stress urinary incontinence ( sui ) , the most common type of urinary incontinence ( ui ) , is usually defined as leakage of urine during movement or activity which puts pressure on the bladder , such as coughing , sneezing , running or heavy lifting ( 1 , 2 ) . it is reported in most countries that 15% to 40% of women struggle with sui and its severe implications for daily life , including social interactions , sexuality , and psychological wellbeing .
therefore , the identification and possible reduction of risk factors for sui is important , and could also decrease health care costs ( 3 ) . weight is a modifiable risk factor for sui .
many non - modifiable risk factors for sui have been identified , such as age , delivery , and pelvic surgery , but urinary tract infections ( utis ) need more study ( 2 ) .
women are particularly at risk of uti , and more than 50% will experience at least one episode during their lifetime ( 3 ) .
the majority of utis cause a short acute illness and may be treated with a course of antibiotics , but occasionally , depending on the site and type of infection , they can develop into a serious , even life - threatening condition ( 3 , 4 ) .
although many factors such as nutrition and smoking have been researched in relation to sui , urinary tract infection was not one of them .
the aim of our study was to assess the relationship between urinary tract infection and sui severity .
this investigation was a cross - sectional study conducted in a public urology clinic in tehran .
the study population were all females with complaints of sui who visited the clinic during 2014 .
we compared valsalva leak point pressure ( vlpp ) in two groups of female sui patients with and without uti history .
history of uti was defined as a self - reported uti having occurred at least once in the previous year . according to our preliminary results ,
the mean and standard deviation of vlpp were 80  17 cm h2o in patients with history of uti , and 88  16 cm h2o in those without history of uti .
therefore , according to the following equation , with 95% assurance , 136 patients ( 68 in each group ) was an appropriate sample size to compare the mean of the quantitative dependent variable ( vlpp ) between the two groups .
300 patients were selected randomly from clinic patients to be asked to participate in our study . of these , 140 patients showed interest and were qualified through filling out an informed consent form .
the selection criteria were absence of anticholinergic or alpha - blocker drugs during the two weeks prior to the urodynamic test and no history of pelvic surgery , hysterectomy or cesarean delivery .
the mean of the vlpp was compared between the two groups of patients using a t - test and a mann - whitney test , and after controlling for confounding variables including age , body mass index ( bmi ) , history of hysterectomy and delivery status .
the mean of the valsalva leak point pressure was 83.10 cm h2o and 81.29 cm h2o , respectively in patients with uti history and without uti history .
the difference in vlpp between the two groups was not significant ( p = 0.61 ) ( table 1 ) .
abbreviations : sd , standard deviation ; se , standard error deviation . in order to control the effect of delivery status , we compared the mean of vlpp in the study groups according to delivery numbers .
as shown in table 2 , in each delivery status , the mean of vlpp was higher for patients with uti history but the difference was significant only in patients with 1 to 4 deliveries ( p < 0.05 )
similarly , in order to control the effect of age , we compared the mean of vlpp in the study group according to age .
as shown in table 3 , the mean of vlpp in all age groups was higher for patients with uti history , but the difference was not significant ( p > 0.05 ) .
abbreviations : sd , standard deviation ; se , standard error deviation . to control the effect of bmi , the mean of the valsalva leak point pressure was compared according to bmi . as shown in table 4 ,
the mean of the valsalva leak point pressure in overweight and obese patients was higher for patients with uti history , but the difference was not significant ( p > 0.05 ) .
according to our study results , there was no statistically significant relationship between urinary tract infection and severity of female stress urinary incontinence , as measured by valsalva leak point pressure .
of course , a decisive opinion would require more extensive studies by prospective methods . however , our study found that urine leakage occurred with higher bladder pressure in patients with history of uti , although the result was not significant , and therefore they were suffering from milder sui .
future investigations could clarify the relationship , if any . finally , we suggest future studies to analyze the relationship between different types of urinary tract infections and sui .
also , the confounding variables which were not considered in our study , such as lifestyle factors including nutrition and smoking , should be studied .
 backgroundstress urinary incontinence ( sui ) , the most common type of urinary incontinence ( ui ) , is usually defined as leakage of urine during movement or activity which puts pressure on the bladder , such as coughing , sneezing , running or heavy lifting . 
 it is reported in most countries that 15% to 40% of women struggle with sui and its severe implications for daily life , including social interactions , sexuality , and psychological wellbeing.objectivesthe aim of our study was to assess the relationship between urinary tract infection and the severity of stress urinary incontinence ( sui).patients and methodsthis research was a cross - sectional study conducted in a public urology clinic in tehran . 
 the study population was all females with complaints of sui who visited the clinic during 2014 . 
 we compared valsalva leak point pressure ( vlpp ) in two groups of patients , with and without history of urinary tract infection ( uti).resultsaccording to the findings of our study , the mean vlpp was 83.10 cm h2o in the group with uti history , and 81.29 cm h2o in those without history of uti . 
 the difference in vlpp between the two groups was not significant ( p < 0.05 ) , even after controlling for confounding variables including age , body mass index , history of hysterectomy and number of deliveries.conclusionsour study did not confirm a significant relationship between uti and severity of sui as measured by vlpp . 
 a decisive opinion would require extensive future studies by prospective methods . 
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion