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Palma T, Raimondi M, Souto S, Fozzatti C, Palma P, Riccetto C. [Correlation between age and overactive bladder symptoms in young women in Brazil]. Actas Urol Esp 2013; 37:156-61. [PMID: 23411070 DOI: 10.1016/j.acuro.2012.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 07/02/2012] [Indexed: 11/30/2022]
Abstract
UNLABELLED Overactive Bladder Syndrome (OAB) is defined by the ICS (International Continence Society) as urinary urgency, with or without urgency incontinence and frequently associated with increase of frequency and nocturia. PURPOSE The aim of the study was to establish a correlation between OAB symptoms and Age in women aged 20-45. MATERIALS AND METHODS We interviewed 1050 women aged 20-45 in the area of Campinas, Brazil, to investigate the prevalence of Overactive Bladder Symptoms. In this study we used the ICIQ-OAB questionnaire (ICS standard), in its validated Portuguese version and a specific questionnaire for the demographics. RESULTS Overall, women aged 35-45 years showed significantly higher scores in the ICIQ-OAB questionnaire than all other groups (P<.001). Older women (35-45) presented a significantly higher score than younger women (all other groups) (P<.0001) regarding urinary frequency. Regarding frequency, there was a significant difference between the age group 35-45 (higher score) and the age groups 20-22 and 23-27 (P<.0001). Women aged 35-45 presented significantly more nocturia than women in the age groups of 28-34, 23-27 and 20-22. Women in the group of 28-34 also presented more nocturia than women aged 20-22 (P<.0001). Women aged 35-45 experienced more urgency than those in the age groups of 28-34 and 23-27 (P<.0001). Women aged 35-45 had significantly more urgency incontinence than all the other groups, and women in group of 20-22 also presented more incontinence than those aged 23-27 (P<.0001). Significant differences were also found regarding symptom bother, women in group 35-45 years old presented higher scores than the other groups regarding frequency (P<.0001), nocturia (P=.0011), urgency (P=.0015) and urgency incontinence (P<.0001). CONCLUSIONS In conclusion, older women present more OAB symptoms and therefore a higher score than younger women.
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Smith MD, Seth JH, Hanna MG, Panicker JN. Detrusor overactivity in Becker muscular dystrophy. Muscle Nerve 2013; 47:464-5. [PMID: 23382079 DOI: 10.1002/mus.23623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 08/03/2012] [Accepted: 08/06/2012] [Indexed: 11/10/2022]
Abstract
A 20-year-old man with normal motor milestones as an infant but subsequent progressive difficulty in walking in childhood, was genetically confirmed to have Becker muscular dystrophy (BMD) at age 13. He was independent in ambulation and activities of daily living. He was referred to the Department of Uro-neurology for a 5-year history of urinary urgency and incontinence. He would visit the toilet 10 times in the daytime and experience urinary urgency daily, often associated with incontinence. He did not report difficulties initiating voiding, stress incontinence, pain, or hematuria. There was no history of urinary tract infections.
