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Monaghan TF, Fang A, Ksido LR, Hachicho C, Muneeb M, Rahman SN, Bou Kheir G, Lazar JM, Everaert K, Wein AJ, Weiss JP. Prevalence of Sleep CALM nocturia factors in a male veteran population. Neurourol Urodyn 2024; 43:1127-1133. [PMID: 38511613 DOI: 10.1002/nau.25410] [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: 10/06/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Nocturia is a complex and multifactorial condition, associated with several genitourinary abnormalities as well as a host of conditions beyond the urinary tract, and thus often poses a significant diagnostic challenge in real-world practice. Sleep Disorders, Comorbidities, Actions, Lower Urinary Tract Dysfunction, and Medications, the so-called "Sleep C.A.L.M." factors, are five common causes of nocturia requiring judicious evaluation according to current consensus guidelines. This study aims to assess the prevalence of the Sleep C.A.L.M. factors in a nocturia clinical population. METHODS Retrospective analysis of frequency-volume charts from men with ≥2 nocturnal voids as well as concurrent demographic, clinical, and medical history data to identify patients with each of the Sleep C.A.L.M. FACTORS Comorbidities and medications were classified as a single group. RESULTS A total of 213 subjects met the criteria for inclusion (median age 68.0 [63.5-75.5] years). The prevalence of 1) sleep disorders, 2) comorbidities and/or medication use, 3) actions (i.e., modifiable behaviors/lifestyle factors), and 4) lower urinary tract dysfunction was 31%, 31%, 19%, and 41%, respectively. Among included participants, 73% were found to have at least 1 Sleep C.A.L.M. factor, and 33% had multiple Sleep C.A.L.M. FACTORS Results were similar upon stratification by age and nocturnal polyuria status. CONCLUSIONS The Sleep C.A.L.M. factors are highly common among nocturia patients in the clinical urology setting. Although many of these factors are strongly associated with advanced age in community-based nocturia study samples, they appear common even among younger men in a nocturia patient population; the differential effect of age and individual Sleep C.A.L.M. factors on nocturia pathophysiology requires further investigation.
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Affiliation(s)
- Thomas F Monaghan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Alexander Fang
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Lennox R Ksido
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Carla Hachicho
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Manahil Muneeb
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Syed N Rahman
- Department of Urology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - George Bou Kheir
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Jason M Lazar
- Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Alan J Wein
- Desai Sethi Urology Institute, Department of Urology, University of Miami Health System, Miami, Florida, USA
| | - Jeffrey P Weiss
- Department of Urology, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
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Gravas S, Gacci M, Gratzke C, Herrmann TRW, Karavitakis M, Kyriazis I, Malde S, Mamoulakis C, Rieken M, Sakalis VI, Schouten N, Speakman MJ, Tikkinen KAO, Cornu JN. Summary Paper on the 2023 European Association of Urology Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms. Eur Urol 2023; 84:207-222. [PMID: 37202311 DOI: 10.1016/j.eururo.2023.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/06/2023] [Indexed: 05/20/2023]
Abstract
CONTEXT Lower urinary tract symptoms (LUTS) are common, often bothersome, and have multifactorial aetiology. OBJECTIVE To present a summary of the 2023 version of the European Association of Urology guidelines on the management of male LUTS. EVIDENCE ACQUISITION A structured literature search from 1966 to 2021 selected the articles with the highest certainty evidence. The Delphi technique consensus approach was used to develop the recommendations. EVIDENCE SYNTHESIS The assessment of men with LUTS should be practical. A careful medical history and physical examination are essential. Validated symptom scores, urine test, uroflowmetry, and postvoid urine residual, as well as frequency-volume charts for patients with nocturia or predominately storage symptoms should be used. Prostate-specific antigen should be ordered if a diagnosis of prostate cancer changes the treatment plan. Urodynamics should be performed for selected patients. Men with mild symptoms are candidates for watchful waiting. Behavioural modification should be offered to men with LUTS prior to, or concurrent with, treatment. The choice of medical treatment depends on the assessment findings, predominant type of symptoms, ability of the treatment to change the findings, and the expectations to be met in terms of the speed of onset, efficacy, side effects, and disease progression. Surgery is reserved for men with absolute indications, and for patients who fail or prefer not to receive medical therapy. Surgical management has been divided into five sections: resection, enucleation, vaporisation, and alternative ablative and nonablative techniques. The choice of surgical technique depends on patient's characteristics, expectations, and preferences; surgeon's expertise; and availability of modalities. CONCLUSIONS The guidelines provide an evidence-based approach for the management of male LUTS. PATIENT SUMMARY A clinical assessment should identify the cause(s) of symptoms and define the clinical profile and patient's expectations. The treatment should aim to ameliorate symptoms and reduce the risk of complications.
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Affiliation(s)
- Stavros Gravas
- Department of Urology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Mauro Gacci
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Christian Gratzke
- Department of Urology, University Hospital Freiburg, Freiburg, Germany
| | | | - Markos Karavitakis
- Department of Urology, University General Hospital of Heraklion, University of Crete Medical School, Heraklion, Crete, Greece
| | - Iason Kyriazis
- Department of Urology, General University Hospital of Patras, Patras, Greece
| | - Sachin Malde
- Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete Medical School, Heraklion, Crete, Greece
| | | | - Vasileios I Sakalis
- Department of Urology, Hippokrateion General Hospital, Thessaloniki, Greece.
| | - Natasha Schouten
- European Association of Urology Guidelines Office, Arnhem, The Netherlands
| | - Mark J Speakman
- Department of Urology, Taunton & Somerset Hospital, Taunton, UK
| | - Kari A O Tikkinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Department of Surgery, South Karelia Central Hospital, Lappeenranta, Finland
| | - Jean-Nicolas Cornu
- Department of Urology, CHU Hôpitaux de Rouen - Hôpital Charles Nicolle, Rouen, France
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Mehta S, Geng B, Xu X, Harmanli O. Current state of bladder diary: a survey and review of the literature. Int Urogynecol J 2023; 34:809-823. [PMID: 36322174 DOI: 10.1007/s00192-022-05398-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The objectives of this study are (1) to assess practice patterns among urogynecology/female pelvic medicine and reconstructive surgery (FPMRS) providers regarding the use of bladder diaries (BD) and (2) to review the literature regarding BD. METHODS For the first objective, a survey was emailed to United States-based urogynecology providers in 2019 querying frequency of use of bladder diaries (FBD), indications, problems, patient education methods, and perception of utility. Chi-square tests and multiple logistic regression were performed. For the second objective, we reviewed literature published in English by searching the terms "voiding," "bladder," or "incontinence," in combination with "diary," "log," or "questionnaire." RESULTS A total of 371 of 851 (43.5%) contacted providers responded. Nearly 80% were attending physicians, 75.5% of whom completed the FPMRS fellowship; 20.8% of all respondents and nearly 25% of fellowship-trained attendings reported FBD <20% in the last year. FPMRS providers were more likely to report FBD >80%. A total of 97.5% of respondents cited difficulty in using BD. Most (71.6%) taught patients to use BD themselves or shared responsibility with a nonphysician staff member (53.4%). BD is a validated and valuable instrument; however, there are obstacles to its use. Despite recent innovations including electronic and automated BD, there is a paucity of data regarding the provider-viewed challenges in implementing BD. CONCLUSIONS The literature supports the use of BD; however, many survey respondents, including fellowship-trained attendings, never or rarely use BD. Most respondents reported difficulty in using BD. More research is needed to improve the ease, accuracy, and widespread adaptation of BD use in clinical practice.
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Affiliation(s)
- Shailja Mehta
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, FMB 329, New Haven, CT, 06510, USA
| | - Bertie Geng
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, FMB 329, New Haven, CT, 06510, USA
| | - Xiao Xu
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, FMB 329, New Haven, CT, 06510, USA
| | - Oz Harmanli
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, FMB 329, New Haven, CT, 06510, USA.
