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Van de Borne S, Tilborghs S, Vaganée D, Vermandel A, De Wachter S. Detailed Investigation of Bladder Diary Parameters During Sacral Neuromodulation in Patients With Overactive Symptoms. Neuromodulation 2023; 26:1831-1835. [PMID: 36266179 DOI: 10.1016/j.neurom.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/22/2022] [Accepted: 09/13/2022] [Indexed: 03/23/2023]
Abstract
AIMS Sacral neuromodulation (SNM) is a well-accepted, minimally invasive modality for patients with overactive bladder (OAB). Successful response to SNM is defined as at least 50% improvement in key symptoms, evaluated in a bladder diary (BD). BDs provide much useful information on bladder behavior during daily life. The aim of this study is to investigate BD parameter changes during SNM therapy in patients with OAB. MATERIALS AND METHODS The International Consultation on Incontinence Questionnaires (ICIQ)-BD was filled out by 34 patients with OAB, for three days at baseline and after three weeks of subthreshold sensory stimulation. The patients were considered responders for SNM when 50% improvement was seen in the BD. They underwent implantation of an internal pulse generator (IPG), and subsequently, an ICIQ-BD and a visual analog scale (VAS) evaluating bladder satisfaction during three days were filled out six weeks, six months, and one year after IPG implantation. RESULTS IPGs were implanted in 29 patients (85%). The BD showed a significant decrease in 24-hour leakage at three weeks from 4.2 to 0.6 (-86%, p < 0.001), similar significant decreases at six weeks and six months, and at one year (-80%). Voided volume (VV) at corresponding bladder sensation codes was not different between baseline and at three weeks of tined-lead procedure (TLP) (p > 0.05), and at six weeks (p > 0.05), six months (p > 0.1), and one year of IPG (p > 0.08). After three weeks of TLP, urgency episodes decreased from 4.8 to 3.4 (-30%, p = 0.025), with 59% reduction at six-weeks IPG (p < 0.001) and 49% at six-months IPG (p = 0.013). At one year, a decrease from 4.7 to 2.3 (52% reduction, p = 0.017) was noted. VAS showed the strongest correlation with urgency (p < 0.001) and frequency (p = 0.006). No significant correlation was found with VV (p = 0.87). CONCLUSIONS Our study describes how bladder sensation parameters change over time in patients on SNM. VV does not significantly increase, nor does frequency significantly decrease over the first year. Leaks and the percentage of urgency episodes significantly decrease, reaching a plateau level between six-weeks and six-months SNM.
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Affiliation(s)
- Sigrid Van de Borne
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium
| | - Sam Tilborghs
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium
| | - Donald Vaganée
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium
| | - Alexandra Vermandel
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, Division of Occupational and Physical Therapy, University of Antwerp, Antwerp, Belgium
| | - Stefan De Wachter
- Department of Urology, Antwerp University Hospital, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre, Faculty of Medicine and Health Sciences, Anatomy, University of Antwerp, Antwerp, Belgium.
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Koh N, Kim MJ, Lee SY, Oh S, Jeon MJ. The Diagnostic Accuracy of a Retrograde Voiding Trial for Restoration of Spontaneous Voiding Function after Prolapse and Urinary Incontinence Surgery. J Minim Invasive Gynecol 2023; 30:999-1002. [PMID: 37774779 DOI: 10.1016/j.jmig.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/03/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023]
Abstract
STUDY OBJECTIVE To assess the diagnostic accuracy of a retrograde voiding trial for the restoration of spontaneous voiding function after prolapse and urinary incontinence surgery and thereby determine whether the retrograde method can be a reliable alternative to the spontaneous voiding trial. DESIGN A retrospective cohort study. SETTING A single tertiary hospital in South Korea. PATIENTS Women who underwent operations for prolapse, urinary incontinence, or both. INTERVENTION Sequential voiding trials on postoperative day 1 or 2-retrograde voiding trial followed by spontaneous voiding trial. MEASUREMENTS AND MAIN RESULTS Of the 408 women analyzed, 278 (68.1%) passed the spontaneous voiding trial on the first day of assessment and none experienced urinary retention after a successful voiding trial. Receiver operating characteristic analyses of retrograde voiding trials evaluating voided volume (VV), postvoid residual (PVR), and voiding efficiency (VE) all demonstrated high diagnostic accuracy for restoration of spontaneous voiding function, whereas measuring PVR and VE had better discriminative ability than VV (area under the curve [95% confidence interval] = 0.93 [0.90-0.95] for PVR, 0.94 [0.91-0.96] for VE, and 0.88 [0.85-0.91] for VV; DeLong's test between PVR/VE and VV p < .01). The optimal cutoffs determined by the Youden index were 200 mL for VV (sensitivity 85.0%, specificity 78.0%), 100 mL for PVR (sensitivity 84.0%, specificity 87.0%), and 66.7% for VE (sensitivity 86.0%, specificity 88.0%). CONCLUSIONS The retrograde voiding trial is an accurate predictor for restoration of spontaneous voiding function after prolapse and incontinence surgery and can be a useful alternative to the spontaneous voiding trial.
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Affiliation(s)
- Nahyun Koh
- Department of Obstetrics and Gynecology (Drs. Koh, Kim, Lee, and Jeon), Seoul National University Hospital, Seoul, Korea
| | - Min Ju Kim
- Department of Obstetrics and Gynecology (Drs. Koh, Kim, Lee, and Jeon), Seoul National University Hospital, Seoul, Korea
| | - So Yeon Lee
- Department of Obstetrics and Gynecology (Drs. Koh, Kim, Lee, and Jeon), Seoul National University Hospital, Seoul, Korea
| | - Sumin Oh
- Department of Obstetrics and Gynecology (Dr. Oh), Korea University Guro Hospital, Seoul, Korea
| | - Myung Jae Jeon
- Department of Obstetrics and Gynecology (Drs. Koh, Kim, Lee, and Jeon), Seoul National University Hospital, Seoul, Korea; Department of Obstetrics and Gynecology (Dr. Jeon), Seoul National University College of Medicine, Seoul, Korea.
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Özçift B. Correspondence of uroflowmetry and voiding diary in evaluation of voiding volume in children with lower urinary tract dysfunction. AFRICAN JOURNAL OF UROLOGY 2022. [DOI: 10.1186/s12301-022-00277-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Objective assessment of voided volumes in children with lower urinary tract dysfunction is important. This study aimed to compare and evaluate voided volumes obtained from a 48-h voiding diary and uroflowmetry in children with lower urinary tract dysfunction.
Methods
In this retrospective cohort study, voided volumes obtained by 48-h voiding diary and contemporaneous uroflowmetry were compared in terms of age, sex, and the three most common subtypes of lower urinary tract dysfunction (monosymptomatic nocturnal enuresis, overactive bladder, and dysfunctional voiding) in children. Patients were stratified according to voided volume differences between uroflowmetry and 48-h voiding diary.
Results
A total of 242 children were included in the study. Maximum and average voided volumes in uroflowmetry were higher than those in 48-h voiding diaries in the entire population (P < 0.001). While there was a significant difference between maximum voided volume in the two methods when evaluating patients with overactive bladder and dysfunctional voiding, there was no significant difference in those with monosymptomatic nocturnal enuresis (P = 0.001, P = 0.030, P = 0.206, respectively). A significant difference was observed between the three subtypes of lower urinary tract dysfunction in voided volumes (P < 0.001). When maximum and average voided volumes were compared for age subgroups, there was no significant difference in maximum and mean voided volumes only in voiding diary measurements (P > 0.05). When the two methods were compared, there was a difference in maximum and average voided volumes of more than 30% of the estimated bladder capacity in 94 (38.9%) and 86 (34.3%) children, respectively.
Conclusions
Uroflowmetry and a 48-h voiding diary should not be used interchangeably when evaluating children with lower urinary tract dysfunction. The results of uroflowmetry measurements should be used to support the diagnosis of underlying lower urinary tract dysfunction.
