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May 26, 2004

Cartilage Structure as a Risk Factor for Urinary Incontinence

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(20):2431-2432. doi:10.1001/jama.291.20.2431-b

Letter to the Editor: In the Scientific Review of urinary incontinence, Drs Holroyd-Leduc and Straus1 did not discuss the structure of the connective tissue as a risk factor. For instance, women with decreased collagen content and altered morphology in the pelvic support tissue may be at higher risk of stress incontinence.2,3 We4 reported significant reduction of collagen content in the uterine cervix among women with stress urinary incontinence, regardless of age, parity, body mass index, or tobacco use. This suggests that a systemic defect in collagen production, rather than damage to local collagen in the pelvic floor, may predispose to urinary incontinence.

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