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de Wall LL, Kragt EAM, Van De Wetering EHM, Cobussen-Boekhorst JGL, Mantel-van Stel J, Kortmann BBM, Feitz WF, Bootsma-Robroeks CMHHT. Challenges in e-Health: The effect of digitalisation of frequency voiding charts on compliance in paediatric patients. Randomised controlled trial comparing digital and versus paper frequency voiding charts. Digit Health 2023; 9:20552076231207577. [PMID: 37954691 PMCID: PMC10634267 DOI: 10.1177/20552076231207577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/28/2023] [Indexed: 11/14/2023] Open
Abstract
Objective Frequency voiding charts are commonly used to gain better insight into the voiding and drinking behaviours of patients with voiding symptoms. Non-compliance when filling out a chart is known to be high. The use of a digital application might increase adherence, but little research has been conducted on this topic. The aim of this study is to compare the quality (number of correctly filled out charts) and quantity (number of complete charts) of digital versus paper frequency voiding charts among children and their parents. Methods A multi-centre parallel randomised controlled trial was conducted. Participants were assigned either a 48-h digital frequency voiding chart or a 48-h paper frequency voiding chart. Completion rates were scored based on a predefined scoring method and transcribed into a percentage. Secondary objectives included user friendliness, feasibility, degree of the child's participation, and attractiveness. Trail registry data: NTR NL9383. Results Ninety-seven patients were randomised to either a digital (N = 53) or paper (N = 44) frequency voiding chart. No significant difference in complete and accurately filled out frequency voiding charts was seen between the groups, with 35% (N = 18) for digital and 50% (N = 22) for paper, p = 0.12. Subjects considered the digital application more appealing, more educative, and more inviting compared to the paper chart (p < 0.05). Conclusions In this underpowered study, no significant difference appeared between the groups in the number of complete and accurately filled out frequency voiding charts. Implementation of e-health did not seem to improve compliance. In daily practice, personal preference might offer the best solution.
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Affiliation(s)
- Liesbeth L de Wall
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Elisabeth AM Kragt
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Eline HM Van De Wetering
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Johanna GL Cobussen-Boekhorst
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Joyce Mantel-van Stel
- Department of Paediatric Urology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Barbara BM Kortmann
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Wout F Feitz
- Division of Paediatric Urology, Department of Urology, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Charlotte MHHT Bootsma-Robroeks
- Department of Paediatrics, Paediatric Nephrology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Efficacy of transcutaneous tibial nerve stimulation in the treatment of bladder pain syndrome. Curr Urol 2022; 16:83-87. [PMID: 36570363 PMCID: PMC9782322 DOI: 10.1097/cu9.0000000000000082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/20/2021] [Indexed: 12/27/2022] Open
Abstract
Background This study aimed to demonstrate the effectiveness of transcutaneos tibial nerve stimulation (TTNS) in the treatment of bladder pain syndrome (BPS). Materials and methods The data of 16 female patients, diagnosed with BPS in our clinic between 2019 and 2021 and had TTNS twice a week for 12 weeks, were retrospectively analyzed. Results The mean age of the patients was 46.00 ± 13.11 years, and the mean body mass index was 26.43 ± 3.07 kg/m2. After the treatment, the median day time frequency of the patients decreased from 13.37 (3.69) to 10.25 (4.56) (p < 0.001). Nocturia also decreased after treatment from 4.37 (1.81) to 3.00 (1.94) (p = 0.001). The median voiding volume increased by 26.5 mL (p = 0.001). The median of the patients' visual analog scale scores decreased after treatment (median of visual analog scale score changed from interquartile range 8 [1] to 7 [4]) (p = 0.001). In addition, the median interquartile range interstitial cystitis symptom index scores decreased from 17 (4) to 15 (10) (p = 0.002). Conclusions In this study it was demonstrated that TTNS is an alternative method that can be successfully applied before invasive methods in the treatment of BPS.
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Gomes CM, Moromizato JKM, Ribeiro LS. Mobile health may improve evaluation of lower urinary tract symptoms. Int Braz J Urol 2021. [PMID: 34469671 PMCID: PMC8486450 DOI: 10.1590/s1677-5538.ibju.2021.0211.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Evaluation of a new frequency-volume chart for children with primary monosymptomatic nocturnal enuresis: a prospective, comparative study. World J Pediatr 2021; 17:643-652. [PMID: 34716893 DOI: 10.1007/s12519-021-00474-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/06/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION To improve compliance with voiding diaries in children with primary monosymptomatic nocturnal enuresis (PMNE), a new modified 3-day weekend frequency-volume chart (FVC) was designed, and the compliance and validity of this modified FVC was evaluated by comparing with the International Children's Continence Society (ICCS) recommended voiding diary. METHODS A total of 1200 patients with PMNE were enrolled in the study from 13 centers in China and were randomly assigned to record this modified FVC or the ICCS-recommended voiding diary. The primary outcome measure was the compliance, assessed by comparing the completing index and the quality score of diaries between two groups. The secondary outcome measure was the validity, evaluated by comparing the constituent of subtypes, micturition parameters and response rate to desmopressin. RESULTS Among the 1200 participants enrolled in the study, 447 patients completed the ICCS-recommended voiding diary and 469 completed the modified diary. The diurnal completing index and the quality score of the modified FVC group were better than those of the ICCS group. In addition, there was no significant difference between these two groups in the subtype classification, or in the response rate to desmopressin. CONCLUSIONS The modified FVC could be applied to obtain the voiding characteristics of children with PMNE as the ICCS-recommended voiding diary does and offers a reasonable and better choice for children with PMNE from the unselected population in the future.
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Sussman RD, Escobar C, Jericevic D, Oh C, Arslan A, Palmerola R, Pape DM, Smilen SW, Nitti VW, Rosenblum N, Brucker BM. Estimation of Urinary Frequency: Does Question Phrasing Matter? Urology 2021; 156:90-95. [PMID: 33901531 DOI: 10.1016/j.urology.2021.04.013] [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: 12/21/2020] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate if question phrasing and patient numeracy impact estimation of urinary frequency. MATERIALS AND METHODS We conducted a prospective study looking at reliability of a patient interview in assessing urinary frequency. Prior to completing a voiding diary, patients estimated daytime, and nighttime frequency in 3 ways: (1) how many times they urinated (2) how many hours they waited in between urinations (3) how many times they urinated over the course of 4 hours. Numeracy was assessed using the Lipkus Numeracy Scale. RESULTS Seventy-one patients completed the study. Correlation of estimates from questions 1, 2, and 3 to the diary were not statistically different. Prediction of nighttime frequency was better than daytime for all questions (correlation coefficients 0.751, 0.754, and 0.670 vs 0.596, 0.575, and 0.460). When compared to the diary, Question 1 underestimated (8.5 vs 9.7, P = .014) while Question 2 overestimated (11.8 vs 9.7, P = .027) recorded voids on a diary. All questions overpredicted nighttime frequency with 2.6, 2.9, and 3.9 predicted versus 1.6 recorded voids (P < .001). Although not statistically significant, for each question, the predicted frequency of numerate patients was more correlated to the diary than those of innumerate patients. CONCLUSION When compared to a voiding diary for daytime urinary frequency, asking patients how many times they urinated underestimated, and asking patients how many hours they waited between urinations overestimated the number recorded voids. Regardless of phrasing, patients overestimated nighttime urination. Patients in our functional urology population have limited numeracy, which may impact accuracy of urinary frequency estimation.