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Sakai M, Akai T, Takata Y, Shimizu SI, Koyama SI, Iwamoto T. [Screening test for overactive bladder in a newly developed comprehensive geriatric assessment initiative]. Nihon Ronen Igakkai Zasshi 2013; 50:249-257. [PMID: 23979249 DOI: 10.3143/geriatrics.50.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Lower urinary tract symptoms, particularly in overactive bladder (OAB), are frequently observed among elderly patients. The impact of OAB on their quality of life is so strong that the assessment of OAB is necessary in comprehensive geriatric assessment (CGA). As CGA takes time to complete, we established a convenient instrument consisting of 2 questions on OAB and assessed its utility. METHOD We recruited 123 elderly patients with various diseases (mean age: 83.2 years, 63 men), in whom 2 questions on nocturia (Q1) and urinary incontinence at night (Q2) were asked. Thereafter, overactive bladder symptom scores (OABSS) were obtained to diagnose OAB based on the OAB criteria. Statistical analyses for Q1 and Q2 were performed using the OABSS criterion as a gold standard. To elucidate the clinical characteristics of the elderly patients, they were divided into 2 groups on the basis of the presence or absence of nocturia: nocturia (+) and nocturia (-) groups. The nocturia (+) group was subdivided into 2 subgroups: with or without incontinence. RESULTS Nocturia (Q1) was observed in 82 elderly patients and urinary incontinence (Q2) in 23, whereas OAB was diagnosed in 22. The sensitivity, specificity, and positive predictive value (PPV) of Q1 (Q1+Q2) were 100% (68.2%), 40.6% (92.1%), and 26.8% (65.2%), respectively. The nocturia (+) group patients were characterized as predominantly composed of men with cerebrovascular disease, disturbed activities of daily living, interrupted sleep, delayed wake-up time, and treatment with diuretics. Furthermore, Parkinson disease, depressive state, sedentary life style, and treatment without diuretics were frequently observed in patients in the incontinence (+) subgroup. CONCLUSION A low PPV with a high sensitivity of Q1 was improved by using Q1+Q2, where both Q1 and Q2 enable better assessment of OAB resulting in being a useful screening test for OAB.
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Arnold J, McLeod N, Thani-Gasalam R, Rashid P. Overactive bladder syndrome - management and treatment options. AUSTRALIAN FAMILY PHYSICIAN 2012; 41:878-883. [PMID: 23145420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Overactive bladder syndrome is a symptom-based clinical diagnosis. It is characterised by urinary urgency, frequency and nocturia, with or without urge urinary incontinence. These symptoms can often be managed in the primary care setting. OBJECTIVE This article provides a review on overactive bladder syndrome and provides advice on management for the general practitioner. DISCUSSION Overactive bladder syndrome can have a significant effect on quality of life, and affects 12-17% of the population. Prevalence increases with age. The management of overactive bladder syndrome involves exclusion of underlying pathology. First line treatment includes lifestyle interventions, pelvic floor exercises, bladder training and antimuscarinic agents. Failure of conservative management necessitates urology referral. Second line therapies are more invasive, and include botulinum toxin, neuromodulation or surgical interventions such as augmentation cystoplasty or urinary diversion.
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155
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Radomski SB, Barkin J. Medical management of overactive bladder. THE CANADIAN JOURNAL OF UROLOGY 2012; 19 Suppl 1:2-9. [PMID: 23089342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Overactive bladder (OAB) with or without urinary incontinence is a common condition in both men and women. OAB has a significant impact on quality of life for most patients. In most cases, sophisticated testing is not required for a primary care physician to diagnose OAB and start treating a patient. Management of OAB requires behavioral modification and, if necessary, pharmacotherapy may be added. If a patient does not respond to treatment initiated by a primary care physician, then he or she should be referred to a specialist in OAB to undergo further investigations and treatments.
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Kul'chavenia EV, Brizhatiuk EV, Breusov AA. [Overactive bladder as a mask of chronic prostatitis]. UROLOGIIA (MOSCOW, RUSSIA : 1999) 2012:43-46. [PMID: 23379238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In order to investigate the frequency of symptoms of overactive bladder (OAB) in patients with chronic prostatitis and determine the effectiveness of trospium chloride in their treatment, the analysis of case histories of 154 patients referred to a urologist for the exacerbation of chronic prostatitis was performed. 27 (17.5%) patients had a diagnosis of overactive bladder; in 19 patients it was accompanied by chronic prostatitis, and in 8 patients OAB was diagnosed as separate disease. All of them have received trospium chloride 30 mg once daily for a month; patients with prostatitis simultaneously have received standard etiopathogenic therapy for this disease. A month later, a comprehensive treatment led to significant positive effect. Urinary frequency decreased by 56.1%, the functional bladder capacity increased by 82.8%, the number of urgent vesical tenesmus was reduced more than by half.