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Erbes NA, Foster SN, Harris-Hayes M, Spitznagle TM. Movement Impairments in Women with and without Urinary Urgency/Frequency. JOURNAL OF WOMEN'S HEALTH PHYSICAL THERAPY 2021; 45:164-173. [PMID: 35002578 PMCID: PMC8741169 DOI: 10.1097/jwh.0000000000000211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVES 1) examine the relationship between spine, hip, and pelvis movement patterns and urinary urgency and frequency 2) report the prevalence of pelvic girdle and hip joint impairments among women with and without urinary urgency and frequency 3) report the most common movement impairments observed in women with and without urinary urgency and frequency. METHODS Women age 18-60 with urinary urgency and frequency were matched 1:1 to women without on age, body mass index, and vaginal parity. Participants completed primary movement tests of the hip, pelvis and spine. Additional clinical tests included Stork test, sidelying position, pubic symphysis palpation, flexion-abduction-external rotation, flexion-adduction-internal rotation, and seated hip internal and external rotation. Urge symptoms were monitored before and during each test. Movement patterns and positioning of the thoracic and lumbar spine, pelvis, and hips were observed. Secondary tests to correct a movement or positional impairment were performed if an impairment was noted or if symptoms were provoked during the primary test. RESULTS 42 women completed testing. More participants with urinary urgency and frequency 1) demonstrated impairments during forward bend, single leg stance, sidelying and Stork tests; 2) reported urgency provocation during forward bend, flexion-adduction-internal rotation test, pubic symphysis palpation, and hip internal rotation; and 3) reported symptom relief with sidelying position secondary test; and secondary tests of the thoracic, lumbar and hip regions compared to those without. CONCLUSION Musculoskeletal impairments may be associated with urinary urgency and frequency and should therefore be considered when determining management options for these patients.
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Affiliation(s)
- Nicole A Erbes
- Program in Physical Therapy, Washington University in St. Louis, St Louis, MO
| | | | - Marcie Harris-Hayes
- Program in Physical Therapy, Washington University in St. Louis, St Louis, MO
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Dong X, Pan C, Wang D, Shi M, Li Y, Tan X, Guo T. Bladder Backfilling versus Standard Catheter Removal for Trial of Void after Outpatient Laparoscopic Gynecologic Surgery: A Systematic Review and Meta-Analysis. J Minim Invasive Gynecol 2021; 29:196-203.e1. [PMID: 34481986 DOI: 10.1016/j.jmig.2021.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/11/2021] [Accepted: 08/26/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare the rate of postoperative urinary retention and time to discharge between bladder backfilling and standard catheter removal for trial of void (TOV) after outpatient laparoscopic gynecologic surgery. Our secondary objectives were to compare the time to void, postoperative complications, and patient satisfaction. DATA SOURCES We searched the PubMed, Ovid MEDLINE, Embase, Cochrane Library databases, and relevant reference lists of eligible articles up to March of 2021. METHODS OF STUDY SELECTION This review included randomized controlled trials (RCTs) of TOV after outpatient laparoscopic gynecologic surgery. Odds ratios (ORs) with 95% confidence interval (CI) and weighted mean differences (WMDs) were reported. The quality of the studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Data were analyzed with Review Manager 5.4 software (RevMan 5.4.1; Cochrane Collaboration, London, United Kingdom). TABULATION, INTEGRATION, AND RESULTS Five RCTs (N = 488) were included. The bladder backfilling group had a significantly shorter time to void than the standard TOV group (WMD, -25.19 minutes; 95% CI, -44.60 to -5.77; p = .01). Successful TOV was not significantly different between the 2 (OR, 0.92; 95% CI, 0.51 to -1.65; p = .77), without significant heterogeneity (I2 = 24%). There was also no significant difference in the time to discharge between the 2 TOV techniques (WMD, -25.19 minutes; 95% CI, -44.60 to -5.77; p = .01). There was no significant difference in complication rates or patient satisfaction between the 2 groups. CONCLUSION The bladder backfilling technique of TOV after outpatient laparoscopic gynecologic surgery may reduce the time to first spontaneous void without affecting patient satisfaction or postoperative complications, but it does not significantly affect the time to discharge or urinary retention.
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Affiliation(s)
- Xue Dong
- Ambulatory Surgery Department (Dr. Tan and Ms. Dong), West China Second Hospital, Sichuan University, Chengdu
| | - Changqing Pan
- Gynecology and Obstetrics Department, Mianyang Central Hospital (Mr. Pan and Mr. Wang), Mianyang, China
| | - Dan Wang
- Gynecology and Obstetrics Department, Mianyang Central Hospital (Mr. Pan and Mr. Wang), Mianyang, China
| | - Mengdan Shi
- Gynecology and Obstetrics Department (Drs. Shi, Tan and Mr. Guo), West China Second Hospital, Sichuan University, Chengdu
| | - Yonghong Li
- Gynecology and Obstetrics Department, People's Hospital of Wenjiang District (Mr. Li), Chengdu, China
| | - Xin Tan
- Ambulatory Surgery Department (Dr. Tan and Ms. Dong), West China Second Hospital, Sichuan University, Chengdu; Gynecology and Obstetrics Department (Drs. Shi, Tan and Mr. Guo), West China Second Hospital, Sichuan University, Chengdu
| | - Tao Guo
- Gynecology and Obstetrics Department (Drs. Shi, Tan and Mr. Guo), West China Second Hospital, Sichuan University, Chengdu.
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Zakhari A, Paek W, Chan W, Edwards D, Matelski J, Solnik MJ, Murji A. Retrograde Bladder Filling after Laparoscopic Gynecologic Surgery: A Double-blind Randomized Controlled Trial. J Minim Invasive Gynecol 2020; 28:1006-1012.e1. [PMID: 33017685 PMCID: PMC7532349 DOI: 10.1016/j.jmig.2020.09.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 11/27/2022]
Abstract
Study Objective To evaluate whether retrofilling the bladder on completion of elective laparoscopic gynecologic surgery for benign indications has an effect on the timing of the first postoperative void and the timing of discharge from the hospital. Design Double-blind randomized controlled trial. Setting Single academic surgical day hospital. Patients Patients undergoing outpatient laparoscopic gynecologic surgery, excluding hysterectomy or pelvic reconstructive surgery. Interventions On completion of surgery, patients were randomized to either retrograde filling of the bladder with 200 mL of saline before catheter removal or standard care (immediate catheter removal). Patients and postanesthesia care unit nurses (outcome assessors) were both blinded. Measurements and Main Results The primary outcome was the time to first void. The secondary outcomes were time to hospital discharge, postoperative urinary tract infection, and patient satisfaction. Over a 3-month period, 47 patients were approached on the day of surgery, 42 consented and were randomized (21 to intervention and 21 to control). There were no significant differences in baseline demographics between the groups. The median time to first void was significantly shorter for patients in the intervention arm than controls (104 ± 75 minutes vs 162 ± 76 minutes, p <.001). Patients who had retrofilled bladders were discharged faster from post-anesthesia care unit compared to controls (155.0 ± 74 minutes vs 227 ± 58 minutes, p = .001). There were no urinary tract infections in either group, and the proportion of satisfied or very satisfied patients was high (93.8% vs 88.2%, p = .512). Conclusion Retrograde filling of the bladder after outpatient laparoscopic gynecologic surgery is a safe, effective method that significantly reduces the length of hospital stay.
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Affiliation(s)
- Andrew Zakhari
- Department of Obstetrics and Gynecology, Mount Sinai Hospital (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji); Department of Obstetrics & Gynecology, University of Toronto (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji); Department of XXX, McGill University Health Center, Montreal, Quebec (Dr. Zakhari), Canada
| | - Wusun Paek
- Department of Obstetrics and Gynecology, Mount Sinai Hospital (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji); Department of Obstetrics & Gynecology, University of Toronto (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji)
| | - Wilson Chan
- Department of Obstetrics and Gynecology, Mount Sinai Hospital (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji); Department of Obstetrics & Gynecology, University of Toronto (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji)
| | - Darl Edwards
- Department of Obstetrics and Gynecology, Mount Sinai Hospital (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji); Department of Obstetrics & Gynecology, University of Toronto (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji)
| | - John Matelski
- Biostatistics Research Unit, University Health Network (Dr. Matelski), Toronto, Ontario
| | - M Jonathon Solnik
- Department of Obstetrics and Gynecology, Mount Sinai Hospital (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji); Department of Obstetrics & Gynecology, University of Toronto (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji)
| | - Ally Murji
- Department of Obstetrics and Gynecology, Mount Sinai Hospital (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji); Department of Obstetrics & Gynecology, University of Toronto (Drs. Zakhari, Paek, Chan, Edwards, Solnik, and Murji).
