The prevalence of lower urinary tract symptoms in population aged 40 years or over, in South Korea

Prevalence and impact on daily life of lower urinary tract symptoms in Japan: Results of the 2023 Japan Community Health Survey (JaCS 2023)

OBJECTIVES

A large-scale nationwide epidemiological survey of lower urinary tract symptoms (LUTS) was conducted via the Internet in 2023 to clarify the current prevalence of LUTS and evaluate its impact on daily life in Japan.

METHODS

The survey was conducted among individuals aged 20-99 years old who had anonymously registered with a Japanese online research company. The survey consisted of 48 questions related to LUTS and daily life.

RESULTS

A total of 6210 participants (3088 females and 3122 males), who were selected by probability sampling based on the composition of the Japanese population (age range: 20-99), were recruited. The overall prevalence of LUTS was 77.9% among the subjects aged ≥20 and 82.5% among those aged ≥40. The prevalence of LUTS differed between the sexes and trends toward significant increases in prevalence with age were seen for almost all LUTS. Furthermore, the prevalence of overactive bladder (OAB) was 11.9% among the subjects aged ≥20 and 13.8% among those aged ≥40. This study also showed that LUTS negatively affected daily life. However, the percentage of subjects who visited a physician to receive treatment for LUTS was low, including for participants with a history of treatment for LUTS, although this increased with age.

CONCLUSION

The prevalence of LUTS, including OAB, increased with age and negatively affected daily life. However, since the percentage of patients who visit a physician to receive treatment for LUTS remains low, further educational activities regarding LUTS are necessary.

Sex differences in lower urinary tract symptoms of Korean workers: Prevalence, mental health, and associated factors

Objectives

Lower urinary tract symptoms (LUTS) in workers can aggravate mental health, lower quality of life, and decrease work productivity. We aimed to examine the prevalence of LUTS, sex-related differences in LUTS, mental health of workers with LUTS, and factors associated with LUTS in Korean workers.

Methods

This cross-sectional study included 192 workers from D city and the Gyeongbuk province of South Korea. LUTS were measured using self-reported questionnaires, and mental health was assessed for anxiety, depression, and perceived stress. Differences in characteristics between workers with and without LUTS were analyzed using the chi-square test or independent t-test. Multiple logistic regression analysis was performed to identify factors associated with LUTS.

Results

Urinary urgency (UU) was significantly more prevalent in men than in women; however, stress urinary incontinence (SUI) was more prevalent in women than in men. The average anxiety and perceived stress scores were significantly higher in men with UU than in men without UU. Men with hypertension or nocturia were more likely to have UU than those without hypertension or nocturia. The anxiety scores significantly increased the odds of UU in men. Advanced age significantly increased the odds of SUI in women. Blue-collar female workers were more likely to develop SUI than their white-collar counterparts.

Conclusions

Our study highlighted the prevalence and burden of LUTS among workers. Occupational health providers need to regularly assess workers' bladder storage problems and provide manageable interventions for UU in men and SUI in women.

A national survey of lower urinary tract symptoms in Jordan

Objective

To determine the prevalence of lower urinary tract symptoms (LUTS) and their severity population in Jordan.

Methods

This cross-sectional survey was conducted using a paper-based survey between August and September in 2019. The study was carried out in the health care centers or hospitals in three different regions of Jordan: North (Irbid and Jarash), Middle (Amman, Madaba, Salt, and Zarqa), and South (Karak and Aqaba).

Results

To estimate the prevalence of LUTS, two definitions were used, including the first definition (presence of any LUTS regardless of the degree of severity) and the second definition (presence of any LUTS that occurs half the time or more). According to the first definition, 1038 (89.9%) reported LUTS (male: 47.3%, female: 52.7%), while 763 (66.1%) reported LUTS according to the second definition (male: 45.6%, female: 54.4%). According to the International Prostate Symptom Score characterization, 73.9% had nocturia and 62.9% reported daytime increased frequency.

Conclusion

LUTS are highly prevalent among the Jordanian population, and more than half of them have nocturia or daytime increased frequency as most frequently reported symptoms.