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Preud'homme XA, Amundsen CL, Webster GD, Krystal AD. Comparison of diary-derived bladder and sleep measurements across OAB individuals, primary insomniacs, and healthy controls. Int Urogynecol J 2012; 24:501-8. [PMID: 22855113 DOI: 10.1007/s00192-012-1890-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 07/02/2012] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Can diary-derived bladder and sleep measurements differentiate individuals with overactive bladder syndrome (OAB) from individuals with primary insomnia and healthy controls? METHODS Bladder- and sleep-diary data were compared in nine OAB, ten insomnia, and five control individuals. One-way analysis of variance (ANOVA) was used for normally and Kruskal-Wallis test for nonnormally distributed variables, followed, when significant effects were found, by pairwise comparisons. RESULTS OAB individuals woke up as frequently as insomniacs, but their awakenings were respectively shorter in duration (18.6 vs. 38.1 min.) and were predominantly initiated by nocturic events (89.2 vs. 23.9 % respectively). Regardless, their reported quality of sleep was as impaired as for the insomniacs. Furthermore, smaller mean volume voided awakenings were evident not only in those with OAB but also in insomniacs compared to controls. CONCLUSIONS Bladder- and sleep-diary data provide means to differentiate those with OAB from those with insomnia and healthy controls. Awakenings in OAB individuals were shorter than those with insomnia and much more likely due to the need to void. Thus, a reduction in the number of nocturic voids could be the most appropriate sleep-related outcome for nocturia therapy in individuals with OAB. In addition, limited nocturnal bladder capacity, though expected in OAB, was unexpectedly found in insomnia, possibly reflecting the role of consciousness (wakefulness at night) in modulating bladder sensation.
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Saito M. Editorial comment to higher glycosylated hemoglobin levels increase the risk of overactive bladder syndrome in patients with type 2 diabetes mellitus. Int J Urol 2012; 19:1001-2. [PMID: 22774874 DOI: 10.1111/j.1442-2042.2012.03097.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sumardi R, Mochtar CA, Santoso BI, Purwara BH, Hardjowijoto S, Paraton H, Yunaidi DA. Test - retest reliability of the Indonesian version of the Overactive Bladder Symptom Score (OABSS) and its correlation with standard assessment tools. ACTA MEDICA INDONESIANA 2012; 44:214-221. [PMID: 22983076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM to evaluate the test-retest reliability of the Indonesian version of OABSS and its correlation with other validated assessment tools for OAB. METHODS eligible patients aged 18 years with established OAB were instructed to complete 3-day micturition diaries and the OABSS, International Prostate Symptom Score (IPSS) and Patient Perception of Bladder Condition (PPBC) on two separate visits: Week 0 and Week 2. Test-retest reliability was examined using the internal correlation coefficient (ICC) and weighted Kappa coefficients between first and second applications of the OABSS. Pearson or Spearman correlation coefficients were calculated to test the correlation of OABSS with IPSS, IPSS Quality of Life (QOL) item, PPBC and clinical variables of the 3-day voiding diary. RESULTS ICC for the OABSS total score was 0.83. The weighted Kappa coefficients of individual scores in OABSS were 0.55-0.66. In the first and second applications of OABSS, the Pearson correlation coefficients were 0.46-0.56 and 0.36-0.53 between OABSS and three clinical variables of the 3-day voiding diary (frequencies of micturition, urgency and urge incontinence). At Visit 1, the Spearman correlation coefficients were 0.41 between OABSS and IPSS total score, 0.47 between OABSS and IPSS QOL, and 0.34 between OABSS and PPBC. At Visit 2, the Spearman correlation coefficients were 0.45 between OABSS and IPSS total score, 0.55 between OABSS and IPSS QOL, and 0.44 between OABSS and PPBC. CONCLUSION the Indonesian version of OABSS showed excellent test-retest reliability in Indonesian OAB patients. A satisfactory correlation with IPSS total and QOL scores, PPBC and several clinical variables of the 3-day voiding diary was obtained, particularly with urgency frequency.