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McCloskey KD, Wyndaele JJ, Speich JE, Birder L, Nelson PP. Should we be revisiting LUT basic science and clinical measurement of LUT sensation to improve patient care? ICI-RS 2019. Neurourol Urodyn 2020; 39 Suppl 3:S23-S29. [PMID: 32662560 DOI: 10.1002/nau.24273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/27/2019] [Indexed: 11/10/2022]
Abstract
AIMS This article reviews current knowledge of the underpinning mechanisms of how the bladder senses fullness locally and also revisits clinical measurements of lower urinary tract sensation. The former represents cellular sensing during bladder filling whereas the latter describes the sensations leading to conscious perception of bladder fullness. METHODS The topic was discussed in a "think tank" session at the 2019 International Consultation on Incontinence-Research Symposium in Bristol, UK; summarized in the present review. RESULTS Recent advances in the basic science of bladder sensing relating to (a) the bladder wall-urothelial cells, sensory nerves, interstitial cells, and smooth muscle cells and (b) putative chemo/mechanosensors in the urethra-paraneurons or "brush cells" are discussed. Validated clinical measurement of lower urinary tract sensation is reviewed in the context of how this could be better harnessed for patient benefit. We discuss the potential of app/tablet/mobile technology based on triggers and distractors to override aberrant local sensing/higher sensation and how these technologies could be utilized in treatment. CONCLUSIONS We conclude that a better understanding of bladder sensation is essential to inform clinical management of lower urinary tract symptoms.
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Affiliation(s)
- Karen D McCloskey
- Centre for Cancer Research and Cell Biology, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | | | - John E Speich
- Department of Mechanical and Nuclear Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia
| | - Lori Birder
- Departments of Medicine-Renal Electrolyte Division and Pharmacology/Chemical Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Pierre P Nelson
- Department of Physical Medicine and Rehabilitation, Hôpital Rothschild, Sorbonne Université, Paris, France
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Wyman JF, Zhou J, Yvette LaCoursiere D, Markland AD, Mueller ER, Simon L, Stapleton A, Stoll CRT, Chu H, Sutcliffe S. Normative noninvasive bladder function measurements in healthy women: A systematic review and meta-analysis. Neurourol Urodyn 2020; 39:507-522. [PMID: 31917870 DOI: 10.1002/nau.24265] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/18/2019] [Indexed: 01/01/2023]
Abstract
AIM To conduct an evidence synthesis of normative reference values for bladder function parameters in women. METHODS We conducted a systematic review and meta-analysis of studies reporting bladder function parameters obtained from noninvasive tests in healthy women. Seven databases were searched for relevant studies from inception through December 2018, with manual searching of reference lists. We included English language articles that provided quantitative data on urination frequency, voided and postvoid residual volumes, and uroflowmetry results in women without lower urinary tract symptoms. Study selection, data extraction, and quality assessment were undertaken by at least two independent reviewers. Random-effects meta-analytic models were used to derive study-level pooled mean estimates and 95% confidence intervals. RESULTS A total of 24 studies (N = 3090 women, age range, 18-91 years) met eligibility criteria. Pooled mean estimates of bladder function parameters were: 6.6 daytime voids (95% confidence interval (95% CI), 6.2, 7.0), 0.4 nighttime voids (95% CI, 0.0, 0.8), 1577 mL for 24-hour voided volume (95% CI 1428,1725); 12 mL for postvoid residual volume (95% CI, 4, 20); and 28 mL/sec for maximum flow rate (95% CI, 27,30). Between-study heterogeneity was high for all outcomes (I2 = 61.1-99.6%), but insufficient data were available to explore reasons for this high heterogeneity (eg, differences by age). CONCLUSION Although summary mean estimates of bladder function parameters were calculated, the wide heterogeneity across studies precludes generalization of these estimates to all healthy women. Further research is needed to determine normative reference values within specific groups, such as those defined by age.
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Affiliation(s)
- Jean F Wyman
- School of Nursing, University of Minnesota, Minneapolis, Minnesota
| | - Jincheng Zhou
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - D Yvette LaCoursiere
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, LaJolla, California
| | - Alayne D Markland
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, Birmingham/Atlanta Geriatrics Research, Education, and Clinical Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Elizabeth R Mueller
- Departments of Urology and Obstetrics/Gynecology, Loyola University Medical Center, Loyola University Chicago, Maywood, Illinois
| | - Laura Simon
- Bernard Becker Medical Library, Washington University in St. Louis, St. Louis, Missouri
| | - Ann Stapleton
- Department of Medicine, University of Washington, Seattle, Washington
| | - Carolyn R T Stoll
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri
| | - Haitao Chu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri
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Schimpf MO, Smith AR, Miller JM. Fluids affecting bladder urgency and lower urinary symptoms (FABULUS): methods and protocol for a randomized controlled trial. Int Urogynecol J 2019; 31:1033-1040. [PMID: 31875256 DOI: 10.1007/s00192-019-04209-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS We present the design of a randomized controlled trial, Fluids Affecting Bladder Urgency and Lower Urinary Symptoms (FABULUS), with the purpose of testing the common clinical advice of treating overactive bladder by eliminating potentially irritating beverages (PIBs) that are caffeinated, artificially sweetened, citric, or alcoholic. The primary hypothesis is that women taught to reduce PIBs will show less void frequency compared with a control group instructed in diet/exercise recommendations. Secondary outcomes include change in urgency symptoms and volume per void. METHODS We report the methods for FABULUS and discuss how challenges presented in the literature and from a prior proof-of-concept feasibility trial are addressed by strengthening study design, procedures, and instruments. We introduce the concept of standardized automated tutorials for assisting participants in compliance from study start to finish. The tutorials contain a detailed explanation of the study, including tips for complying with the extensive diary requirements, and parallel tutorials to intervention and control groups for consistency in format and time of instructional content. The intervention tutorial on eliminating PIBs places emphasis on maintaining steady fluid intake volume, as fluctuations have been a confounder in prior work. RESULTS Study results promise to inform about both the tutorial approach and specific PIB reduction for effectively treating overactive bladder. CONCLUSIONS OAB can have a negative impact on quality of life, and current medical treatments carry costs and side-effect risks. If simple lifestyle changes can improve or prevent these bladder symptoms, multiple medical and public health advances could result.
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Affiliation(s)
- Megan O Schimpf
- Department of Obstetrics and Gynecology, Division of Gynecology, University of Michigan, L4000 University Hospital South, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.
| | | | - Janis M Miller
- Department of Obstetrics and Gynecology, Division of Gynecology, University of Michigan, L4000 University Hospital South, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Herrewegh AGM, Vrijens DMJ, Marcelissen TAT, van Koeveringe GA. Bladder sensations in male and female overactive bladder patients compared to healthy volunteers: a sensation-related bladder diary evaluation. Scand J Urol 2019; 53:255-260. [PMID: 31354017 DOI: 10.1080/21681805.2019.1641551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: To investigate the differences in bladder sensations of overactive bladder (OAB) patients compared to healthy volunteers. In addition, to see if bladder sensations are different in men and women.Methods: In a prospective, longitudinal study (METC 09-2-095), 66 volunteers and 68 OAB patients were included. Anticholinergic medication was stopped. Subjects filled out a sensation-related bladder diary (SR-BD), for two periods of 3 days, including a 4-points urgency scale and visual analogue scale for perception of bladder fullness.Results: In total, 6160 voids were assessed. Patients voided more often with higher degrees of urge at a lower mean voided volume (193 vs 270 ml/void; p < 0.001) than healthy volunteers. The mean urinary frequency per litre diuresis was also higher (5.8 vs 4.1/l; p < 0.001) in patients. At the same voided volume: patients perceived a higher mean bladder fullness, independent of the degree of urge, and higher urgency (1.4 vs 0.5/100 ml; p < 0.001) than healthy volunteers. There were no gender differences in the above-mentioned voiding parameters, except for the mean voided volume at urge 3 in volunteers (340 ml in men vs 362 ml in women; p = 0.03) and urge 1 in patients (171 ml in men vs 135 ml in women; p = 0.027).Conclusions: Bladder sensations were significantly increased in everyday life for both male and female OAB patients compared to healthy volunteers. OAB patients experienced a higher mean bladder fullness sensation, independent of the degree of urge, and higher mean urge/urgency at the same voided volume than volunteers. Bladder sensations are crucial in the assessment of treatment response.