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Affiliation(s)
- Rachael D Sussman
- Department of Urology, New York University Medical Center, New York, NY.
| | - Christina Escobar
- Department of Urology, New York University Medical Center, New York, NY
| | - Dora Jericevic
- Department of Urology, New York University Medical Center, New York, NY
| | - Cheonguen Oh
- Departments of Population Health and Environmental Medicine, New York University Medical Center, New York, NY
| | - Alan Arslan
- Departments of Population Health, Environmental Medicine & Obstetrics and Gynecology New York University Medical Center, New York, NY
| | - Ricardo Palmerola
- Department of Urology, New York University Medical Center, New York, NY
| | - Dominique M Pape
- Department of Urology, New York University Medical Center, New York, NY
| | - Scott W Smilen
- Department of Obstetrics and Gynecology, Hackensack Meridian Health Jersey Shore University Medical Center, Neptune City, NJ
| | - Victor W Nitti
- Department of Urology, UCLA Medical Center, Santa Monica, CA
| | - Nirit Rosenblum
- Department of Urology, New York University Medical Center, New York, NY
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Gomes CM, Moromizato JKM, Ribeiro LS. Mobile health may improve evaluation of lower urinary tract symptoms. Int Braz J Urol 2021; 47:1195-1197. [PMID: 34469665 PMCID: PMC8486462 DOI: 10.1590/s1677-5538.ibju.2021.06.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Cristiano M Gomes
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Julyana K M Moromizato
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Lucia S Ribeiro
- Divisão de Urologia do Departamento de Cirurgia da Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
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Jaekel AK, Kirschner-Hermanns R, Knüpfer SC. [Diagnostic testing of female urinary incontinence: dos and dont's]. Aktuelle Urol 2021; 52:237-244. [PMID: 34020505 DOI: 10.1055/a-1492-5287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Urinary incontinence causes significant limitations in quality of life and reduces mental and physical health. It is a widespread and chronic disease. About 200 million people are affected by urinary incontinence worldwide. Females are more often affected than males. For the therapy of female urinary incontinence various conservative and surgical treatment measures are available. A comprehensive diagnostic work-up is crucial for effective and successful use of those therapeutical measures. The current paper gives a review of diagnostic options for female urinary incontinence: from non-invasive up to invasive investigations. It presents potential pitfalls and possibilities for improving the diagnostic work-up.
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Affiliation(s)
- Anke K. Jaekel
- Universitätsklinikum Bonn, Klinik und Poliklinik für Urologie und Kinderurologie, Abteilung Neuro-Urologie, Bonn
| | - Ruth Kirschner-Hermanns
- Universitätsklinikum Bonn, Klinik und Poliklinik für Urologie und Kinderurologie, Abteilung Neuro-Urologie, Bonn
| | - Stephanie C. Knüpfer
- Universitätsklinikum Bonn, Klinik und Poliklinik für Urologie und Kinderurologie, Abteilung Neuro-Urologie, Bonn
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Takai S, Matsukawa Y, Hashizume N, Gotoh M. A small pilot study to evaluate the accuracy and feasibility of a novel automated voiding diary device for recording urine output measurements. Neurourol Urodyn 2020; 40:272-277. [PMID: 33137844 DOI: 10.1002/nau.24547] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/27/2020] [Accepted: 10/06/2020] [Indexed: 11/10/2022]
Abstract
AIMS Recording a voiding diary can be bothersome for patients and is sometimes inaccurate and unhygienic. This study aimed to develop and assess the accuracy and convenience of a novel device that automatically records the voiding diary by measuring pre- and post-void body weight. METHODS We used this novel device for seven healthy volunteers and ten hospitalized patients. The examinees got on the device before and after voiding and the device recorded the voiding diary automatically. The examinees also manually recorded a voiding diary by collecting their urine in a cup and measuring its volume and weight. We examined the correlation between the traditional and the automated voiding diary to confirm the accuracy of voiding measurements using this device. Additionally, we investigated which measurement method was preferred by the participants. RESULTS In the healthy volunteers group, there was a strong correlation between the voided urine weight recorded by the device and voided urine weight measured manually by the examinee (R2 = 0.9935). In the patients group, there was a strong (R2 = 0.9117) but lower correlation than that of the volunteers group, with an error of ±25 g 62% of the time, and ±50 g 82% of the time, respectively. All of the healthy volunteers and seven of the ten patients preferred using the automated voiding diary. CONCLUSIONS This novel device recorded a reasonably accurate voiding diary for everyday clinical practice.
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Affiliation(s)
- Shun Takai
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuya Hashizume
- Shimadzu Corporation, Technology Research Laboratory, Kyoto, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Marques SAA, Silveira SRBD, Pássaro AC, Haddad JM, Baracat EC, Ferreira EAG. Effect of Pelvic Floor and Hip Muscle Strengthening in the Treatment of Stress Urinary Incontinence: A Randomized Clinical Trial. J Manipulative Physiol Ther 2020; 43:247-256. [PMID: 32703614 DOI: 10.1016/j.jmpt.2019.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 12/17/2018] [Accepted: 01/25/2019] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the effectiveness of strengthening the hip muscles in addition to strengthening the pelvic floor muscles (PFM) in the treatment of stress urinary incontinence. METHODS This study used a prospective, assessor-blind, randomized clinical trial with parallel groups. We randomly allocated 47 individuals with stress urinary incontinence to 2 groups: 1 performing only pelvic floor strengthening exercises (PF, n = 21) and the other performing pelvic floor strengthening exercises plus exercises for the gluteus maximus and medius and hip adductor muscles (PFH, n = 22). Four individuals did not complete the study. Frequency of urine leakage was the primary outcome (3-day voiding diary and a follow-up voiding diary). Secondary outcomes were pelvic floor muscle strength (Ortiz scale, PERFECT scheme [Oxford Scale], and perineometry) and quality of life (QoL; International Consultation on Incontinence Questionnaire-Short Form and King's Health Questionnaire), which were evaluated by a blinded assessor before and after 20 sessions over 10 weeks. RESULTS Regarding the daily frequency of urine loss evaluated by the follow-up voiding diary, an effect of group was observed (P < .001), with the PFH group showing a significant decrease in daily loss frequency, although no significant differences were found in the comparison between groups for the 3-day voiding diary, QoL, or functional assessment of the PFM. CONCLUSION Strengthening the PFM together with the hip synergic muscles showed better results for frequency of daily urine loss throughout the sessions, although there was no accompanying superiority in improvement of strength, perineometry, or QoL over the group that performed only PFM-strengthening exercises.
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Affiliation(s)
- Simone A A Marques
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Simone R B da Silveira
- Department of Obstetrics and Gynecology, Urogynecology Section, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Anice C Pássaro
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jorge M Haddad
- Department of Obstetrics and Gynecology, Urogynecology Section, Clinical Hospital, University of São Paulo, São Paulo, Brazil
| | - Edmund C Baracat
- Department of Obstetrics and Gynecology, Urogynecology Section, University Hospital, University of São Paulo, São Paulo, Brazil; Department of Obstetrics and Gynecology, Urogynecology Section, Clinical Hospital, University of São Paulo, São Paulo, Brazil
| | - Elizabeth A G Ferreira
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
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Oh CK, Park M, Chung JS, Park SH, Kim SC. Factors affecting the response rate of frequency volume chart: A prospective nonrandomized controlled study. Neurourol Urodyn 2019; 39:353-360. [PMID: 31737925 DOI: 10.1002/nau.24212] [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: 07/28/2019] [Accepted: 10/20/2019] [Indexed: 11/10/2022]
Abstract
AIMS To evaluate if compliance with frequency volume charts can be improved if a physician explains its importance and to identify factors affecting compliance and accurate responses to frequency volume chart (FVC). METHODS We identified patients ≥18 years of age with voiding dysfunction reported from July 2013 to February 2014. Patients were explained the importance of frequency volume charts by a doctor and then a nurse explained how to fill it (group A). Others were only explained how to fill it (group B). RESULTS A total of 137 patients were enrolled. The response rate to frequency volume charts was higher in group A than in group B (94.3% vs 82.9%, P = .038). Patients ≥70 years of age, without a private health insurance, with high school education or higher, and without past medical history had a higher response rate in group A than in group B. In the multivariate binary logistic regression analysis, group A (odds ratio [OR], 4.87; 95% confidence interval [95% CI], 1.04-22.89; P = .045) and QoL (OR, 2.28; 95% CI, 1.16-4.46; P = .017) were factors associated with the response rate. In addition, group A (OR, 3.46; 95% CI, 1.03-11.70; P = .045) and being 60's years old (vs 50's years, OR, 7.01; 95% CI, 1.36-36.23; P = .020) were related to FVC complete response rate. CONCLUSIONS Frequency volume chart compliance can be improved if physicians explain its importance for lower urinary tract symptoms diagnosis and management. The explanation and severe lower urinary tract symptoms are factors affecting compliance and the explanation and being 60's years old are related to accurate response.