Baseline Lower Urinary Tract Symptoms and Sexual Dysfunction in Men with Newly Diagnosed Localized Prostate Cancer

We evaluated baseline lower urinary tract symptoms (LUTS) and sexual dysfunction in patients with newly diagnosed localized prostate cancer. Data were obtained from a cohort registry of patients with localized prostate cancer scheduled for radical prostatectomy. Before surgery, patients completed a 3-day voiding diary; International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), and Expanded Prostate Cancer Index Composite (EPIC) questionnaires; and a urodynamic study. Data were analyzed according to benign prostatic hyperplasia treatment status and age group. In total, 380 patients (median age, 67 years) were enrolled in this study. On the IPSS, 10.8% of patients had severe symptoms. On the IIEF-5, 8.7% of patients did not have erectile dysfunction and 52.9% had moderate-to-severe erectile dysfunction. On the EPIC, 3% of patients indicated that they did not have urinary control and only 13% responded that their erectile function was good or very good. The mean IPSS and IIEF-5 scores showed significant differences among age groups. Thus, patients with localized prostate cancer show various LUTS and sexual dysfunction at baseline, and these symptoms worsened with increased age.

The effect of transrectal ultrasound-guided prostate biopsy on erectile function and lower urinary tract symptoms: a prospective study

Background

Prostate biopsy (PB) is the gold standard for verifying the diagnosis of prostate cancer in men with clinical symptoms. Transrectal ultrasound (TRUS)-guided PB is the most common method for diagnosis; however, it has a few adverse effects. Mild consequences like bleeding and pain are prevalent but temporary. Since the relationship between erectile dysfunction and lower urinary tract symptoms (LUTS) and TRUS-guided PB is inconsistent in the literature, we aimed to conduct a study on these two consequences on males within 1 month following TRUS-guided PB.

Methods

Patients with a PSA ≥ 4 ml/ng who were determined to undergoTRUS-guided PB were enrolled in this prospective study. Patients' urinary symptoms and erectile function were evaluated using the International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) questionnaires the day before and 1 month after PB. Also, using uroflowmetry, the patients' urinary peak flow rate (Qmax) was recorded. SPSS version 18 was used to compare and analyze variables.

Results

The mean age of the participants was 67.47 ± 9.38 years. Before the PB, the IIEF-5 score was 20.19 ± 7.24, and after the PB, it was 20.25 ± 7.24 (p = 0.865). The Qmax level rose from 7.35 ± 2.15 to 7.74 ± 2 ml/s (p = 0.07). After TRUS-guided PB, the average IPSS score reduced from 11.48 ± 9.93 to 9.88 ± 8.22 which was statistically significant (p < 0.001).

Conclusions

This study indicated that TRUS-guided PB had no negative impact on erectile function or LUTS in participants and may even relieve urinary symptoms to some extent. Overally, TRUS-guided PB appears to be a safe strategy for evaluating prostate cancer suspects.

Estimation of Urine Flow Velocity Using Millimeter-Wave FMCW Radar

This study investigated the feasibility of remotely estimating the urinary flow velocity of a human subject with high accuracy using millimeter-wave radar. Uroflowmetry is a measurement that involves the speed and volume of voided urine to diagnose benign prostatic hyperplasia or bladder abnormalities. Traditionally, the urine velocity during urination has been determined indirectly by analyzing the urine weight during urination. The maximum velocity and urination pattern were then used as a reference to determine the health condition of the prostate and bladder. The traditional uroflowmetry comprises an indirect measurement related to the flow path to the reservoir that causes time delay and water waves that impact the weight. We proposed radar-based uroflowmetry to directly measure the velocity of urine flow, which is more accurate. We exploited Frequency-Modulated Continuous-Wave (FMCW) radar that provides a range-Doppler diagram, allowing extraction of the velocity of a target at a certain range. To verify the proposed method, first, we measured water speed from a water hose using radar and compared it to a calculated value. Next, to emulate the urination scenario, we used a squeezable dummy bladder to create a streamlined water flow in front of the millimeter-wave FMCW radar. We validated the result by concurrently employing the traditional uroflowmetry that is based on a weight sensor to compare the results with the proposed radar-based method. The comparison of the two results confirmed that radar velocity estimation can yield results, confirmed by the traditional method, while demonstrating more detailed features of urination.