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Affiliation(s)
- A G M Herrewegh
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - D M J Vrijens
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - T A T Marcelissen
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - G A van Koeveringe
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Monaghan TF, Bliwise DL, Suss NR, Epstein MR, Wu ZD, Michelson KP, Agudelo CW, Robins DJ, Wagg A, Weiss JP. Overnight Urge Perception in Nocturia Is Independent of Depression, PTSD, or Anxiety in a Male Veterans Administration Population. J Clin Sleep Med 2019; 15:615-621. [PMID: 30952224 PMCID: PMC6457520 DOI: 10.5664/jcsm.7726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/27/2018] [Accepted: 01/09/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The goal of this study was to compare the urge perception associated with nocturnal voiding at the time of voiding in individuals with and without depression, posttraumatic stress disorder (PTSD), or anxiety diagnoses to test the hypothesis that patients with such diagnoses are more likely to experience insomnia-driven convenience voiding during the sleep period. METHODS A database of voiding diaries with urge perception grades (UPGs) from 429 adult males seeking treatment for nocturia at a Veterans Affairs-based urology clinic was analyzed. The UPG categorizes perception for urinating from 0 (out of convenience) to 4 (desperate urge). Diaries completed by males age 18 years and older showing ≥ 2 nocturnal voids were included. Those included (n = 178) were divided into two cohorts based on the presence (n = 62) or absence (n = 116) of one or more previously established mental health diagnoses (depression, PTSD, or anxiety). The chi-square test was used to determine significance between groups. RESULTS Patients with a mental health diagnosis were more likely to report convenience voiding compared to those without depression, PTSD, or anxiety (14.5% versus 0.8%, P < .01). However, most voids in both groups were associated with the perception of urinary urgency. There were no differences in urinary volumes or hourly rates of urine production between the groups. CONCLUSIONS A relatively small subset of urology patients experience nocturnal voiding because they are awake for reasons other than the urge to void. Mental health factors had a substantial, albeit minimal, effect. Most nocturia reflects urgency to urinate rather than voiding by convenience.
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Affiliation(s)
- Thomas F. Monaghan
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York
- Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Donald L. Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Nicholas R. Suss
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York
- Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Matthew R. Epstein
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York
- Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Zhan D. Wu
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York
- Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Kyle P. Michelson
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York
- Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | | | - Dennis J. Robins
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York
- Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
| | - Adrian Wagg
- Department of Geriatric Medicine, University of Alberta, Edmonton, Canada
| | - Jeffrey P. Weiss
- Department of Urology, SUNY Downstate Medical Center, Brooklyn, New York
- Department of Urology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York
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12
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Dessie A, Steele D, Liu AR, Amanullah S, Constantine E. Point-of-Care Ultrasound Assessment of Bladder Fullness for Female Patients Awaiting Radiology-Performed Transabdominal Pelvic Ultrasound in a Pediatric Emergency Department: A Randomized Controlled Trial. Ann Emerg Med 2018; 72:571-580. [DOI: 10.1016/j.annemergmed.2018.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/10/2018] [Accepted: 04/13/2018] [Indexed: 01/06/2023]
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Medina Lucena H, Tincello DG. Methods of assessing and recording bladder sensation: a review of the literature. Int Urogynecol J 2018; 30:3-8. [PMID: 30187093 PMCID: PMC6510803 DOI: 10.1007/s00192-018-3760-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 08/21/2018] [Indexed: 12/13/2022]
Abstract
Introduction and hypothesis The objective was to review different methods that have been used to assess bladder sensation and to provide an overview of the accuracy and objectivity of the measurement of the subjective perception of the bladder. Methods The MEDLINE and PubMed databases were searched to identify articles. References from those articles were also searched. Terms used for the search were: urinary bladder, sensation, cystometry, urodynamics, urinary incontinence and focus group. Eight hundred and fifty abstracts were identified from databases, and 12 from other sources. Twenty-two duplicate articles were removed. Irrelevant articles were excluded after reading their titles. Fifty-four articles were eligible, but 17 were excluded after reading the full text, leaving 37 articles where assessment of bladder sensation was the main aim. Results Six different methods of measuring bladder sensation have been described in the literature. Although the most frequently used was cystometry, this is an invasive tool and does not reproduce bladder behaviour during daily life because it records bladder sensation as episodic events. The visual analogue scale using a forced diuresis protocol seemed to be an excellent tool. It was non-invasive and evaluated bladder sensation continuously, from an empty to a full bladder. Conclusions In some of the studies, the samples were too small to draw any significant conclusions. There were also conflicting data on which tool was the most accurate, especially as each method of evaluating bladder sensation may influence the way it is described by participants.
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Affiliation(s)
- Hayser Medina Lucena
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK.
| | - Douglas G Tincello
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK
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14
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Medina Lucena H, Tincello DG. Validation of a water-load protocol to define the pattern of bladder sensation. Int Urogynecol J 2018; 30:767-772. [PMID: 30121702 PMCID: PMC6491398 DOI: 10.1007/s00192-018-3735-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 07/23/2018] [Indexed: 12/21/2022]
Abstract
Introduction and hypothesis The aim of this study was to confirm reliability of a water-load diuresis protocol and to assess the utility of bladder sensation curves. Methods For confirmation of fixed diuresis rate (phase 1), 12 volunteers consumed 250–300 ml of water every 15 min and recorded bladder sensation on a visual analogue scale (VAS) every 5 min to maximum sensation over two filling cycles: voids 1 and 2 (V1 and V2). The test was performed twice. For test–retest validation (phase 2), 24 participants underwent the same protocol drinking 300 ml of water every 15 min. Diuresis rates and voided volumes were compared between cycles and across tests. Results In phase 1, there was no difference in median void volume (V1 735 ml, V2 678 ml p = 0.433) or median diuresis rates (V2 12.1 ml/min, V3 14.4 ml/min p = 0.136) between cycles. When comparing those who drank 250–300 ml/15 min, there was less variability in those drinking 300-ml aliquots, so this was standardised for later experiments; 95% upper confidence limit of variability of the diuresis rate was calculated as 4.5 ml/min. Any test with a greater difference was rejected as invalid. In phase 2, only 16 participants were analysed. There was no difference in median void volumes between tests [V1 763 ml and 820 ml (p = 0.109) and V2 788 ml and 796 ml (p = 0.266)] or in diuresis rates between test 1 (12.33 ml/min) and 2 (14.40 ml/min) (p = 0.056). Median area under the curve was similar between test 1 404.96 and test 2 418.63. Conclusions This refined protocol reliably produced stable diuresis with a water load of 300 ml/15 min, excluding those with a difference in diuresis rate > 4.5 ml/min.
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Affiliation(s)
- Hayser Medina Lucena
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK.
| | - Douglas G Tincello
- Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester, Leicestershire, LE1 7RH, UK
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Cruz Y, Lucio RA, Palacios JL. Neural and Endocrine Factors Contribute to the Comorbidity of Urinary and Sexual Dysfunctions. CURRENT SEXUAL HEALTH REPORTS 2017. [DOI: 10.1007/s11930-017-0129-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Vrijens D, Marcelissen T, Drossaerts J, Heeringa R, Degaillier S, Leue C, van Koeveringe G. Self-consciousness/awareness and bladder sensations: Comparative study of overactive bladder patients and healthy volunteers. Low Urin Tract Symptoms 2017; 11:3-7. [DOI: 10.1111/luts.12186] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/25/2017] [Accepted: 05/09/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Desiree Vrijens
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
- School of Mental Health and Neuroscience (MHeNS); Maastricht University; Maastricht The Netherlands
| | - Tom Marcelissen
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Jamie Drossaerts
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
| | - Rhea Heeringa
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
| | - Sam Degaillier
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
| | - Carsten Leue
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
- School of Mental Health and Neuroscience (MHeNS); Maastricht University; Maastricht The Netherlands
- Department of Psychiatry; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
| | - Gommert van Koeveringe
- Department of Urology; Maastricht University Medical Centre (MUMC+); Maastricht The Netherlands
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
- School of Mental Health and Neuroscience (MHeNS); Maastricht University; Maastricht The Netherlands
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Does Instruction to Eliminate Coffee, Tea, Alcohol, Carbonated, and Artificially Sweetened Beverages Improve Lower Urinary Tract Symptoms?: A Prospective Trial. J Wound Ostomy Continence Nurs 2017; 43:69-79. [PMID: 26727685 DOI: 10.1097/won.0000000000000197] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Common advice for lower urinary tract symptoms (LUTS) such as frequency, urgency, and related bother includes elimination of potentially irritating beverages (coffee, tea, alcohol, and carbonated and/or artificially sweetened beverages). The purpose of this study was to determine compliance with standardized instruction to eliminate these potentially irritating beverages, whether LUTS improved after instruction, and whether symptoms worsened with partial reintroduction. DESIGN The 3-phase fixed sequence design was (1) baseline, (2) eliminate potentially irritating beverages listed above, and (3) reintroduce at 50% of baseline volume, with a washout period between each 3-day phase. We asked participants to maintain total intake volume by swapping in equal amounts of nonpotentially irritating beverages (primarily water). SUBJECTS AND SETTING The study sample comprised 30 community-dwelling women recruited through newspaper advertisement. METHODS Quantification measures included 3-day voiding diaries and detailed beverage intake, and LUTS questionnaires completed during each phase. RESULTS During Phase 2, we found significant reduction in potentially irritating beverages but complete elimination was rare. Despite protocol demands, total beverage intake was not stable; mean (± standard deviation) daily total intake volume dropped by 6.2 ± 14.9 oz (P = .03) during Phase 2. In Phase 3, the volume of total beverage intake returned to baseline, but the intake of potentially irritating beverages also returned to near baseline rather than 50% as requested by protocol. Despite this incomplete adherence to study protocols, women reported reduction in symptoms of urge, inability to delay voiding, and bother during both phases (P ≤ .01). The number of voids per day decreased on average by 1.3 and 0.9 voids during Phases 2 and 3, respectively (P = .002 and P = .035). CONCLUSIONS Education to reduce potentially irritating beverages resulted in improvement in LUTS. However, eliminating potentially irritating beverages was difficult to achieve and maintain. Study findings do not allow us to determine whether LUTS improvement was attributable to intake of fewer potentially irritating beverages, reduced intake of all beverages, the effect of self-monitoring, or some combination of these factors.
