attempted to explore the risk of urinary incontinence (UI) after traumatic brain injury (TBI). This study aimed to examine the relationship between TBI in Taiwanese women and their risk of developing UI.


The study was based on 2,416 female patients newly diagnosed with TBI together with 12,080 matched enrollees without a history of TBI as a comparison group. All patients were tracked for a 1-year period from their index date to identify those who developed subsequent UI. The stratified Cox proportional hazards models were performed to compute the risk of UI between groups.


Of 14,496 patients, 104 (4.30%) from the TBI group and 192 (1.59%) from the comparison group had a diagnosis of UI during the follow-up period. The incidence rate of UI was 4.50 (95% CI: 3.69–5.43) per 100 person-years in patients with TBI and 1.62 (95% CI: 1.40–1.86) per 100 person-years in patients without TBI.

The stratified Cox proportional analysis showed that after adjusting for socioeconomic status, obesity, hypertension, diabetes, and hysterectomy, the increased UI risk of patients with TBI persisted at about the same level as in the unadjusted analysis (hazard ratio = 2.78; 95% CI = 2.16–3.53). In addition, although patients with severe and moderate TBI had higher incidence rates of UI than patients with mild TBI, the difference did not reach a statistically significant level (P = 0.090).


Our results suggest that an increased risk of UI exists at the first year follow-up in patients with a TBI diagnosis. Neurourol. Urodynam. 32: 354–358, 2013. © 2012 Wiley Periodicals, Inc.