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Affiliation(s)
- Cheol Kyu Oh
- Department of Urology, College of Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea
| | - Myungchan Park
- Department of Urology, College of Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea
| | - Jae-Seung Chung
- Department of Urology, College of Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea
| | - Sang Hyun Park
- Department of Urology, College of Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea
| | - Seong Cheol Kim
- Department of Urology, College of Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea
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Monaghan TF, Rahman SN, Bliwise DL, Michelson KP, Agudelo CW, Miller CD, Weinstein CS, Olesen TK, Lazar JM, Everaert K, Verbalis JG, Weiss JP. Identifying men with global polyuria on a nocturnal-only voiding diary. Neurourol Urodyn 2019; 39:347-352. [PMID: 31692071 DOI: 10.1002/nau.24210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 10/20/2019] [Indexed: 11/05/2022]
Abstract
AIMS Nocturnal polyuria (NP) and global polyuria (GP) are not mutually exclusive. However, by rate, the common criteria for GP (40 mL/kg/24 hours [117 mL/kg/hour in a 70-kg individual] or 3000 mL/24 hours [125 mL/h]) are more stringent than those for NP (90 mL/hour during the sleep period or NP index [NPi; nocturnal volume/24-hour volume] > 0.33 [no minimum rate]). It remains unclear whether total nocturnal urine volume (NUV) may reliably delineate between NP patients with and without comorbid GP. METHODS A clinical database of men with lower urinary tract symptoms was searched for voiding diaries completed by patients reporting greater than or equal to 1 nocturnal void(s). Four separate analyses were performed using all combinations of the two NP and two GP criteria listed above. For each analysis, patients were included if they met the criteria for NP, and then stratified by presence or absence of GP (ie, NP + GP vs isolated NP). RESULTS Median NUV was greater among patients with NP + GP for all criteria combinations. Sensitivities greater than or equal to 80%/90%/100% for NP + GP were observed at 1275/1230/1085 mL for {NPi > 0.33 + 24-hour volume > 3000 mL}; 1075/1035/1035 mL for {NPi > 0.33 + 24-hour volume > 40 mL/kg}; 900/745/630 mL for {NUP > 90 mL/hour + 24-hour volume > 3000 mL}; and 1074/1035/990 mL for {NUP > 90 mL/hour + 24-hour volume > 40 mL/kg}. CONCLUSIONS An inordinate NUV among men with NP is fairly sensitive for comorbid GP. In the appropriate clinical setting, nocturnal-only diaries may suffice in the evaluation and follow-up of patients with NP, so long as outlying nocturnal volumes prompt a 24-hour diary/urine collection.
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Affiliation(s)
- Thomas F Monaghan
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Syed N Rahman
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Donald L Bliwise
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Kyle P Michelson
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Christina W Agudelo
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Connelly D Miller
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Corey S Weinstein
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Tine K Olesen
- Department of Urogynaecology, Ghent University Hospital, Ghent, Belgium
| | - Jason M Lazar
- Department of Medicine, Division of Cardiovascular Medicine, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Joseph G Verbalis
- Department of Medicine, Division of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, District of Columbia
| | - Jeffrey P Weiss
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York
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15
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Cameron AP, Wiseman JB, Smith AR, Merion RM, Gillespie BW, Bradley CS, Amundsen CL, Yang CC, Lai HH, DeLancey JOL, Helmuth ME, Bradley MS, Agochukwu N, Andreev VP, Kirkali Z, Clemens JQ. Are three-day voiding diaries feasible and reliable? Results from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) cohort. Neurourol Urodyn 2019; 38:2185-2193. [PMID: 31347211 DOI: 10.1002/nau.24113] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/03/2019] [Indexed: 11/08/2022]
Abstract
AIMS The aims of this study were to assess the completeness of voiding diaries in a research context and to correlate diary data with patient-reported questionnaires. METHODS Men and women enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) were given a 3-day voiding and fluid-intake diary to fill-out. Diaries were assessed for completeness and intake-output imbalances. They were assigned to one of four categories based on a percentage of missing data and fluid imbalance: no diary submitted, unusable (>40% missing void or intake volumes, or unphysiological fluid imbalance), usable but not complete, and complete. RESULTS A total of 1064 participants were enrolled and 85% (n = 902) returned the bladder diary. Of the diaries returned, 94% (n = 845) had data on three separate days, 87% (n = 786) had no missing intake volumes, 61% (n = 547) had no missing voided volumes, and 70% (n = 635) had a fluid imbalance within 3 L across the 3-day time period, resulting in 50% (n = 448) of participants with 100% complete diaries. Younger age was associated with a higher likelihood of not submitting a diary, or submitting an unusable diary. Women had a higher likelihood of submitting an unusable diary or a usable but incomplete diary. CONCLUSION Overall, 50% of LURN participants returned voiding diaries with perfectly complete data. Incomplete data for voided volumes was the most common deficiency. There was only a moderate correlation between diary data and questionnaire responses, indicating that diaries are a source of unique information.
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Affiliation(s)
- Anne P Cameron
- Departments of Urology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | | | - Abigail R Smith
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | - Robert M Merion
- Arbor Research Collaborative for Health, Ann Arbor, Michigan
| | - Brenda W Gillespie
- Departments of Urology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Catherine S Bradley
- Iowa Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Cindy L Amundsen
- Duke Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, Washington
| | - Henry H Lai
- Department of Urology, Washington University School of Medicine, St Louis, Missouri
| | - John O L DeLancey
- Departments of Urology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | | | - Megan S Bradley
- Duke Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
| | - Nnena Agochukwu
- Departments of Urology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | | | - Ziya Kirkali
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - J Quentin Clemens
- Departments of Urology and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
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Abstract
Urinary incontinence is a common, often undertreated, condition that impacts millions of Americans. Primary care physicians are well equipped to diagnose and treat urinary incontinence. Key to successful treatment is accurately determining the type of incontinence that ails the patient and using patient-reported quality-of-life indicators to guide stepwise treatment.
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Affiliation(s)
- Gretchen M Irwin
- Family Medicine Residency, Department of Family and Community Medicine, Wesley Medical Center, University of Kansas School of Medicine--Wichita, 1010 North Kansas, Wichita, KS 67214, USA.
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17
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[How to evaluate BPH-related SBAUs in clinical practice and research?]. Prog Urol 2018; 28:830-838. [PMID: 30220536 DOI: 10.1016/j.purol.2018.07.277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe the useful explorations in the clinical evaluation of the symptoms of the lower urinary tract symptoms possibly related to BPH (LUTS/BPH), and to list the information necessary to allow an evaluation of an instrumental or surgical intervention in the treatment of the hypertrophy and benign prostatic obstruction. METHOD Bibliographic research in English using the European, American and French recommendations on the evaluation of BPH, supplemented by a Pubmed search. RESULTS AND CONCLUSIONS A number of systematic investigations into the evaluation of a man with LUTS/BPH include interrogation, clinical examination with rectal examination, urinalysis, flowmeter and post-micturition residual volume. The voiding catalog is necessary to understand the mechanism of a nocturia. PSA has a triple potential of interest: evaluation of the risk of progression, evaluation of the prostatic volume and diagnosis of a cancer of the prostate. Creatinine is needed only when chronic retention is observed and before surgery. Urethrocystoscopy is essential in case of hematuria, suspicion of stenosis of the urethra or bladder tumor. Ultrasound for evaluation of prostate volume is essential before surgery, and may be helpful in guiding the decision to prescribe a 5 alpha reductase inhibitor. No non-invasive technique has proven its possible substitution for pressure flow studies when indicated. When a researcher is considering evaluating a surgical or instrumental treatment for BPH, preoperative, perioperative and follow-up parameters are expected from readers to get a fair idea of the technique being evaluated. LEVEL OF EVIDENCE 5: Consensus d'experts.