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Rosier PF, Schaefer W, Lose G, Goldman HB, Guralnick M, Eustice S, Dickinson T, Hashim H. International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn 2016; 36:1243-1260. [DOI: 10.1002/nau.23124] [Citation(s) in RCA: 257] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/13/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Peter F.W.M Rosier
- Department of Urology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Werner Schaefer
- Department of Medicine (Geriatrics); University of Pittsburgh; Pittsburgh Pennsylvania
| | - Gunnar Lose
- University of Copenhagen Herlev Hospital; Herlev Denmark
| | - Howard B. Goldman
- Glickman Urologic and Kidney Institute Cleveland Clinic; Lerner College of Medicine; Cleveland Ohio
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Konstantinidis C, Kratiras Z, Samarinas M, Skriapas K. Optimal bladder diary duration for patients with suprapontine neurogenic lower urinary tract dysfunction. Int Braz J Urol 2016; 42:766-72. [PMID: 27564288 PMCID: PMC5006773 DOI: 10.1590/s1677-5538.ibju.2015.0292] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/12/2015] [Indexed: 12/03/2022] Open
Abstract
Purpose: To identify the minimum bladder diary's length required to furnish reliable documentation of LUTS in a specific cohort of patients suffering from neurogenic urinary dysfunction secondary to suprapontine pathology. Materials and Methods: From January 2008 to January 2014, patients suffering from suprapontine pathology and LUTS were requested to prospectively complete a bladder diary form for 7 consecutive days. Micturitions per day, excreta per micturition, urgency and incontinence episodes and voided volume per day were evaluated from the completed diaries. We compared the averaged records of consecutive days (2-6 days) to the total 7 days records for each patient's diary, seeking the minimum diary's length that could provide records comparable to the 7 days average, the reference point in terms of reliability. Results: From 285 subjects, 94 male and 69 female patients enrolled in the study. The records of day 1 were significantly different from the average of the 7 days records in every parameter, showing relatively small correlation and providing insufficient documentation. Correlations gradually increased along the increase in diary's duration. According to our results a 3-day duration bladder diary is efficient and can provide results comparable to a 7 day length for four of our evaluated parameters. Regarding incontinence episodes, 3 days seems inadequate to furnish comparable results, showing a borderline difference. Conclusions: A 3-day diary can be used, as its reliability is efficient regarding number of micturition per day, excreta per micturition, episodes of urgency and voided volume per day.
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Affiliation(s)
| | - Zisis Kratiras
- Department of Urology, General Hospital of Larissa "Koutlibanio", Larissa, Greece
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20
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Wang Q, Wang HB, Xu H, Zhou W, Liu GZ. Noninvasive Urination-Desire Sensing Method Based on Bladder Bioimpedance Spectrum Analysis. J Med Biol Eng 2016. [DOI: 10.1007/s40846-016-0128-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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21
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Veit-Rubin N, Cartwright R, Esmail A, Digesu GA, Fernando R, Khullar V. The location of pain and urgency sensations during cystometry. Neurourol Urodyn 2016; 36:620-625. [PMID: 26879227 DOI: 10.1002/nau.22975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 01/26/2016] [Indexed: 11/10/2022]
Abstract
AIMS The relationship between bladder pain and urinary urgency sensations is poorly understood. We analyzed the relationship between locations and intensities of urgency and pain sensations felt during filling cystometry. METHODS Participants completed the King's Health Questionnaire (KHQ) to indicate presence of bladder pain or urgency. During cystometry, participants scored the intensity of urgency and pain, both in the suprapubic and the urethral region, on a VAS scale of 0-10 at a baseline, at first desire, normal desire, strong desire to void, and at maximum cystometric capacity during filling. We allocated the participants to six groups; those reporting urgency or not, pain or not, both symptoms and neither. Friedman's Test was used to ascertain if all scores increased significantly, the Wilcoxon Signed Rank Test was used to demonstrate the difference between scores, and agreement for findings during cystometry was tested with Mann-Whitney U. RESULTS A total of 68 women participated; 38 participants reported pain, 57 reported urgency, and 33 reported both symptoms. Pain and urgency scores significantly increased during cystometry (P < 0.0001). For participants reporting pain, suprapubic pain was rated significantly higher than urethral pain. Participants reporting both symptoms, felt more urgency than pain, and again pain more suprapubically than urethrally. Participants reporting only urgency scored suprapubic and urethral urgency similarly at all desires. CONCLUSIONS Pain and urgency are well differentiated sensations and are felt at different locations although pain is seemingly easier localized. Neurourol. Urodynam. 36:620-625, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Nikolaus Veit-Rubin
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Rufus Cartwright
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Alisha Esmail
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - G Alessandro Digesu
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Ruwan Fernando
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
| | - Vikram Khullar
- Department of Urogynaecology, St. Mary's Hospital, Imperial College London, London, United Kingdom
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22
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Urinary nerve growth factor and a variable solifenacin dosage in patients with an overactive bladder. Int Urogynecol J 2015; 27:275-80. [DOI: 10.1007/s00192-015-2825-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/04/2015] [Indexed: 11/27/2022]
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Kaynar M, Kucur M, Kiliç O, Akand M, Gul M, Goktas S. The effect of bladder sensation on uroflowmetry parameters in healthy young men. Neurourol Urodyn 2015; 35:622-4. [PMID: 25850360 DOI: 10.1002/nau.22762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 02/16/2015] [Indexed: 11/10/2022]
Abstract
AIMS To investigate the effect of the bladder sensation grade on uroflowmetry parameters. METHODS Fifty healthy volunteering young men were enrolled in the present study. In total, three uroflowmetry evaluations were made. Qmax , Qave , VV, and PVR urine was obtained three times in three described bladder sensation grades, nearly at the same time of the day. RESULTS The mean age of the participants in the present study is 29.08 ± 3.8 years. The mean Qmax values of the volunteers were 17.4 ± 4.8 ml/s, 24.1 ± 6.0 ml/s, and 29.6 ± 6.5 ml/s in the first, second, and third, voiding desire grades, respectively. The mean Qave values were 9.9 ± 2.1 ml/s, 12.9 ± 2.9 ml/s, and 15.9 ± 4.0 ml/s for each of the voiding desire grades mentioned. A statistically significant difference was obvious for all three bladder sensation grades in terms of Qmax and Qave values (P = 0.000). However, no statistically significant difference was seen regarding the PVR urine volumes. The mean voided volume in the first, second and third uroflowmetry were 140 ± 42 ml, 245 ± 64 ml, and 449 ± 105 ml, respectively. The highest Qmax and Qave values were obtained when the desire to void was urgent. CONCLUSIONS The findings of the study show that, uroflowmetry evaluations are to be made if the patients have a strong desire to void. Only thus the highest Qmax values can be obtained; yet, the degree of perceived bladder sensation does not have a statistically significant impact on PVR quantity. Neurourol. Urodynam. 35:622-624, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Mehmet Kaynar
- Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey
| | - Mustafa Kucur
- Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey
| | - Ozcan Kiliç
- Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey
| | - Murat Akand
- Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey
| | - Murat Gul
- Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey
| | - Serdar Goktas
- Department of Urology, Selcuk University, Faculty of Medicine, Konya, Turkey
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Krhut J, Gärtner M, Zvarová K, Desarno M, Zvara P. Validating of a Novel Method for Electronically Recording Overactive Bladder Symptoms in Men. Low Urin Tract Symptoms 2015; 8:177-81. [PMID: 27619783 DOI: 10.1111/luts.12093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 12/10/2014] [Accepted: 01/07/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The goal of this study was to compare a novel wireless phone and web based technology to record and store overactive bladder symptoms (OAB-S) to a traditional pen and paper micturition chart. METHODS Overactive bladder symptoms were recorded over a period of 3 days using both an electronic micturition chart (EMC) and the standard pen and paper micturition chart (MC). Twenty-nine men, with lower urinary tract symptoms (LUTS), were included in the study. Dropout rate, patient's preference, and correlation between the quality of life measures (QoL) and symptoms recorded with EMC versus MC, were assessed and compared. RESULTS Of the total number of 29 patients enrolled into the study, 24 completed the full 3-day trial using MC and 27 using EMC. MC was preferred by 50%, while EMC was preferred by 50% of participants. Using MC, 21% of patients forgot to record at least one episode of urgency, versus 17% using EMC, 17% forgot to record at least one micturition using MC versus 8% using EMC. A statistically significant correlation was found between lower severity of OAB-S and higher QoL, using both recording methods. CONCLUSIONS In this study population, recording symptoms with EMC did not prove to be preferable compared to MC; however, EMC provided the same level of accuracy with the same or better adherence to the study protocol.