Functional and Immunofluorescence Evaluations of Vascular and Neural Integrities in Urinary Bladder of Streptozotocin-Induced Diabetic Mice

Purpose

To assess functional and structural changes in vascular and neural structures associated with diabetic bladder dysfunction (DBD) in the bladders of streptozotocin (STZ)-induced diabetic mice.

Methods

Eight-week-old C57BL/6 mice were injected with STZ at 50 mg/kg daily for 5 consecutive days. Catheters were inserted 12 weeks later, and 5 days after catheter placement bladder functions were assessed by conscious cystometry. Neurovascular and extracellular matrix marker changes in harvested urinary bladders were investigated by immunofluorescent staining. Body weights and fasting and postprandial blood glucose levels were measured 12 weeks after STZ injection.

Results

STZ-induced diabetic mice had significantly lower body weights and significantly higher blood glucose levels. Assessment of bladder function in STZ-induced diabetic mice revealed a nearly 3-fold increase in bladder capacity and intercontractile interval compared to controls. However, basal pressure, maximal bladder pressure, and threshold pressure were not significantly different. Morphological and structural analysis showed that STZ-induced diabetic mice had significantly reduced microvascular density in lamina propria (33% of the nondiabetic control values), and severely decreased nerve contents in the detrusor region (42% of the nondiabetic control values).

Conclusions

STZ-induced diabetic mice exhibit functional and structural derangements in urinary bladder. The present study provides a foundation and describes a useful means of evaluating the efficacies of therapeutic targets and exploring the detailed mechanism of DBD.

Phytotherapy for male luts: What happens then? 10-year research

INTRODUCTION AND OBJECTIVES

Our objective is to assess the long-term results of phytotherapy, focusing on the interval between phytotherapy and pharmacological treatment and the predisposing risk factors to such switch on a 10-year follow-up.

MATERIAL AND METHODS

The data of patients taking phytotherapy for mild to moderate male lower urinary tract symptoms (LUTS) from January to December 2010 were retrospectively reviewed from a prospectively maintained database. Patients were followed for 10 years through medical visits and telephone consultations.

RESULTS

102 patients underwent at least one cycle of phytotherapy for LUTS. Twenty (19.6%) patients resolved their symptoms after one phytotherapy cycle and stopped any treatment, 27 (26.4%) continued phytotherapy, and 52 (51%) switched to alpha-blockers and/or 5a-reductase inhibitors after a median interval of 24 months. The reasons for treatment switch were symptoms (n = 45) or clinical progression (increased residual volume n = 15; urinary retention, n = 5). Patients switching to synthetic drugs had median higher age (60 vs 49), prostate volume (40 vs 26 cc), prostate specific antigen (PSA) (1.9 vs 0.9 ng/ml), residual volume (40 vs 0 cc), and a lower maximum flow rate (Qmax) (12 vs 15 ml/s) at presentation.

CONCLUSIONS

46% patients with mild to moderate LUTS undergoing phytotherapy will be either free of treatment or still on phytotherapy at 10 years from disease presentation. Older patients with larger prostates, increased residual volume and PSA, should be informed regarding their higher risk of symptomatic or clinical progression: the risk of a treatment switch to alpha-blockers or 5a-reductase inhibitors becomes an actual fact after an average span of 2 years.

Higher Levels of Serum Uric Acid Have a Significant Association with Lower Incidence of Lower Urinary Tract Symptoms in Healthy Korean Men

Gout has been correlated with the risk of incident benign prostatic hyperplasia. In line with increasing prevalence of hyperuricemia, the aim of this study was to investigate the relationship between serum uric acid (SUA) level and the incidence of lower urinary tract symptoms (LUTS) among clinically healthy middle-aged men. We performed a cohort study in 101,091 Korean men without LUTS at baseline who completed health checkups between 2011 and 2016. LUTS were evaluated using the International Prostate Symptom Score, where a score ≥ 8 was defined as significant LUTS. Men were divided into six groups according to their SUA levels in mg/dL (<5.5, 5.5−6.4, 6.5−7.4, 7.5−8.4, 8.5−9.4, and ≥9.5). Throughout the follow-up—encompassing a total of 358,982.6 person years—13,424 people had significant LUTS (37.3 per 1000 person years for incidence rate). The multivariable models demonstrated that the highest level of SUA (≥9.5 mg/dL) was related to the lowest risk of significant LUTS compared with the reference category (<5.5 mg/dL) (0.77 (95% CI 0.59−0.99) for adjusted HR). In this large cohort composed of middle-aged men, higher SUA levels were related to a reduced risk of LUTS. This result suggests another potential role of SUA in restraining LUTS. Additional studies are needed to explain the underlying biological mechanisms of this phenomenological relationship.