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18
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Yoo S, Park J, Cho SY, Cho MC, Jeong H, Son H. Usefulness of the frequency-volume chart over the International Prostate Symptom Score in patients with benign prostatic hyperplasia in view of global polyuria. PLoS One 2018; 13:e0197818. [PMID: 29995878 PMCID: PMC6040686 DOI: 10.1371/journal.pone.0197818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/09/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose We aimed to determine the usefulness of the frequency-volume chart over the International Prostate Symptom Score in patients with benign prostatic hyperplasia. Furthermore, we investigated the clinical characteristics suggesting that patients could benefit from frequency-volume chart assessment in addition to International Prostate Symptom Score assessment. Methods A total of 193 patients with benign prostatic hyperplasia were analyzed. The relationship between the information obtained from the frequency-volume chart and the International Prostate Symptom Score was assessed. Because the urine output per kilogram per hour was not associated with any question in the International Prostate Symptom Score questionnaire, patients were divided into 2 groups according to the presence of global polyuria, defined as urine output >40 mL·kg-1·h-1. Multivariable analysis was performed to determine the predictors of global polyuria, and the results were externally validated using 397 patients with benign prostatic hyperplasia. Results Although the other information obtained from the frequency-volume chart correlated with the International Prostate Symptom Score, the urine output was not associated with the International Prostate Symptom Score. Based on these results, patients were dichotomized into the global polyuria group (n = 19, 9.8%) and the non-global polyuria group. Although the patient characteristics did not differ between the 2 groups, the number of voids was higher in patients with global polyuria. Multivariable analysis showed that diabetes mellitus (odds ratio: 3.497, p = 0.039) and increased number of voids (odds ratio: 1.320, p < 0.001) were significant predictors of global polyuria. On external validation, the area under curve for the model was 0.723. Conclusions Global polyuria cannot be suspected using the International Prostate Symptom Score, although it worsens the lower urinary tract symptoms of patients with benign prostatic hyperplasia. Assessment with the frequency-volume chart needs to be considered in diabetic patients with increased number of voids.
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Affiliation(s)
- Sangjun Yoo
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Juhyun Park
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sung Yong Cho
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Min Chul Cho
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hyeon Jeong
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hwancheol Son
- Department of Urology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
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19
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Gacci M, Sebastianelli A, Spatafora P, Corona G, Serni S, De Ridder D, Gravas S, Abrams P. Best practice in the management of storage symptoms in male lower urinary tract symptoms: a review of the evidence base. Ther Adv Urol 2017; 10:79-92. [PMID: 29434675 DOI: 10.1177/1756287217742837] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/16/2017] [Indexed: 01/28/2023] Open
Abstract
Storage lower urinary tract symptoms (LUTS) are characterized by an altered bladder sensation, increased daytime frequency, nocturia, urgency and urgency incontinence. Some evidence underlines the role of metabolic factors, pelvic ischemia, prostatic chronic inflammation and associated comorbidities in the pathophysiology of storage LUTS. A detailed evaluation of the severity of storage LUTS, and the concomitance of these symptoms with voiding and postmicturition symptoms, is mandatory for improving the diagnosis and personalizing treatment. A detailed medical history with comorbidities and associated risk factors, a physical examination, a comprehensive analysis of all the features of LUTS, including their impact on quality of life, and a frequency-volume chart (FVC) or bladder diary, are recommended for men with storage LUTS. Several drugs are available for the treatment of LUTS secondary to benign prostatic obstruction (BPO). Alpha-blockers (α-blockers), 5-α-reductase inhibitors and phosphodiesterase type 5 inhibitors are commonly used to manage storage LUTS occurring with voiding symptoms associated with BPO. Muscarinic receptor antagonists and Beta 3-agonists (β3-agonists) alone, or in combination with α-blockers, represent the gold standard of treatment in men with predominant storage LUTS. There is no specific recommendation regarding the best treatment options for storage LUTS after prostatic surgery.
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Affiliation(s)
- Mauro Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, AOUC, University of Florence, Largo Brambilla 3 - 50134 Florence
| | - Arcangelo Sebastianelli
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Pietro Spatafora
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Giovanni Corona
- Medical Department, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Sergio Serni
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Dirk De Ridder
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Stavros Gravas
- Department of Urology, University of Thessaly, Larissa, Greece
| | - Paul Abrams
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
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20
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Noninvasive Medical Tools for Evaluating Voiding Pattern in Real Life. Int Neurourol J 2017; 21:S10-16. [PMID: 28446014 PMCID: PMC5426433 DOI: 10.5213/inj.1734860.430] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 04/10/2017] [Indexed: 11/08/2022] Open
Abstract
Voiding dysfunction is a common disease that contributes to a lower quality of life and has an increased prevalence in the elderly population. Noninvasive and objective methods such as uroflowmetry (UFM) and voiding diaries (VDs) are essential for exact diagnosis and effective treatment of this condition because patients with different causes of voiding dysfunction can complain of the same lower urinary tract symptoms. Further, different treatment options can be determined based on the diagnosis made from these symptoms. In order to improve the quality of UFM and VDs and to provide a convenient testing environment, several advances have been made by previous investigators. In this study, we investigate the history and technological mechanisms of UFM and VDs. We also aim to review UFM from the viewpoint of clinical and at-home uses, including the recently proposed toilet-shaped UFM and electronic VDs.
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22
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Abstract
Incontinence-associated dermatitis (IAD) is a condition often encountered by dermatologists. IAD is an inflammatory skin condition secondary to prolonged urine exposure-it is a dermatologic sequela of urinary incontinence. Incontinence should not be dismissed simply as an age-related disorder; rather, it is due to a number of pathologic conditions that can be either reversible or manageable. It is thus critical to identify and treat the underlying causes of urinary incontinence. Clinical management of this common medical issue restores normality to patients' lives while also preventing future dermatologic complications. In this article, we aim to provide dermatologists with an overview of IAD and an approach to the diagnosis and initial management of urinary incontinence.
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Affiliation(s)
- Malika Ladha
- 1 Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Adrian Wagg
- 2 Division of Geriatric Medicine, University of Alberta, Edmonton, AB, Canada
| | - Marlene Dytoc
- 3 Division of Dermatology, University of Alberta, Edmonton, AB, Canada
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23
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Chughtai B, Forde JC, Thomas DDM, Laor L, Hossack T, Woo HH, Te AE, Kaplan SA. Benign prostatic hyperplasia. Nat Rev Dis Primers 2016; 2:16031. [PMID: 27147135 DOI: 10.1038/nrdp.2016.31] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Benign prostatic hyperplasia (BPH), which causes lower urinary tract symptoms (LUTS), is a common diagnosis among the ageing male population with increasing prevalence. Many risks factors, both modifiable and non-modifiable, can increase the risk of development and progression of BPH and LUTS. The symptoms can be obstructive (resulting in urinary hesitancy, weak stream, straining or prolonged voiding) or irritative (resulting in increased urinary frequency and urgency, nocturia, urge incontinence and reduced voiding volumes), or can affect the patient after micturition (for example, postvoid dribble or incomplete emptying). BPH occurs when both stromal and epithelial cells of the prostate in the transitional zone proliferate by processes that are thought to be influenced by inflammation and sex hormones, causing prostate enlargement. Patients with LUTS undergo several key diagnostic investigations before being diagnosed with BPH. Treatment options for men with BPH start at watchful waiting and progress through medical to surgical interventions. For the majority of patients, the starting point on the treatment pathway will be dictated by their symptoms and degree of bother.