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Affiliation(s)
- Jan Krhut
- Department of Urology, University Hospital, Ostrava, Czech Republic
| | - Marcel Gärtner
- Department of Obstetrics and Gynecology, University Hospital, Ostrava, Czech Republic
| | - Katarína Zvarová
- Department of Physiology, Slovak Medical University, Bratislava, Slovak Republic
| | - Michael Desarno
- Biostatistics Unit, University of Vermont, Burlington, Vermont, USA
| | - Peter Zvara
- Department of Surgery, University of Vermont, Burlington, Vermont, USA. .,Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic.
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Huppertz ND, Tolba RH, Grosse JO. Micturition in Göttingen minipigs: first reference in vivo data for urological research and review of literature. Lab Anim 2015; 49:336-44. [PMID: 25660835 DOI: 10.1177/0023677215570993] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
One possible symptom of overactive bladder (OAB) is urinary incontinence, which is generally considered to be an age-associated disease and which is rapidly increasing with demographic changes. Rodent models are commonly used for the investigation of lower urinary tract functions, although the use of these species has limitations in several translational aspects. In biomedical research and preclinical toxicology, Göttingen minipigs are used increasingly. But in urological research, only few data are available for Göttingen minipigs. To the best of our knowledge, this study is one of the first to provide reference data of micturition in female Göttingen minipigs. Micturition frequency and volumes were monitored and analyzed in five female Göttingen minipigs. Voided volume was 520 ± 383 mL (mean ± standard deviation of mean [SD]) and micturition frequency 6.17 ± 3.68 (mean ± SD). We also performed a review of the literature to compare our data with data from different species (humans, pigs, rats and mice). Our findings revealed that micturition volume and frequency of Göttingen minipigs are more comparable with that of humans, leading to the conclusion that Göttingen minipigs may be the better choice for translational research in different research fields, such as urology, neurology and nephrology, etc. The provision of in vivo reference values meets with the 3R concept of 'reduction, refinement and replacement' of laboratory animals, because they allow comprehensive statistical power calculations (reduction), planning of telemetric approaches (refinement), and generation of computer-based modulation for the development of intravesical drug delivery systems (replacement).
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Affiliation(s)
- N D Huppertz
- Department of Urology, University Hospital RWTH Aachen, Aachen, Germany
| | - R H Tolba
- Institute for Laboratory Animal Science & Experimental Surgery, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - J O Grosse
- Department of Urology, University Hospital RWTH Aachen, Aachen, Germany
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Hikita KS, Honda M, Hirano S, Kawamoto B, Panagiota T, Muraoka K, Sejima T, Takenaka A. Comparison of the overactive bladder symptom score and the overactive bladder symptom score derived from the bladder diaries. Neurourol Urodyn 2015; 35:349-53. [PMID: 25597478 DOI: 10.1002/nau.22719] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/03/2014] [Indexed: 11/11/2022]
Abstract
AIMS The overactive bladder symptom score (OABSS) is a useful tool for assessing the four key symptoms of overactive bladder (OAB), but it sometimes misrepresents a patient's actual voiding status. To examine whether the patient-determined OABSS underestimates or overestimates the true status, its results were compared to those of the OABSS derived from a 7-day bladder diary (OABSS-BD). METHODS Records of patients who visited our outpatient clinic with lower urinary tract symptoms were evaluated retrospectively. The patients were asked to complete the OABSS and the 7-day bladder diary (BD). The OABSS-BD was created from the 7-day BD. Questions were compared between the OABSS and the OABSS-BD. RESULTS A total of 44 men and 31 women were evaluated. For daytime frequency, the mean OABSS score was 1.03 ± 0.57 and the OABSS-BD score was 0.69 ± 0.52 (P < 0.01). For nighttime frequency, the mean OABSS score was 2.27 ± 0.84, and the OABSS-BD score was 1.96 ± 1.00 (P = 0.04). For urinary urgency, the mean OABSS score was 2.49 ± 1.83, and the OABSS-BD score was 2.70 ± 1.90 (P = 0.27). For urgency incontinence, the mean OABSS score was 1.67 ± 1.92, and the OABSS-BD score was 1.52 ± 1.87 (P = 0.28). For the total score, the mean OABSS total score was 7.26 ± 3.92, and the OABSS-BD score was 6.98 ± 3.26 (P = 0.23). CONCLUSIONS The OABSS is a very simple and useful tool. However, compared to the results from the 7-day FVC, the present patients overestimated daytime and nighttime frequency.
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Affiliation(s)
- Kat Suya Hikita
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masashi Honda
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shinji Hirano
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Bunya Kawamoto
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tsounapi Panagiota
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kuniyasu Muraoka
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Takehiro Sejima
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan
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Wyndaele JJ, Vodušek DB. Approach to the male patient with lower urinary tract dysfunction. NEUROLOGY OF SEXUAL AND BLADDER DISORDERS 2015; 130:143-64. [DOI: 10.1016/b978-0-444-63247-0.00009-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Developing and Validating the International Consultation on Incontinence Questionnaire Bladder Diary. Eur Urol 2014; 66:294-300. [DOI: 10.1016/j.eururo.2014.02.057] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 02/26/2014] [Indexed: 01/15/2023]
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Blaivas JG, Tsui JF, Amirian M, Ranasinghe B, Weiss JP, Haukka J, Tikkinen KAO. Relationship between voided volume and the urge to void among patients with lower urinary tract symptoms. Scand J Urol 2014; 48:554-8. [DOI: 10.3109/21681805.2014.932842] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jerry G. Blaivas
- Department of Urology, SUNY Downstate Medical Center,
Brooklyn, New York, USA
- Department of Urology, Weill Cornell College of Medicine,
New York, New York, USA
- Institute for Bladder and Prostate Research,
New York, USA
| | - Johnson F. Tsui
- Department of Urology, SUNY Downstate Medical Center,
Brooklyn, New York, USA
- Institute for Bladder and Prostate Research,
New York, USA
- Department of Urology, North Shore-LIJ Lenox Hill Hospital,
New York, New York, USA
| | - Michael Amirian
- Department of Urology, SUNY Downstate Medical Center,
Brooklyn, New York, USA
- Institute for Bladder and Prostate Research,
New York, USA
| | - Buddima Ranasinghe
- Department of Urology, SUNY Downstate Medical Center,
Brooklyn, New York, USA
- Institute for Bladder and Prostate Research,
New York, USA
| | - Jeffrey P. Weiss
- Department of Urology, SUNY Downstate Medical Center,
Brooklyn, New York, USA
- Institute for Bladder and Prostate Research,
New York, USA
| | - Jari Haukka
- Hjelt Institute, Department of Public Health, University of Helsinki,
Helsinki, Finland
| | - Kari A. O. Tikkinen
- Hjelt Institute, Department of Public Health, University of Helsinki,
Helsinki, Finland
- Department of Urology, Helsinki University Central Hospital and University of Helsinki,
Helsinki, Finland
- Department of Clinical Epidemiology and Biostatistics, McMaster University,
Hamilton, Ontario, Canada
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Joussain C, Parratte B, Gremeaux V, Dompeyre P. [Clinical and paraclinical evaluations of bladder sensitivity. Review of the literature]. Prog Urol 2014; 24:495-500. [PMID: 24875568 DOI: 10.1016/j.purol.2014.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/28/2014] [Accepted: 02/12/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this work was to carry out a review of the literature on the clinical and paraclinical evaluation of bladder sensory (BS) to better understand BS disorders in nonneurological patients. METHODS Thirty-three articles were selected from the Medline(®) Database between 1992 and 2012 using the following key words: "sensory/sensitivity bladder evaluation", "sensory/sensitivity bladder scale", "sensory/sensitivity bladder questionnaire", "urodynamic bladder sensory", "urgency questionnaire" and "Overactive Bladder (OAB) questionnaire". RESULTS Evaluation of BS by asking questions during cystometry is validated (LE 2). The sensation of the desire to void progresses linearly with bladder filling (LE 2). Many symptoms and quality of life questionnaires related to BS anomalies have been proposed. Bladder diaries, frequency/volume curves (LE 2) and clinical algorithms (LE 3) could be an alternative to evaluate BS. CONCLUSION Current evaluation only provides a partial view of BS. A multidimensional approach should lead to better understanding of BS disorders.