Lower urinary system symptoms and affecting factors in female students staying in a dormitory

OBJECTIVE:

The aim of the study was to determine the lower urinary system symptoms and the factors affecting it among young women living in the dormitory.

METHODS:

This is a descriptive and cross-sectional study. A total of 355 women attending education in a public university were interviewed, considering a 95% confidence interval. Data were collected using the descriptive form and the Bristol Female Lower Urinary Tract Symptoms Scale. Necessary permissions were obtained, and appropriate analyses were carried out using the SPSS-22 program.

RESULTS:

Findings showed that 71.6% of women have problems with urine storage, 29.7% have urinating disorders, 18.4% have urinary incontinence, 8.8% have sexual life problems, and 37.2% have symptoms related to quality of life. Factors affecting the symptoms include history of chronic disease (such as neurological diseases and depression), smoking, low income, history of urinary incontinence in childhood, the presence of symptoms in the mother or family history, the presence and number of urinary tract infections, chronic constipation, and not paying attention to toilet cleaning.

CONCLUSION:

It is recommended to carry out community-based studies to raise awareness of women, support priority risk groups by screening, and increase the number of specialist healthcare personnel for quality care and treatment.

The Prevalence of Lower Urinary Tract Symptoms and Overactive Bladder in South Korea: A Cross-Sectional, Population-Based Study

Purpose

Lower urinary tract symptoms (LUTS) affect over half of the adults’ population worldwide, with an increasing prevalence among the older age groups. Therefore, with the increasing elderly population, LUTS is an important disease, highlighting the need for accurate data on its prevalence. This present study aimed to investigate the prevalence of LUTS in South Korea.

Methods

The study targeted individuals aged at least 19 years nationwide. We conducted computer-assisted telephone interviews, 80% mobile random digital dialing (RDD) sampling frame, and 20% landline RDD sampling frame between April and May 2020. Questionnaires included The International Prostate Symptom Score (IPSS), the overactive bladder symptom score (OABSS), and the characteristics of respondents. Current International Continence Society definitions were used for individual LUTS and OAB.

Results

There were 2,000 respondents, 1,009 (50.4%) were women and 546 (27.3%) were aged ≥60 years. Based on our IPSS questionnaire survey results, 77.9% of the respondents had LUTS; 63.7% had mild symptoms (1–7), 11.7% had moderate symptoms (8–19), and 2.4% had severe symptoms (20–35). The prevalence and severity of LUTS increased with age with 22.1% of respondents aged 60 years and above complaining of moderate or severe LUTS. According to the survey through OABSS, the prevalence of OAB was 9.6%, males were 10.3% and females were 9.0%.

Conclusions

Based on our survey results, 77.9% of the Korean adult population (over the age of 19) experienced at least one LUTS, and the severity increased with age. The prevalence and severity of OAB increased with age, especially after 40 years; the prevalence of OAB was 9.6%, and 13.4% of them were over 60 years old.

Sacral Acupuncture for Lower Urinary Tract Symptoms: A Systematic Review of Randomized Controlled Trials

Lower urinary tract symptoms (LUTS) associated with storage, voiding, and post-micturition reduce quality of life and cause mental health problems. In traditional medicine, Baliao points have been empirically used to treat urinary system diseases. In this review, randomized controlled trials (RCTs) using sacral acupuncture on Baliao points with sham treatment, other remedies, or other acupoints were retrieved from 8 electronic databases up to June 2021. Sixteen RCTs met the inclusion criteria. The quality of the included studies was assessed using a risk-of-bias (ROB) tool. Most of the evaluation indicators used in the included RCTs showed that sacral acupuncture had a significant therapeutic effect compared with the sham control intervention groups, and other remedies. However, all studies using acupoints (other than the Baliao points) as a control intervention had a “high” ROB and only reported secondary processed information, making it difficult to evaluate the efficacy of sacral acupuncture treatment for LUTS. No serious adverse effects were reported for sacral acupuncture, and only a low number of minor side effects were observed. These results suggest that sacral acupuncture could be considered as an alternative to existing treatments, with the added benefit of low cost. Large-scale, long-term RCTs are required in the future.