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Affiliation(s)
- Bilal Chughtai
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - James C Forde
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - Dominique Dana Marie Thomas
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - Leanna Laor
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - Tania Hossack
- Department of Urology, Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Henry H Woo
- Department of Urology, Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Alexis E Te
- Department of Urology, Weill Cornell Medical College-New York Presbyterian Hospital, New York, New York, USA
| | - Steven A Kaplan
- Department of Urology, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, 625 Madison Avenue, New York, New York 10022, USA
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24
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Are Bladder Diaries Helpful in Management of Overactive Bladder? CURRENT BLADDER DYSFUNCTION REPORTS 2016. [DOI: 10.1007/s11884-016-0343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lopes I, Veiga ML, Braga AANM, Brasil CA, Hoffmann A, Barroso U. A two-day bladder diary for children: Is it enough? J Pediatr Urol 2015; 11:348.e1-4. [PMID: 26386888 DOI: 10.1016/j.jpurol.2015.04.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/11/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION A bladder diary (BD) is a simple and non-invasive method of evaluating people with lower urinary tract symptoms (LUTS). Recently, the ICCS recommended a 48-h daytime frequency and volume chart (which does not need to be recorded on 2 consecutive days) to evaluate lower urinary tract (LUT) dysfunction. However, some studies on adults have demonstrated that a minimum of 3 days is required. It is believed that, to date, there are no studies in the literature that compare a 2-day BD with a 3-day BD. The advantages of a BD over a shorter period of time are the simplicity and possible better parent compliance. OBJECTIVE The aim of this study was to evaluate if a 2-day BD is statistically and clinically comparable to a 3-day BD. STUDY DESIGN A voiding diary was filled in over a 3-day period for 92 children (ages ranged from to 3-16 years, mean 7.9 ± 3.07) attending the present institution. By using the voiding diary, the following parameters were calculated: urination frequency, maximum and average volumes of urine (MVV and AVV) and fluid intake. The diary considered the 2 days as the first and second days of the 3-day diary. RESULTS Out of the 92 children, eight (8.7%) did not properly complete the diary. The sample predominantly comprised females (n = 55, 59.8%). No differences were seen between 2-day and 3-day bladder diaries regarding fluid intake, maximum and average voided volume. The sensitivity, specificity, positive and negative predictive values of the 2-day bladder diary for detecting frequency were 83.4%, 91.7%, 80% and 93.2%, and for low bladder capacity they were 97.2%, 90.9%, 99% and 88%, respectively (Table). DISCUSSION In a 2006 document, the ICCS recommended that a bladder diary be kept for 3 days, but in new documentation (2014) there is a reference stating that 2 days are enough. Bladder capacity is an important parameter in evaluating LUTS. Using a 2-day BD, the data showed that only a small percentage of reduced bladder capacity diagnosis would be lost. CONCLUSION When using the 2-day diary, a 16% false negative rate for frequency should be expected. A 2-day bladder diary is sufficient to evaluate bladder capacity and fluid intake.
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Affiliation(s)
- I Lopes
- Center of Voiding Disorders in Children (CEDIMI), Bahiana School of Medicine, Salvador, Bahia, Brazil
| | - M L Veiga
- Center of Voiding Disorders in Children (CEDIMI), Bahiana School of Medicine, Salvador, Bahia, Brazil.
| | - A A N M Braga
- Center of Voiding Disorders in Children (CEDIMI), Bahiana School of Medicine, Salvador, Bahia, Brazil.
| | - C A Brasil
- Center of Voiding Disorders in Children (CEDIMI), Bahiana School of Medicine, Salvador, Bahia, Brazil.
| | - A Hoffmann
- Center of Voiding Disorders in Children (CEDIMI), Bahiana School of Medicine, Salvador, Bahia, Brazil.
| | - U Barroso
- Center of Voiding Disorders in Children (CEDIMI), Bahiana School of Medicine, Salvador, Bahia, Brazil.
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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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Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, Oelke M, Tikkinen KAO, Gravas S. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction. Eur Urol 2015; 67:1099-1109. [PMID: 25613154 DOI: 10.1016/j.eururo.2014.12.038] [Citation(s) in RCA: 607] [Impact Index Per Article: 67.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 12/26/2014] [Indexed: 11/25/2022]
Abstract
CONTEXT Lower urinary tract symptoms (LUTS) represent one of the most common clinical complaints in adult men and have multifactorial aetiology. OBJECTIVE To develop European Association of Urology (EAU) guidelines on the assessment of men with non-neurogenic LUTS. EVIDENCE ACQUISITION A structured literature search on the assessment of non-neurogenic male LUTS was conducted. Articles with the highest available level of evidence were selected. The Delphi technique consensus approach was used to develop the recommendations. EVIDENCE SYNTHESIS As a routine part of the initial assessment of male LUTS, a medical history must be taken, a validated symptom score questionnaire with quality-of-life question(s) should be completed, a physical examination including digital rectal examination should be performed, urinalysis must be ordered, post-void residual urine (PVR) should be measured, and uroflowmetry may be performed. Micturition frequency-volume charts or bladder diaries should be used to assess male LUTS with a prominent storage component or nocturia. Prostate-specific antigen (PSA) should be measured only if a diagnosis of prostate cancer will change the management or if PSA can assist in decision-making for patients at risk of symptom progression and complications. Renal function must be assessed if renal impairment is suspected from the history and clinical examination, if the patient has hydronephrosis, or when considering surgical treatment for male LUTS. Uroflowmetry should be performed before any treatment. Imaging of the upper urinary tract in men with LUTS should be performed in patients with large PVR, haematuria, or a history of urolithiasis. Imaging of the prostate should be performed if this assists in choosing the appropriate drug and when considering surgical treatment. Urethrocystoscopy should only be performed in men with LUTS to exclude suspected bladder or urethral pathology and/or before minimally invasive/surgical therapies if the findings may change treatment. Pressure-flow studies should be performed only in individual patients for specific indications before surgery or when evaluation of the pathophysiology underlying LUTS is warranted. CONCLUSIONS These guidelines provide evidence-based practical guidance for assessment of non-neurogenic male LUTS. An extended version is available online (www.uroweb.org/guidelines). PATIENT SUMMARY This article presents a short version of European Association of Urology guidelines for non-neurogenic male lower urinary tract symptoms (LUTS). The recommended tests should be able to distinguish between uncomplicated male LUTS and possible differential diagnoses and to evaluate baseline parameters for treatment. The guidelines also define the clinical profile of patients to provide the best evidence-based care. An algorithm was developed to guide physicians in using appropriate diagnostic tests.
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Affiliation(s)
- Christian Gratzke
- Department of Urology, Urologische Klinik und Poliklinik, Klinikum der Universität München-Grosshadern, Munich, Germany
| | | | - Aurelien Descazeaud
- Department of Urology, Dupuytren Hospital, University of Limoges, Limoges, France
| | - Marcus J Drake
- Bristol Urological Institute and School of Clinical Sciences, University of Bristol, Bristol, UK
| | | | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete Medical School, Heraklion, Crete, Greece
| | - Matthias Oelke
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - Kari A O Tikkinen
- Departments of Urology and Public Health, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Stavros Gravas
- Department of Urology, University of Thessaly, Larissa, Greece.
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Wang L, Wang L, Shi G, Zeng L, Yang Y, Zhang T, Liu H. Efficacy and safety of ginger-salt-indirect moxibustion for urge urinary incontinence after stroke: protocol for a pilot multicentre randomised controlled trial. BMJ Open 2014; 4:e006326. [PMID: 25335962 PMCID: PMC4208054 DOI: 10.1136/bmjopen-2014-006326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 09/19/2014] [Accepted: 09/24/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Ginger-salt-indirect moxibustion is widely applied to treat urge urinary incontinence after stroke, which is a common complication in stroke survivors. Moxa cone moxibustion and moxa box moxibustion are the main techniques of ginger-salt-indirect moxibustion. Our previous study had shown that ginger-salt-indirect moxibustion using moxa cones was feasible and effective for urination disorders post-stroke. This pilot study aims to assess the feasibility of conducting research to evaluate the efficacy and safety of ginger-salt-indirect moxibustion for patients with post-stroke urge urinary incontinence. METHODS AND ANALYSIS This is a multicentre, prospective, single-blinded, pilot randomised controlled trial. 120 eligible patients will be randomly allocated to three groups. Treatment group A (n=40) will receive moxa cone moxibustion and routine care; treatment group B (n=40) will receive moxa box moxibustion and routine care; control group (n=40) will only receive routine care for stroke recovery. The entire moxibustion treatment will consist of a total of 28 sessions during the course of 4 weeks. The primary outcome measure will be the increase in mean volume per void assessed at week 4 from the first moxibustion session (baseline). Secondary outcome measures will include mean frequency of urination per day and quality of life assessments measured by completion of the Incontinence Quality of Life Questionnaire and Barthel Index. All outcome measures will be assessed at baseline and at 4 and 16 weeks from baseline. Adverse events in the three groups will be recorded to assess the safety of moxibustion. ETHICS AND DISSEMINATION Research ethics was approved by the Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical University (ref: 2013BL-094). Written informed consent will be obtained from all participants. Study results will be published in peer reviewed journals. TRIAL REGISTRATION NUMBER ISRCTN 44706974.