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Affiliation(s)
- C Joussain
- Service de médecine physique et de réadaptation, centre hospitalier universitaire de Dijon, 21000 Dijon, France.
| | - B Parratte
- Service de médecine physique et de réadaptation, centre hospitalier universitaire, 25030 Besançon, France
| | - V Gremeaux
- Service de médecine physique et de réadaptation, centre hospitalier universitaire de Dijon, 21000 Dijon, France
| | - P Dompeyre
- Service de gynécologie-obstétrique, centre hospitalier Poissy-St-Germain-en-Laye, 78303 Poissy, France; Laboratoire privé d'explorations urodynamiques, 78300 Poissy, France
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Zeren MF, Yüksel MB, Temeltas G. The comparison of urodynamic findings ?n women with various types of urinary ?ncontinence. Int Braz J Urol 2014; 40:232-9. [DOI: 10.1590/s1677-5538.ibju.2014.02.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/25/2013] [Indexed: 11/22/2022] Open
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De Wachter SGG, Heeringa R, Van Koeveringe GA, Winkens B, Van Kerrebroeck PEV, Gillespie JI. “Focused introspection” during naturally increased diuresis: Description and repeatability of a method to study bladder sensation non-invasively. Neurourol Urodyn 2013; 33:502-6. [DOI: 10.1002/nau.22440] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 04/29/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Stefan G G De Wachter
- Department of Urology; Maastricht University Medical Centre; Maastricht The Netherlands
- Department of Urology; University Antwerpen; Universiteitsplein 1 Wilrijk Belgium
| | - Rhea Heeringa
- Department of Urology; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Gommert A Van Koeveringe
- Department of Urology; Maastricht University Medical Centre; Maastricht The Netherlands
- European Graduate School of Neuroscience (EURON); Maastricht University; Maastricht The Netherlands
| | - Bjorn Winkens
- Department of Statistics and Methodology; Maastricht University; Maastricht The Netherlands
| | - Philip E V Van Kerrebroeck
- Department of Urology; Maastricht University Medical Centre; Maastricht The Netherlands
- European Graduate School of Neuroscience (EURON); Maastricht University; Maastricht The Netherlands
| | - James I Gillespie
- Uro-Physiology Research Group; Medical and Dental School, University of Newcastle Upon Tyne; Tyne England
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Park KK, Lee SH, Chung BH, Kim SJ, Kwak C, Son HC, Kim SW, Lee JY. Efficacy and safety of low-dose anticholinergics to treat men with lower urinary tract symptoms with overactive bladder: a retrospective study based on real life practice. Prostate Int 2013; 1:37-41. [PMID: 24223400 PMCID: PMC3821520 DOI: 10.12954/pi.12005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Accepted: 02/02/2013] [Indexed: 01/16/2023] Open
Abstract
Purpose: To investigate whether combination treatment using an α-blocker and 2 mg of tolterodine could improve the International Prostate Symptom Score (IPSS) as much as α-blocker and 4 mg of tolterodine without voiding difficulties in real life practice. Methods: We restrospectively recruited patients who were treated at four urology clinics between January 2006 and May 2008. A total of 1,094 men with lower urinary tract symptoms/overactive bladder (LUTS/OAB) were assigned to one of three groups: an α-blocker only group (group I, n=152), an α-blocker plus tolterodine 2 mg group (group II, n=520), and an α-blocker plus tolterodine 4 mg group (group III, n=574). Eligible patients were 50 years or older men who had a total IPSS of 8 or higher and a IPSS storage subscore of 5 or higher and were followed up for 12 weeks. Results: The total IPSS score and quality of life scores were significantly improved at week 12 in groups II and III. The incidence of acute urinary retention was similar between both combination treatment groups, but the incidence of voiding difficulty was much lower in group II (2.1%) than group III (10.8%) tolterodine. Conclusions: Our results suggest that treatment of LUTS/OAB patients with an α-blocker plus tolterodine 2 mg is as effective as α-blocker plus tolterodine 4 mg, and the incidence of voiding difficulty was in the low-dose anticholinergic is lower. These results indicate that dose strength should be decided on a case-by-case basis to balance the efficacy and safety.
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Affiliation(s)
- Kyung Kgi Park
- Department of Urology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea
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Birder L, Wyndaele JJ. From urothelial signalling to experiencing a sensation related to the urinary bladder. Acta Physiol (Oxf) 2013; 207:34-9. [PMID: 23110490 DOI: 10.1111/apha.12011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 12/22/2011] [Accepted: 09/10/2012] [Indexed: 02/02/2023]
Abstract
The mechanisms underlying bladder sensation and the way we experience sensations during normal voiding and in pathology is complex and not well understood. During storage and emptying, mechanical changes occurring in number of cell types within the bladder wall (i.e. the uroepithelium and bladder afferents) can have a major influence on our sensory systems. In this review, we discuss bladder sensation with a focus on coding events in the periphery.
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Affiliation(s)
- L. Birder
- Departments of Medicine and Pharmacology; University of Pittsburgh School of Medicine; Pittsburgh; PA; USA
| | - J.-J. Wyndaele
- Antwerp University and Antwerp University Hospital; Antwerp; Belgium
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Jäger W, Mirenska O, Brügge S. Surgical treatment of mixed and urge urinary incontinence in women. Gynecol Obstet Invest 2012; 74:157-64. [PMID: 22890409 DOI: 10.1159/000339972] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 06/10/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The etiology of urge urinary incontinence is unknown. Pharmacological treatments are disappointing, since they are only slightly more effective than a placebo. In this study, we analyzed whether the surgical replacement of the uterosacral ligaments by an alloplastic tape can cure patients with mixed and urge urinary incontinence. METHODS This study was a nonrandomized clinical trial. The study was performed in the Department of Gynecology of a general hospital and a university clinic. 135 women with urge or mixed urinary incontinence were operated on. The utero-sacral ligaments as well as the pubo-urethral ligaments - if necessary - were replaced by alloplastic tapes. Clinical outcome was evaluated immediately after surgery, 3 months later and 1 year later. Outcome was classified as cure, improvement or failure and recurrences. RESULTS 102 patients (77%) were cured and a further 24 patients (18%) showed improvement after surgery. 19 patients developed a recurrence between 5 and 33 months after surgery. CONCLUSION We therefore conclude that most patients with urge and mixed urinary incontinence can be cured by surgery.
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Affiliation(s)
- Wolfram Jäger
- Urogynaecology Unit, Department of Obstetrics and Gynecology, University of Cologne, Cologne, Germany.