Family Physician's Educational Interview with Patients Helps in Early Recognition of Lower Urinary Tract Symptoms

Purpose

Lower urinary tract symptoms (LUTS) can have an etiology outside the lower urinary tract (LUT) and are therefore an important diagnostic indicator for assessing the overall health of a person. However, LUTS is still mainly neglected by primary health care providers as well as by patients. In this study, we assessed the importance of an educational interview (EI) conducted by a GP on the patients’ ability to recognize LUTS. We also investigated other factors that affect the recognition of LUTS: subjects’ personal educational level, number of LUT symptoms and their bothersome level on a scale 0–10.

Patients and Methods

This cross-sectional study was conducted in Croatia (2018–2020) by interviewing 499 subjects. We compared recognized LUT symptoms before and after the EI and determined whether their number, their bothersome level, or the subjects’ personal educational level were associated with LUTS recognition.

Results

EI significantly improved the ability to recognize LUTS (p=0.001). The number of LUT symptoms and bothersome level in subjects before EI was much greater than the number in subjects after EI (p<0.0001, mean>4 and p<0.0001, median>8, respectively). Subjects with higher educational level recognized LUTS with fewer symptoms after the EI (p<0.01), but no difference was observed among subjects who recognized LUTS before the EI.

Conclusion

For subjects to recognize LUTS, their condition had to be severe – more than 4 symptoms and bothersome level >8/10. Personal educational level had little impact on LUTS recognition. However, an EI proved to be an excellent tool for raising awareness about LUTS and its early recognition.

The Relationship Between Lower Urinary Tract Symptoms and Osteoarthritis Symptoms Among Vendors in a Conventional Market

Purpose

This study aimed to investigate lower urinary tract symptoms (LUTS) and the correlation between LUTS and osteoarthritis (OA) symptoms in the vendors working in a conventional market.

Methods

This cross-sectional study was conducted on 153 vendors aged 40 and over from August 10th to September 8th, 2020, in a conventional market. Data were collected via the self-reported questionnaires. We assessed LUTS by International Prostate Symptom Score (IPSS) and OA symptoms by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

Results

The mean age of 153 subjects was 61.31±9.92 years old. The mean score of IPSS and WOMAC was 5.37±5.68 (range, 0–35) and 16.89±19.61 (range, 0–96). Fifty-one percent of subjects had urinary incontinence at least monthly. Twenty-four point two percent of subjects had moderate-to-severe LUTS which were defined as a score of IPSS ≥8. LUTS were positively correlated with OA symptoms (r=0.41, P<0.001).

Conclusions

The results showed that LUTS were associated with OA symptoms, and it also emphasized the need for vendors to be provided with a health education program to manage and prevent their LUTS and OA symptoms.

Correlation between neutrophil to lymphocyte ratio and overactive bladder in South Korean women: a community-based, cross-sectional study

OBJECTIVE

Many women with overactive bladder (OAB) do not seek medical care despite urinary symptoms. As the diagnosis and treatment of OAB are often late, there is a need to identify undiagnosed OAB patients and start effective treatment. Furthermore, an objective and appropriate screening biomarker for OAB is needed. This study aimed to investigate the relationship between serum neutrophil-to-lymphocyte ratio (NLR) and OAB in South Korean women.

DESIGN

Cross-sectional, retrospective study.

SETTING

Jeju National University Hospital.

PARTICIPANTS

This study included a total of 4394 women (mean age=48.6 years) who underwent self-referred health screenings.

INTERVENTIONS

Blood tests were conducted and the NLR was calculated by dividing the number of neutrophils by the number of lymphocytes.

OUTCOME MEASURES

The severity of OAB was evaluated using the OAB Symptom Score (OABSS).