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Affiliation(s)
- Linpeng Wang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Lichen Wang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Guangxia Shi
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Lin Zeng
- Research Center of Clinical Epidemiology Affiliated to Peking University, Beijing, China
| | - Yi Yang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Tao Zhang
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
| | - Huilin Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
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Chiang CY, Fan YH, Lin ATL, Chen KK. First morning voided volume as a valuable tool for evaluating patients with overactive bladder. UROLOGICAL SCIENCE 2014. [DOI: 10.1016/j.urols.2014.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Application of guidelines to the evaluation of the male patient with urgency and/or incontinence. Curr Opin Urol 2014; 24:547-52. [PMID: 25144144 DOI: 10.1097/mou.0000000000000110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To review and evaluate the evidence from contemporary evidence-based guidelines regarding the assessment of men with urinary urgency and/or incontinence. RECENT FINDINGS There are a number of evidence-based guidelines which describe the pathways for assessing men with the symptoms of urgency and/or incontinence. We summarize the conclusions of the European Association of Urology, American Urological Association and National Institute of Clinical Excellence guidelines. SUMMARY All guidelines recommend a directed history, examination (including digital rectal examination), urinalysis and bladder diary as being essential in the assessment of men with lower urinary tract symptoms, although there are no high levels of evidence studies to support this. Creatinine estimation and prostate-specific antigen are recommended in selected groups of men, the latter after appropriate counselling. Uroflowmetry with postvoid residual assessment is recommended for at specialist assessment. Pad tests may be useful to quantify leakage. Ultrasound assessment of prostatic size and protrusion into the bladder base may be useful. Cystometry is recommended for men considering prostatic surgery, although there is a poor level of evidence underpinning this. Noninvasive surrogates for cystometry, such as penile plethysmography, lack sufficient evidence to allow recommendations to be made.
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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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Jimenez-Cidre MA, Lopez-Fando L, Esteban-Fuertes M, Prieto-Chaparro L, Llorens-Martinez FJ, Salinas-Casado J, Castro-Diaz D, Müller-Arteaga C, Adot-Zurbano JM, Rodriguez-Escobar F, Gutierrez C, Arlandis-Guzman S, Bonillo-Garcia MA, Madurga-Patuel B, Leva-Vallejo M, Franco de Castro A, Peri-Cusi L, Conejero-Sugrañes J, Jimenez-Calvo J, Rebollo P, Mora A. The 3-day bladder diary is a feasible, reliable and valid tool to evaluate the lower urinary tract symptoms in women. Neurourol Urodyn 2013; 34:128-32. [DOI: 10.1002/nau.22530] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 10/21/2013] [Indexed: 11/09/2022]
Affiliation(s)
| | - Luis Lopez-Fando
- Department of Urology; Hospital Universitario Ramón y Cajal; Madrid Spain
| | | | | | | | | | - David Castro-Diaz
- Department of Urology; Hospital Universitario de Canarias; Santa Cruz de Tenerife Spain
| | | | | | | | | | | | | | | | | | | | - Lluis Peri-Cusi
- Department of Urology; Hospital Clinic i Provincial; Barcelona Spain
| | | | | | | | - Ana Mora
- Medical Department; Astellas Pharma; Madrid Spain
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van Haarst EP, Bosch JLHR. The optimal duration of frequency-volume charts related to compliance and reliability. Neurourol Urodyn 2013; 33:296-301. [DOI: 10.1002/nau.22410] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 03/14/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Ernst P. van Haarst
- Department of Urology; Sint Lucas Andreas Ziekenhuis; Amsterdam The Netherlands
| | - J. L. H. Ruud Bosch
- Department of Urology; University Medical Centre Utrecht; Utrecht The Netherlands
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Mangera A, Marzo A, Heron N, Fernando D, Hameed K, Soliman AHA, Bradley M, Hosking I, Abdel-Maguid M, Levermore M, Tindale WB, Chapple C. Development of two electronic bladder diaries: a patient and healthcare professionals pilot study. Neurourol Urodyn 2013; 33:1101-9. [PMID: 24000163 DOI: 10.1002/nau.22469] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 07/02/2013] [Indexed: 11/08/2022]
Abstract
AIMS Assess patients' preferences in a pilot crossover study of two different electronic voiding diaries against a standard paper diary. Assess urological health professional (HP) opinions on the electronic bladder diary reporting system. METHODS Two different electronic diaries were developed: (1) electronically read diary-a card with predefined slots read by a card reader and (2) e-diary-a handheld touch screen device. Data uploaded from either electronic diary produced an electronic report. We recruited 22 patients split into two cohorts for each electronic diary, 11 completed each type of electronic diary for 3 days either preceded or followed by a standard paper diary for 3 days. Both diaries were completed on the 7th day. Patients' perceptions of both diaries were recorded using a standardized questionnaire. A HP study recruited 22 urologists who were given the paper diary and the electronic reports. Time taken for analysis was recorded along with accuracy and HP preferences. RESULTS The majority of patients (82%) preferred the e-diary and only 1/11 found it difficult to use. Patients had the same preference for the electronically read diary as the paper diary. The paper diary took 66% longer to analyze than the electronic report (P < 0.001) and was analyzed with an accuracy of 58% compared to 100%. Slightly more HP (9%) preferred the electronic report to the paper diary. CONCLUSIONS This proposed e-diary with its intuitive interface has overcome previous deficiencies in electronic diaries with most patients finding the format user-friendly. Electronic reports make analysis and interpretation by HP quicker and more accurate.
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Bright E, Cotterill N, Drake M, Abrams P. Developing a validated urinary diary: Phase 1. Neurourol Urodyn 2012; 31:625-33. [DOI: 10.1002/nau.21254] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 11/21/2011] [Indexed: 11/09/2022]
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Abstract
Nocturia is a common and bothersome symptom that impacts on sleep-quality and quality of life. Nocturia often has a multi-factorial etiology which makes thorough assessment of the complaint indispensable. This review summarizes the definition of nocturia, its epidemiology, clinical presentation, pathophysiology, diagnostics, and treatment options with special reference to older men. Nocturia is defined as a nocturnal voiding frequency of two or more, based on impact on quality of life. It is very prevalent in older men. Apart from the negative effects of sleep-disruption, it may be a risk-factor for hip fractures and increased mortality. Most common causes are: nocturnal polyuria, 24-h polyuria, overactive bladder (sometimes due to BPH) and sleep disturbance. A clear understanding of the etiology in the individual patient is indispensable when addressing the various possible causes and co-morbidities. Most important tool for this is the frequency-volume chart, but also patient history, physical examination and serum analysis. For treatment, lifestyle adjustments are often helpful. Medical therapy with 5-alpha reductase inhibitors, alpha-blockers, a combination of the two, or anti-muscarinics, has a limited effect. Most important medical option is desmopressin (arginine vasopressin analogue); however, treatment with this drug is limited to men under 65 years mainly due to the risk of hyponatraemia.