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Krhut J, Martan A, Zachoval R, Tvrdík J, Hanus T. [Current state of diagnostics and treatment of overactive bladder in the Czech Republic - five years ago and today]. CESKA GYNEKOLOGIE 2012; 77:205-210. [PMID: 22779719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Overactive bladder (OAB) presents one of the most frequent medical problems among the current adult population, with a significant impact on the quality of life of the affected patients. A questionnaire survey was carried out in 2006, with the aim to assess the level of knowledge regarding the problem of OAB among gynaecologists and urologists in the Czech republic, as well as to evaluate the currently applied methods of OAB diagnostics and treatment. The aim of this work was to perform a repeated survey after five years, and to evaluate, whether there have been any changes achieved in the monitored parameters. MATERIALS AND METHODS A total of 290 respondents (181 gynaecologists, 109 urologists) were included in the survey in 2006; the study group in 2011 included a total of 285 respondents (180 gynaecologists, 105 urologists). The questionnaire used for the survey in 2011 was identical to the document utilized in the initial survey performed five years ago, with minimal changes. The anonymous questionnaire was designed as "multiple-choice", i.e. with a possible selection from proposed answers; the questions were targeted at the topics of definition, diagnostics and therapy of OAB. The obtained results were processed with the methods of descriptive statistics; the concordance of proportions was evaluated with the Fishers exact test. RESULTS A total of 114 gynaecologists (63.3%), and 65 urologists (61.9%) were able to determine the correct definition of OAB, which presents a significant increase when compared to 2006 (p<0.0001). The most frequently applied methods of OAB diagnostics were patient history (gynaecologists: 97.8% in 2011 vs. 96.5% in 2006, urologists: 99.0% in 2011 vs. 99.0% in 2006), local examination (gynaecologists: 57.8% vs. 76.4%, urologists: 86.7% vs. 87.2%), bladder diaries (gynaecologists: 62.8% vs. 40.3%, urologists: 79.0% vs. 60.5%), and urine examination (gynaecologists: 71.1% vs. 82.3%, urologists: 96.2% vs. 97.1%). Anticholinergic medication is the first-choice in the OAB treatment in our conditions, which has been confirmed by 146 (81.1%) gynaecologists, and 89 (84.4%) urologists. In cases when the physicians use anticholinergic medication for the treatment of OAB, the first-choice medication is trospium, among both gynaecologists and urologists. In case of failure of the first-choice treatment, twenty-six (14.4%) gynaecologists from the addressed respondents try to continue with a treatment according to their own decision, 154 (85.6%) gynaecologists refer the patient to a specialist. Similarly, a total of 90 (85.7%) urologists try to manage the further course of treatment by their own means, 15 urologists (14.3%) refer the patient to a specialist. CONCLUSION The level of understanding and awareness about the problem of OAB among the Czech gynaecologists and urologists has significantly improved during the past five years. The applied diagnostic and treatment methods for OAB are being harmonized with the International Continence Society (ICS) recommendations. Taking into consideration the prevalence of OAB among the population, it is desirable to increase the number of clinical departments who deal with the problem of OAB in a complex manner. The remaining significant task lies in the improvement of foreknowledge about the current possibilities and effectiveness of the OAB treatment among the patient population.