RESULTS

Approximately 9.8% of participants (n=432) were diagnosed with OAB. The association pattern between the NLR and urinary tract symptoms was variable; however, NLR was associated with OAB, by the OABSS and OAB severity (p<0.001). The NLR had a significant relationship with OAB after age, body mass index, homoeostatic model assessment for insulin resistance, 25-hydroxyvitamin D, stress status, and medication for hypertension (OR 1.19, 95% CI 1.06 to 1.32) were adjusted.

CONCLUSIONS

Elevated NLR is associated with OAB; hence, NLR may be a cost-effective and readily available biomarker of OAB in women.

Survey on disease insight and prevalence of urinary incontinence in women

Purpose

With a rapidly aging population in Korea, the number of patients with lower urinary tract symptoms is increasing. Therefore, it is important to determine the current extent of incontinence among Korean women to establish future plans. We attempted to create reference materials for organizing public relations and educational activities by investigating the effect of age on incontinence and quality of life in women.

Materials and Methods

The participants comprised women aged 30 years and older who visited a tertiary center for health screening from September 1 to October 31, 2016. The survey included a questionnaire consisting of 12 questions that took approximately 10 minutes to complete. We analyzed the responses and assessed the prevalence of the disease and its rate of recognition.

Results

A total of 509 women completed the survey. Irrespective of age, 76.8% of all respondents were aware of urinary incontinence (UI) and 57.4% of the women exhibited lower urinary tract symptoms. The most prevalent symptom was UI (45.8%), and the incidence rates of stress and urge UI were identified as 33.6% and 12.2%, respectively. Only 8.0% of the women had visited a hospital; 38.3% had awaited spontaneous symptom improvement. Many participants (61.2%) answered that a urology clinic is suitable for treating UI, while 58.9% chose a gynecology clinic.

Conclusions

Our study showed that more than 75% of women are aware of UI, but their perception of the disease mechanism and treatment options was low. We suggest that continuous education and publicity are necessary.

Interventional benefit of Pilates using Oov and mat on middle-aged women with lower urinary tract symptoms: emphasis on abdominal muscle thickness and muscular function

Lower urinary tract symptoms (LUTS) have been considered as clinically prevalent symptom in women, and can be ameliorated by the change of abdominal muscles and pelvic floor muscle (PFM). This study investigated the efficacy of Pilates program using Oov and mat on the change of abdominal muscle thickness, PFM function, and LUTS clinical score. 53 women experiencing LUTS were randomly assigned to Oov Pilates exercise group (OPEG) (n=20), mat Pilates exercise group (MPEG) (n= 16), and symptomatic control group (SCG) (n=17), respectively, and two groups using Oov and mat participated in 8-week Pilates program. Thickness of abdominal muscle, functional movement of PFM, and LUTS clinical score were measured from all groups. Thickness of rectus abdominis, internal oblique abdominis, transversus abdominis was significantly improved in OPEG (P<0.05), however, MPEG showed a significant change only in transversus abdominis (P<0.05). In all abdominal muscles, OPEG had a significantly improved abdominal muscle thickness compared to SCG (P<0.05). Functional movement of PFM in OPEG was significantly decreased (P<0.005), but not in MPEG and SCG. In LUTS clinical score, OPEG and MPEG showed a significantly abated symptoms in degree of voiding-related symptoms and discomfort (P<0.005), but not in SCG. Our study highlighted that Pilates using Oov can be an effective intervention to ameliorate the quantitative quality of abdominal muscle thickness and PFM, which ultimately provides the satisfied self-clinical index in degree of voiding-related symptoms and discomfort.

Urodynamic and clinical features in women with overactive bladder: When to suspect concomitant voiding dysfunction?

AIM

The aim of this study is to describe the prevalence and type of female voiding dysfunction (FVD) in patients with overactive bladder (OAB) who were studied by urodynamics and its relationship with voiding symptoms.

METHODS

This is a cross-sectional study of female adult patients with OAB syndrome who underwent UDS in a University Hospital in Chile between January 2015 and April 2020. FVD was defined either as bladder outlet obstruction (BOO) or detrusor underactivity (DU). BOO was established if the Solomon-Greenwell BOO index was higher than 18. DU was diagnosed when the invasive maximum flow rate (Qmax) was ≤15 ml/sec, detrusor pressure at Qmax (Pdet@Qmax) was ≤20 cmH₂ O and postvoid residual (PVR) was greater than 10%. Urodynamic data and clinical features were compared between groups.