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Affiliation(s)
- Boris van Doorn
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
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Waters P, Hack MA, Richards J, Penney MD. Quantitating nocturia: a study into the recording of solute and water excretion to determine causation. Ann Clin Biochem 2011; 48:321-6. [PMID: 21670093 DOI: 10.1258/acb.2011.010161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nocturia is common but the clinical assessment of its severity and cause rarely involves any biochemical analysis. Investigating the cause of nocturia needs to be informed by the overall 24 h fluid and solute excretion patterns. The aim of this study was to establish a practical method of monitoring the renal excretion of water and solutes over a complete 24 h cycle. METHODS The excretion patterns of sodium, volume and osmoles were assessed in 89 healthy control subjects over a 24 h period by sampling each voiding from the 24 h collection and then using the total urine creatinine as the denominator. A group of 21 patients under investigation for sleep-disordered breathing (SDB: a group of disorders known to increase the risk of nocturia) were also studied to determine comparative excretion patterns. RESULTS Reference excretion patterns of sodium, volume and osmoles were described. Patients under investigation for SDB had overall a significant (P < 0.001) increase in urine sodium excretion at night (nocturnal natriuresis) matched by an increased osmotic excretion and accompanied by a significantly increased nocturnal urine volume (P < 0.001). CONCLUSION Breaking down a 24 h urine collection into voided aliquots provides practical information on the pattern of water and solute excretion. Such patterns may assist in identifying the underlying mechanism of significant nocturia in individual patients presenting with this symptom, and could be used as a method of monitoring treatment.
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Affiliation(s)
- Philip Waters
- Department of Clinical Biochemistry, Royal Gwent Hospital, Newport NP20 2UB, UK
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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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The Natural History and Predictive Factors of Voided Volume in Older Men: The Krimpen Study. J Urol 2011; 185:213-8. [DOI: 10.1016/j.juro.2010.08.080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Indexed: 01/22/2023]
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Cartwright R, Srikrishna S, Cardozo L, Robinson D. Validity and reliability of the patient’s perception of intensity of urgency scale in overactive bladder. BJU Int 2010; 107:1612-7. [DOI: 10.1111/j.1464-410x.2010.09684.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cartwright R, Panayi D, Cardozo L, Khullar V. Reliability and normal ranges for the Patient's Perception of Intensity of Urgency Scale in asymptomatic women. BJU Int 2009; 105:832-6. [PMID: 19818081 DOI: 10.1111/j.1464-410x.2009.08846.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
STUDY TYPE Symptom prevalence (prospective cohort). LEVEL OF EVIDENCE 1b. OBJECTIVE To measure the test-retest reliability of a 7-day bladder diary incorporating the Patient's Perception of Intensity of Urgency Scale (PPIUS), and to establish the normal values of the scale in a population of asymptomatic women. SUBJECTS AND METHODS Women volunteers, aged > or =18 years, were screened with the International Consultation on Incontinence Modular Questionnaire - Female Lower Urinary Tract Symptoms Long Form, to exclude those with bothersome lower urinary tract symptoms. Participants completed two separate 7-day bladder diaries with a 1-week interval between. Reliability was assessed using intraclass correlation, Spearman's correlation, and Student's t-test. RESULTS Forty volunteers were recruited. Most (67.5%) reported no urgency episodes. Convenience voids accounted for 26.8% of all voids. There was a significant positive effect of age (r = 0.34, P = 0.034) on urgency episodes, but no effect on mean urge scores (r = -0.03, P = 0.843). The reliability of assessment of frequency (0.86), nocturia (0.84), and the mean urge scores (0.85), were better than the reliability of assessment of urgency episodes (0.56), which occurred infrequently. The 95th centile for daily urinary frequency was 7.27 and for weekly urgency episodes was 2.00. CONCLUSION The PPIUS is a reliable tool for assessing urinary urge sensation in women. Inclusion of this measure in bladder diaries does not compromise the recording of other variables.
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Affiliation(s)
- Rufus Cartwright
- Department of Urogynaecology, King's College Hospital, London, UK.
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Abstract
Urinary incontinence in older adults is associated with an increased risk of institutionalization, as well as with urinary tract infections and depression. Transient urinary incontinence arises suddenly, lasts less than six months, and results from reversible causes. Many caregivers erroneously consider urinary incontinence to be inevitable in older adults, especially in hospitalized patients. Failure to identify and respond to transient urinary incontinence may lead to established incontinence and to other poor outcomes after hospital discharge. A bladder diary and a mnemonic are two methods nurses can use to assess for transient urinary incontinence and its treatable underlying causes. For a free online video showing nurses using these methods, go to http://links.lww.com/A311.
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Clinically useful measures in women with mixed urinary incontinence. Am J Obstet Gynecol 2008; 198:664.e1-3; discussion 664.e3-4. [PMID: 18538148 DOI: 10.1016/j.ajog.2008.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2007] [Revised: 11/27/2007] [Accepted: 02/06/2008] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The purposes of this study were to assess: 1) clinically relevant relationships between urinary diary and quality of life, and 2) reproducibility of validated questionnaires and urinary diaries in women with mixed urinary incontinence symptoms (MUI). STUDY DESIGN Forty-seven women with MUI completed 7-day diaries, the Urinary Distress Inventory (UDI-6), Incontinence Impact Questionnaire, and Medical, Epidemiological, and Social Aspects of Aging questionnaire 2 weeks apart. RESULTS The number of urge incontinence episodes predicted incontinence severity on UDI-6 (R(2) = .38, P < .03). Except for the number of stress incontinence episodes, diary variables and questionnaire responses were reproducible (range from Spearman's rho = .7 to rho = .96, P < .001). CONCLUSION The 6 questions of the UDI-6 adequately represent incontinence severity. With the exception of the number of stress incontinence episodes recorded on the 7-day diary, common incontinence measures are reproducible over 2 weeks.
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Digesu GA, Khullar V. Re: Michael Mitterberger, Germar-Michael Pinggera, Rainer Marksteiner, et al. Adult stem cell therapy of female stress urinary incontinence. Eur Urol 2008;53:169-75. Eur Urol 2008; 55:e23-4. [PMID: 18433983 DOI: 10.1016/j.eururo.2008.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Accepted: 04/04/2008] [Indexed: 10/22/2022]
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Yap TL, Cromwell DA, Brown C, Emberton M, van der Meulen J. The reliability of the frequency-volume chart in assessing lower urinary tract symptoms. BJU Int 2007; 100:111-5. [PMID: 17552958 DOI: 10.1111/j.1464-410x.2007.06864.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the test-retest reliability of a 1-day frequency-volume chart (FVC) in men with lower urinary tract symptoms (LUTS). PATIENTS AND METHODS Men with uncomplicated LUTS presenting to a urology clinic were asked to complete FVCs on three consecutive days. Standard measures of voiding frequency and volume were derived using International Continence Society definitions. Test-retest reliability of 1-day voiding behaviour was evaluated with an intraclass correlation coefficient (ICC). We also derived 95% confidence intervals (CI) for each measure, thereby indicating the precision of the measurements produced by a 1-day chart. RESULTS Of 140 patients with LUTS enrolled, 96 patients (69%) completed three 1-day FVCs. The frequency and volume measures typically had ICCs of 0.7-0.8; the "number of urgent voids" had the highest ICC. Nocturnal frequency and nocturnal volume were less reliable, with ICCs of 0.59 and 0.60, respectively. However, the 95% CIs around patient measurements tended to be wide. For 24-h voiding frequency, the true value for a patient might be up to +/- three voids away from the observed value for 95% of patients. CONCLUSION The measures of voiding behaviour derived from 1-day FVCs had sufficient test-retest reliability to differentiate between high and low levels of voiding symptoms. However, individual measurements could be imprecise, suggesting that, in men with LUTS, a 1-day FVC cannot be used for diagnosis, or monitoring changes in symptom scores after treatment.
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Affiliation(s)
- Tet L Yap
- Clinical Effectiveness Unit, Royal College of Surgeons of England, University College Hospital, 35-43 Lincoln's Inn Fields, London, UK
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