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Vecchioli Scaldazza C, Morosetti C, Pace G, Azizi B, Giannubilo W, Ferrara V. Has the cost of anti-muscarinic a key role in the success rate of patients diagnosed with overactive bladder syndrome? Arch Ital Urol Androl 2012; 84:68-73. [PMID: 22908774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Overactive bladder syndrome (OAB) is a chronic disease, the prevalence in the general population is reported to be 14-16%. Anti-muscarinic agents are considered the first-line pharmacological treatment for the management of OAB; although a long lasting therapy is indicated to reach a better control of OAB symptoms an high percentage of patients discontinue the cure after a brief period. Our attempt is to investigate whether the cost of solifenacin succinate may influence the long lasting regimen and patients' drug efficacy. MATERIALS AND METHODS 70 consecutive women, with symptoms of OAB were enrolled in this randomized controlled study. In group A, all patients received solifenacin 5 mg by the urologist, without any cost; they were instructed to get the drug once daily for 4 months, differently, in group B, patients need to buy the drug which was administered as in the group A. Frequency, nocturia, incontinence, voided volume, were evaluated by a 3-day micturition diary. Overactive Bladder Questionnaire Short Form (OAB-qSF) was used to assess the impact of OAB symptoms on patients' quality of life (QoL). Urgency was assessed by patient's perception of intensity of urgency scale (PPIUS). Micturition-diary, OAB-qSF, PPIUS, were completed at baseline and after four months. RESULTS A greater number of patients discontinued solifenacin in the group B who need to buy the drug. We observed significant differences in groups A and B in relation to frequency, nocturia, urge incontinence and voided volume comparing the pre and post treatment symptoms. The patients' perceptions of intensity of urgency and the PGI-I scale showed a significant improvement greater in group A in respect with group B. CONCLUSIONS The cost of anticholinergic may be responsible for both early discontinuation of treatment and incomplete adherence to therapy with unsatisfactory results on symptoms and an incorrect assessment of the effectiveness of the drug by the urologist.
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Marinkovic SP, Rovner ES, Moldwin RM, Stanton SL, Gillen LM, Marinkovic CM. The management of overactive bladder syndrome. BMJ 2012; 344:e2365. [PMID: 22511208 DOI: 10.1136/bmj.e2365] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kuo YC, Kuo HC. Potential factors that can be used to differentiate between interstitial cystitis/painful bladder syndrome and bladder oversensitivity in women. Int J Clin Pract 2012; 66:146-51. [PMID: 21951755 DOI: 10.1111/j.1742-1241.2011.02767.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIM There is considerable overlap between symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) and bladder oversensitivity, thereby making it difficult to differentiate between the two based on symptoms alone. We investigated factors that could potentially be used to differentiate between IC/PBS and bladder oversensitivity in women. MATERIALS AND METHODS Video-urodynamic study (VUDS) results in women with lower urinary tract symptoms (LUTS) were retrospectively analysed. Patients classified as having increased bladder sensation (IBS) were selected for analysis. A potassium chloride (KCl) test was performed and pain or urgency elicited was considered positive response. Cystoscopic hydrodistention demonstrating glomerulation was considered diagnosis of IC/PBS; otherwise bladder oversensitivity was diagnosed. LUTS, urodynamic variables and results of the KCl test were used to predict IC/PBS in these women. RESULTS A total of 405 women with IBS and 272 symptomatic controls with normal VUDS findings were included. Among 227 IBS patients undergoing KCl test, a positive result was found in 190 and a negative test result was found in 37. Characteristic glomerulation was noted in 170 patients, including 165 with a positive and five with a negative KCl test. We found that storage symptoms and pain had a positive predictive value of 45.3% for IC/PBS. When a CBC ≤ 350 ml was added the positive predictive value was 65% for IC/PBS. A combination of storage symptoms, a CBC ≤ 350 ml, a positive KCl test result with an increase of ≥ 2 on the visual analogue pain scale (VAS) provided 100% predictive of IC/PBS. CONCLUSION A diagnosis of IC/PBS can be made without cystoscopic hydrodistention in women with increased bladder sensation, having storage symptoms, a CBC ≤ 350 ml, a positive KCl test result and a VAS score ≥ 2.
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Sivalingam N, Loh KY. Concepts in the management of the overactive bladder in women. THE MEDICAL JOURNAL OF MALAYSIA 2012; 67:137-142. [PMID: 22582572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The 'overactive bladder' is a common problem affecting the elderly female population especially after the menopause. Urgency with or without urge incontinence accompanied by frequency of micturition and nocturia are presenting symptoms. The diagnosis is established after excluding other diseases of the lower urinary tract which have similar presenting features. The aetiology is multifactorial and this problem often causes physical, psychological and emotional distress to the patient. Management can be provided by primary care physicians initiating behavioral changes which include life style interventions and bladder drills with or without antimuscarinic drugs. The recalcitrant patient not responding to conventional therapy should be referred for specialist care. Non-conventional treatment using acupressure, neuromodulation and surgical methods are only instituted in indicated cases.