RESULTS

Two hundred and ninety-nine UDS were selected and analyzed. Bladder outlet obstruction was diagnosed in 59 patients (19.7%), whereas DU was found in 10 patients (3.3%). In the multivariate analysis, the logistic regression to predict BOO demonstrated that night-time frequency, the presence of detrusor overactivity and a higher PVR were independent predictors of BOO. Instead, for DU, the only independent predictor was a smaller voided volume in the pressure-flow study.

CONCLUSION

Female voiding dysfunction was found in 23% of patients with overactive bladder. BOO is more frequent than DU, and should be suspected in patients with higher night-time frequency, presence of detrusor overactivity and a high PVR. Instead, DU should be suspected in patients with a smaller voided volume.

Auriculotherapy in adults and elderly people with lower urinary tract symptoms: an integrative review

OBJECTIVE

To analyze the evidence available in the literature on the use of auriculotherapy in adults and elderly people with lower urinary tract symptoms.

METHOD

An integrative literature review. Primary study search was carried out in nine relevant health databases. The characterization of studies regarding the method of application of auriculotherapy was based on the Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture recommendations.

RESULTS

296 studies were found, 17 pre-selected and eight included in the review. Favorable results from auriculotherapy were evidenced in specific populations, such as elderly men with prostatic disorders and individuals undergoing surgical procedures. The main urinary symptoms addressed were frequency, urgency, nocturia, incomplete voiding, intermittency, weak flow, effort to start urination, incontinence, and urinary retention.

CONCLUSION

Despite the limited number of studies and weaknesses with regard to sample size and different intervention protocols, it is suggested that auriculotherapy, associated or not with other complementary therapies, may contribute to lower urinary tract symptom control in adults and elderly people.

Development of a voiding diary using urination recognition technology in mobile environment

We invented a wearable device that can measure voiding time and frequency by checking a habitual series of characteristic motions among men. This study collected and analyzed urination time data collected smart bands worn by patients to resolve the clinical issues posed by using voiding charts. By developing a smart band-based algorithm for assessing urination time in patients, this study aimed to explore the feasibility of urination management systems. This study aimed to assess urination time based on a patient’s posture and changes in posture. Motion data were obtained from a smart band on the arm. An algorithm that identifies the three stages of urination (forward movement, urination, backward movement) was developed based on data collected from a 3-axis accelerometer and tilt angle data. Therefore, we analyze hidden Markov model (HMM)-based sequential data to determine urination time. Real-time data were acquired from the smart band. For data corresponding to a specific duration, the value of the signals was calculated and then compared with the set analysis model to calculate the time of urination. The final accuracy of the algorithm was calculated based on clinical guidelines for urologists. The experiment showed a high average accuracy of 92.5%, proving the robustness of the proposed algorithm. The proposed urination time recognition technology draws on acceleration data and tilt angle data collected via a smart band; these data were then analyzed using a classifier after applying the HMM method.

Quality of life and body image of patients with urinary disorders

OBJECTIVE

to assess the quality of life and body image of men with difficulty urinating and indwelling urinary catheter users, integrating the socio-demographic, economic and morbidity variables.

METHOD

a cross-sectional analytical study with 64 male patients with urinary problems. Three questionnaires were used for data collection: one containing sociodemographic, economic and morbid data, the Medical Outcome Study 36-item short-form health survey to analyze quality of life, and the Body Dysmorphic Examination, which assesses body image. T-test, Mann-Whitney, Pearson, Spearman, Linear Regression and Stepwise were used.

RESULTS

quality of life and body image were compromised in both groups, affecting emotional aspects, with a high degree of body dissatisfaction and altered physical and social adversity.

CONCLUSION

changes in patients' quality of life and body image were observed, confirming the need for improvement in care.

Sex Differences in Prevalence and Patient Behavior Regarding Lower Urinary Tract Symptoms Among Japanese Medical Checkup Examinees

OBJECTIVES

To evaluate the prevalence of lower urinary tract symptoms (LUTS) and patient behavior regarding LUTS and to reveal sex differences among medical checkup examinees.

METHODS

This cross-sectional, community-based study included participants age 40 years and above in Japan who presented for a medical checkup. The study parameters included the International Prostate Symptom Score, International Consultation on Incontinence Questionnaire-Short Form, overactive bladder symptom score, and an original questionnaire regarding patients' distress and behavior with respect to LUTS.