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Harvey J, Finney S, Stewart L, Gillespie J. The relationship between cognition and sensation in determining when and where to void: the concept of cognitive voiding. BJU Int 2012; 110:1756-61. [DOI: 10.1111/j.1464-410x.2012.11078.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Weinberg AC, Brandeis GH, Bruyere J, Tsui JF, Weiss JP, Rutman MP, Blaivas JG. Reliability and validity of the overactive bladder symptom score in spanish (OABSS-S). Neurourol Urodyn 2012; 31:664-8. [DOI: 10.1002/nau.21235] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 10/03/2011] [Indexed: 11/07/2022]
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De Wachter S, Smith P, Tannenbaum C, Van Koeveringe G, Drake M, Wyndaele J, Chapple C. How should bladder sensation be measured?: ICI-RS 2011. Neurourol Urodyn 2012; 31:370-4. [DOI: 10.1002/nau.22214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 01/12/2012] [Indexed: 01/25/2023]
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Das RN, Grimmer-Somers KA. Fluid intake and voiding; habits and health knowledge in a young, healthy population. Res Rep Urol 2012; 4:9-15. [PMID: 24199175 PMCID: PMC3806437 DOI: 10.2147/rru.s27801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives Health professionals commonly advise patients with incontinence and other lower urinary tract symptoms about modifiable contributing factors such as drinking and voiding habits. Poor drinking and voiding habits may begin early in life, before symptoms emerge. However, little is known about the habits and knowledge young people have regarding healthy drinking and voiding behaviors. This research aimed to assess the habits and health knowledge of young people regarding fluid intake and voiding. Methods A questionnaire was used to assess the drinking and voiding behaviors of first year university students and their knowledge about healthy fluid intake and voiding. Results The average daily fluid intake was >2 L/day for both genders. Poor drinking and voiding habits (such as high consumption of caffeinated drinks and alcohol, or nocturia) were common. Widely reported myths about the benefits of a high fluid intake were commonly believed. Conclusion More informed public education regarding healthy fluid intake, and drinking and voiding habits, is required as part of the effort to reduce the development of lower urinary tract symptoms, including incontinence.
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Affiliation(s)
- Rebekah N Das
- School of Health Sciences, University of South Australia, City East Campus, North Terrace, Adelaide, SA 5000, Australia
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Heeringa R, van Koeveringe GA, Winkens B, van Kerrebroeck PEV, de Wachter SGG. Degree of urge, perception of bladder fullness and bladder volume--how are they related? J Urol 2011; 186:1352-7. [PMID: 21855937 DOI: 10.1016/j.juro.2011.05.050] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Indexed: 10/17/2022]
Abstract
PURPOSE We evaluated the reliability of the degree of urge and perception of bladder fullness scales, the relationship between the scales and bladder volume, and possible differences between bladder sensations experienced in a controlled or an uncontrolled setting. MATERIALS AND METHODS Volunteers and patients with overactive bladder symptoms participated in the protocols. They were asked to grade bladder sensation on a 4-point urge scale of no sensation to need to void now and assess the perception of fullness on a visual analog scale of empty to full bladder. This was assessed in a 3-day bladder diary and during controlled, noninvasive bladder filling. RESULTS Each scale was reliable and significantly related to bladder volume (p <0.001). Agreement between the scales and voided volume was poor. Patients and volunteers grade bladder fullness and degree of urge higher in an uncontrolled than in a controlled setting. CONCLUSIONS The perception of bladder fullness and the degree of urge have a significant relation to bladder volume in controlled and uncontrolled settings. Due to poor agreement between the scales and actual voided volume these scales cannot replace measuring voided volume. The perception of bladder sensation depends on the setting. Bladder sensation at the hospital might underestimate the bother of symptoms experienced by a patient in daily life.
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Affiliation(s)
- Rhea Heeringa
- Department of Urology, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
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Normal lower urinary tract assessment in women: I. Uroflowmetry and post-void residual, pad tests, and bladder diaries. Int Urogynecol J 2011; 23:681-5. [DOI: 10.1007/s00192-011-1568-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 08/30/2011] [Indexed: 10/17/2022]
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De Wachter SG, Heeringa R, van Koeveringe GA, Gillespie JI. On the nature of bladder sensation: the concept of sensory modulation. Neurourol Urodyn 2011; 30:1220-6. [PMID: 21661031 DOI: 10.1002/nau.21038] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2010] [Accepted: 10/22/2010] [Indexed: 01/23/2023]
Abstract
AIMS Going to the toilet is an essential everyday event. Normally, we do not give much thought to the sensations and factors that trigger voiding behavior: we just go. For many people, this apparently simple task is complicated and dominates their life. They have strong sensations and sudden desires to void, often resulting in incontinence. It is therefore important that we understand the origins for this functional change and identify means to alleviate it. METHODS Literature survey. RESULTS A considerable body of work has focused on this problem and ideas and concepts on the nature of bladder sensations are embedded in the literature. In this paper we argue the necessity to return to first principles and a re-examination of the problem. We explore the use of focus groups to identify relevant bladder sensation and what triggers 'bladder' behavior. We argue that there are differences in what can be described as 'introspective bladder sensations' and the sensations reported immediately before a void, 'void sensations'. Finally, we propose an alternative model describing how peripheral information generating 'introspective sensations' and 'void sensations' might be different but interrelated sensations. By exploring such ideas and identifying such complexity it is our intention to stimulate debate and generate further research in the field in order to understand better the physiology of bladder sensation and the pathology of increased urge, frequency and incontinence. CONCLUSIONS Review of the literature on bladder sensation and the established ideas suggests that we might be missing something and the problem of normal and increased sensation and of urgency may be much more complex.
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Affiliation(s)
- S G De Wachter
- Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands.
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Heeringa R, de Wachter SGG, van Kerrebroeck PEV, van Koeveringe GA. Normal bladder sensations in healthy volunteers: A focus group investigation. Neurourol Urodyn 2011; 30:1350-5. [PMID: 21608021 DOI: 10.1002/nau.21052] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 11/17/2010] [Indexed: 11/08/2022]
Affiliation(s)
- Rhea Heeringa
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Van Meel TD, Wyndaele JJ. Reproducibility of urodynamic filling sensation at weekly interval in healthy volunteers and in women with detrusor overactivity. Neurourol Urodyn 2011; 30:1586-90. [DOI: 10.1002/nau.21100] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 02/09/2011] [Indexed: 11/06/2022]
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Bright E, Drake MJ, Abrams P. Urinary diaries: Evidence for the development and validation of diary content, format, and duration. Neurourol Urodyn 2011; 30:348-52. [DOI: 10.1002/nau.20994] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 07/13/2010] [Indexed: 11/12/2022]
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Urinary Nerve Growth Factor Levels in Overactive Bladder Syndrome and Lower Urinary Tract Disorders. J Formos Med Assoc 2010; 109:862-78. [DOI: 10.1016/s0929-6646(10)60133-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 04/08/2010] [Accepted: 04/13/2010] [Indexed: 11/18/2022] Open
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Fayyad AM, Hill SR, Jones G. Urine production and bladder diary measurements in women with type 2 diabetes mellitus and their relation to lower urinary tract symptoms and voiding dysfunction. Neurourol Urodyn 2010; 29:354-8. [PMID: 19760759 DOI: 10.1002/nau.20778] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS To establish bladder diary measurements in women with type 2 diabetes mellitus (DM) and their relation to bothersome LUTS and voiding dysfunction. METHODS One hundred ten women with type 2 DM were assessed using the King's Health and ICIQ-FLUTS questionnaires. Patients were divided into bothersome and non-bothersome LUTS according to bother scale of the ICIQ-FLUTS. Voiding was assessed with free flow rate and residuals. Three day bladder diary measurements were obtained and 24 hr, daytime and nighttime urine production, daytime frequency, nighttime frequency, maximum bladder capacity, mean voided volume, mean daytime and nighttime voided volumes, and incontinence episodes were recorded. Differences in bladder diary measurements between bothersome and non-bothersome groups and between normal and abnormal voiding groups were established with multivariate analysis. Correlations between urine production and voided volumes and between diary measurements and domains of the ICIQ-FLUTS were established. RESULTS There were no differences in urine production, between bothersome and non-bothersome LUTS groups. Women with bothersome LUTS had greater nighttime frequency (2.6 vs. 1.4) and number of incontinence episodes (3.3 vs. 0.4). Abnormal voiding group had higher nocturnal urine production (1,007 ml vs. 654 ml). There were significant correlations between nighttime frequency, number of incontinence episodes, and the storage and incontinence domains of the ICIQ-FLUTS. Bladder capacity significantly increased with increased total urine volumes. CONCLUSIONS Bothersome LUTS in DM is not associated with increased urine production. Bladder capacity increased with total urine volume. Nocturia and incontinence episodes were significantly associated with bothersome LUTS.
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Honjo H, Kawauchi A, Nakao M, Ukimura O, Kitakoji H, Miki T. Impact of convenience void in a bladder diary with urinary perception grade to assess overactive bladder symptoms: A community-based study. Neurourol Urodyn 2010; 29:1286-9. [DOI: 10.1002/nau.20874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Chakravarthy V, Tolbert M, Garcia C, Miller J. Overactive bladder and caffeine: comparing women with and without mental health diagnoses. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2010. [DOI: 10.1111/j.1749-771x.2010.01079.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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