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Tikkinen KAO, Auvinen A. Does the imprecise definition of overactive bladder serve commercial rather than patient interests? Eur Urol 2012; 61:746-8; discussion 749-50. [PMID: 22226584 DOI: 10.1016/j.eururo.2011.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 12/10/2011] [Indexed: 01/16/2023]
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Gray M. Traces: making sense of urodynamics testing--Part 9: Evaluation of sensations detrusor response to bladder filling. UROLOGIC NURSING 2012; 32:21-18. [PMID: 22474862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Part 9 of the Traces series continues the discussion of how urodynamic clinicians generate usable data from a filling cystometrogram. This article focuses on the question: "What is the detrusor's response to bladder filling?" Answering this question requires the clinician to identify and differentiate detrusor contractions from abdominal events, artifacts, or low bladder wall compliance; documentation of the volume of the contraction; and assessment of its clinical relevance as an overactive or subclinical detrusor contraction.
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Pisarska-Krawczyk M, Urbaniak T, Klejewski A. [Overactive bladder--diagnosis et treatment]. PRZEGLAD LEKARSKI 2012; 69:1156-1159. [PMID: 23421115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Normal undisturbed voiding is a complex mechanism controlled by central nervous system, peripheral autonomic somatic, parasympathetic and sympathetic nervous system. The process of urination is depended on complex coordinated action of bladder and urethra, regulated by action of several neurotransmitters. This interdependent process may lead to various pathologies. One of it is over activity of detrusor muscle which etiology is multifactorial, diagnosis remains a challenge and therapy may be difficult. Multifactorial etiology of overactive bladder with urgency symptoms and urinary frequency with or without urinary incontinence may lead to difficult therapeutic situations. Combination of lifestyle, changes, pharmacological treatment and physiotherapy are all not fully satisfying. Epidemiological data are not completely clear and environmental influences seem to be important. The clinical problems of overactive bladder due to their substantial impact on women's health need further analysis which should improve prophylaxis, diagnosis and therapy.
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Stachowicz N, Maciejczyk-Pencuła M, Morawska D, Stachowicz S, Kotarski J. [Urgent urinary incontinence--preliminary diagnostics and pharmacological treatment]. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2012; 65:162-166. [PMID: 23289263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In this paper authors describe classification, preliminary diagnosis of urinary incontinence. They also show ways of pharmacological therapy and kinds of available medicines, which are administer in treatment of women with urinary incontinence symptoms of neurologic descent and overactive bladder.
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Humphrey L, Arbuckle R, Moldwin R, Nordling J, van de Merwe JP, Meunier J, Crook T, Abraham L. The bladder pain/interstitial cystitis symptom score: development, validation, and identification of a cut score. Eur Urol 2011; 61:271-9. [PMID: 22050826 DOI: 10.1016/j.eururo.2011.10.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Accepted: 10/06/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is a need to develop a self-report measure that reliably identifies moderate to severe bladder pain syndrome (BPS) patients for inclusion into clinical trials to assess the efficacy of new BPS treatments. OBJECTIVE To develop and validate a patient-reported symptom-based instrument, the Bladder Pain/Interstitial Cystitis Symptom Score (BPIC-SS), for clinical trial eligibility of BPS patients. DESIGN, SETTING, AND PARTICIPANTS Stage 1: Qualitative concept elicitation (CE) interviews were conducted with BPS patients in France (n=12), Germany (n=12), and the United States (US) (n=20), and overactive bladder (OAB) (n=10) patients in the US for comparison. Stage 2: Cognitive debriefing (CD) interviews were performed with US BPS patients (n=20). Stage 3: An observational study with 99 BPS, 99 OAB, and 100 healthy participants in the US was used to perform item reduction, identify cut scores, and validate the measure. A cut score was defined using logistic regression and receiver operating characteristic curves. Psychometric properties, including test-retest reliability, were assessed. MEASUREMENTS In addition to the BPIC-SS, the Pelvic Pain and Urgency/Frequency Patient Symptom Scale, the Interstitial Cystitis Symptom Index, a Clinician Global Impression of Severity, and a Patient Global Impression of Change were included in the observational study. RESULTS AND LIMITATIONS In CE, reported symptoms were bladder pain, persistent urge to urinate, and high urinary frequency. In CD, 13 items were deleted, and 15 were retained. Based on validation analyses, qualitative findings, and clinical relevance, the instrument was reduced to eight items that had strong sensitivity (0.72) and specificity (0.86) with a cut score ≥19 to determine clinical trial inclusion. Psychometric properties were strong. CONCLUSIONS The BPIC-SS is a reliable, valid, and appropriate questionnaire to select BPS/interstitial cystitis patients for clinical trials.