RESULTS

Of 1934 residents who presented for a medical checkup, 1582 (81.8%) individuals agreed to participants. Finally, the data of 1256 participants (808 men, 448 women) were analyzed in this study. The overall prevalence of LUTS was similar in both sexes (men 46.8%, women 44.5%; P = .156). Men had a significantly higher prevalence of LUTS than women for voiding and postmicturition symptoms, and a similar prevalence of storage symptoms and overactive bladder. Women had a significantly higher prevalence of urinary incontinence. The rate of distress regarding LUTS and the need to consult a physician were similar in both sexes. However, the consultation rate for LUTS was significantly lower in women than in men (men 38.5%, women 5.3%; P < .001), and women were more likely to restrict their activities owing to LUTS than men (men 13.0%, women 43.6%; P < .001).

CONCLUSION

Sufficient education regarding LUTS and providing appropriate medical facilities for consultation are warranted to encourage patients, particularly women, to treat their LUTS.

Profile of sexuality and symptoms of lower urinary tract in non-institutionalized elderly

Introduction:

Urinary or sexual dysfunction in the elderly are underreported. However, they are highly prevalent. This study aims to identify the prevalence of these conditions.

Objective:

The aim is to carry out an investigation in non-institutionalized individuals over 60 years of age, to obtain data on its sexual and urinary health in São Paulo, Campinas, Santo André and Londrina.

Results:

6.000 questionnaires were distributed, and 3425 were included in the study, for the analysis of the questionnaires separately. In relation to ADAM, 92% of the 1385 evaluated were suspicious of androgen deficiency (ADAM). As for the male sexual function, it was observed 37% of premature ejaculation. As for the female sexual function, 1300 (74%) did not practice sexual intercourse and the main reasons were: lack of partner and lack of sexual desire. In addition, 988 (78%) of women who had no sexual intercourse responded that they didn't want sex and, more importantly, about 22% of them would like to have sexual intercourse. International prostate symptom score (IPSS) showed gradual worsening of urinary symptoms with increasing age, being the most prevalent: nocturia and urinary urgency. As for the female IPSS, we noted that even after 80 years, the majority have mild symptoms related to voiding dysfunction; with increasing age there is a gradual increase in the result of the IPSS.

Conclusion:

Due to the large number of sexual and urinary disorders found, we recommend the improvement in health conditions, promoting a better quality of life in the elderly.

The mediating role of sleep quality in the association between nocturia and health-related quality of life

Background

Even though the negative impacts of nocturia on sleep quality and health-related quality of life (HRQOL) have been documented in previous research, their interrelationship has been poorly studied. This study aimed to explore whether nocturia would affect sleep quality, which in turn affects HRQOL.

Methods

Participants aged 40 and above were randomly recruited from a Hong Kong public primary care clinic. Participants were asked to report the average number of nocturia (waking up at night to void) pisodes per night over a 1-month period. The Pittsburgh Sleep Quality Index (PSQI) and the 12-Item Short Form Health Survey version 2 (SF-12 v2) were administered. The mediation analysis was tested using multistage regression approach and bootstrap method.

Results

Of the 500 subjects who completed the survey, 31.2% reported symptomatic nocturia (having ≥2 nocturia episodes per night), and 60.4% experienced poor sleep quality (a PSQI global score > 5). Respondents with symptomatic nocturia had a poorer HRQOL in the domains of physical functioning (PF), role physical (RP) and social functioning (SF), general health (GH), vitality (VT) and physical component summary (PCS) of the SF-12 v2 than those without. Compared with the respondents without poor sleep quality, those with poor sleep quality had poorer HRQOL across all domains and summaries of the SF-12 v2. Mediation analysis found that sleep quality fully mediated the association between nocturia and the PF, RP and SF domains of the SF-12 v2, respectively, and partially mediated the association between nocturia and the GH, VT and PCS domains of the SF-12 v2, respectively.

Conclusions

We found that sleep quality mediated the association between nocturia and HRQOL. To enhance the HRQOL of patients with nocturia, clinicians should not only focus on nocturia symptoms, but also on their sleep quality.