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Heesakkers J, Farag F. Re: Jürgen Pannek. Mozart, the brain, and the bladder: clinical usefulness of near-infrared spectroscopy for the detection of detrusor overactivity. Eur Urol 2011;59:763-4. Eur Urol 2011; 60:e49; author reply e50. [PMID: 21899944 DOI: 10.1016/j.eururo.2011.08.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 08/18/2011] [Indexed: 11/19/2022]
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What men should know about overactive bladder. THE JOHNS HOPKINS MEDICAL LETTER HEALTH AFTER 50 2011; 23:6. [PMID: 21702114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Barkin J. Overactive bladder. THE CANADIAN JOURNAL OF UROLOGY 2011; 18 Suppl:8-13. [PMID: 21501545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Overactive bladder (OAB) is common and has a negative impact on a patient's quality of life. It is important for physicians to know how to identify and manage patients with this condition. Usually only basic clinical evaluations and a good patient history are necessary to diagnose OAB. Effective and safe oral therapy is available and can be initiated by primary care physicians.
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[Differential diagnosis and therapy examined under the microscope. LUTS (lower urinary tract symptoms) due to OAB (overactive bladder) - a frequent disease picture in the man]. MMW Fortschr Med 2011; 153:44-45. [PMID: 21638816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Muller N. LUTS and OAB in men: gender matters. OSTOMY/WOUND MANAGEMENT 2011; 57:16-17. [PMID: 21721288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Abstract
AIM The purpose of this study was to validate a short awareness tool to assist patients in identifying if they have bothersome overactive bladder (OAB) symptoms. METHODS This secondary analysis study utilised data from a cross-sectional study of adult patients presenting for primary care visits. Patients completed an 8-item OAB screener. The clinician probed for urinary frequency, urgency, nocturia and urgency urinary incontinence. If the patient screened positive or reported the presence of at least one OAB symptom, additional questions were asked regarding lifestyle and coping issues. The clinician then diagnosed the patient as having No OAB, Possible OAB, or Probable OAB. Multivariate logistic regressions were performed to assess the feasibility of deriving a shorter screener to raise awareness of OAB among primary care patients. RESULTS The 1,260 patients in this study were 51.6±17.0 years old; 62% were women; and most (89%) were Caucasian. Clinicians diagnosed 12.1% of patients with Probable OAB, 19.7% with Possible OAB and 68.3% with No OAB. The logistic regression models were performed with OAB clinical diagnosis as the dependent variable comparing No OAB versus Probable OAB. Three items which included the symptoms of urinary frequency, urinary urgency and urine loss associated with a strong desire to urinate performed well as an awareness tool. A cut-point of four provided the most appropriate sensitivity (82%) and specificity (91%) when identifying Probable OAB and yielded adequate model fit. The final 3-item OAB Awareness Tool (OAB-V3) is gender neutral. CONCLUSION The 3-item OAB Awareness Tool (OAB-V3) correctly identified patients with symptoms of OAB with high sensitivity and specificity and can be used as a conversation starter for patients with symptoms of OAB.
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