Urodynamic findings in patients with nocturia and their associations with patient characteristics

Underactive bladder as defined by the International Continence Society in the 2023 Japan Community Health Survey

OBJECTIVE

To investigate the characteristics of underactive bladder (UAB) in participants of the 2023 Japan Community Health Survey (JaCS 2023).

METHODS

The JaCS 2023 was conducted among individuals aged 20-99 years old who had anonymously registered with a Japanese online research company. We divided the 6210 participants of JACS 2023 into UAB and non-UAB groups as defined by the International Continence Society Working Group (ICS-WG) and evaluated the prevalence of UAB as well as concomitant lower urinary tract symptoms. In addition, an association between UAB and vulnerability-related factors, namely participants' characteristics including frailty and comorbidities, was explored by univariable and multivariable analyses.

RESULTS

The prevalence of UAB in Japanese community-dwelling men and women aged 20 years or older was 9.3% and 4.0% overall (p < 0.0001), respectively, and when excluding benign prostatic hyperplasia or pelvic organ prolapse, 7.0% and 3.7%, respectively, (p < 0.0001). A significant increase in the prevalence of UAB with age was observed (p < 0.0001). In addition, storage symptoms including overactive bladder were more frequent in the UAB group than the non-UAB group (p < 0.0001). Frailty and several comorbidities were independently associated with UAB.

CONCLUSIONS

According to the definition proposed by the ICS-WG, the JaCS 2023 demonstrated that UAB was more prevalent in men than in women and increased in prevalence with age. Storage symptoms including overactive bladder sometimes coexisted with UAB. Vulnerability-related factors were associated with UAB.

Prevalence and relevant factors of nocturia and its impact on sleep quality in Chinese university students

The purpose of this study was to investigate the prevalence and relevant factors of nocturia and its impact on sleep quality in university students in Mainland China. A large-scale survey was conducted on 14,000 university students from 3 universities in Henan province, China by using an anonymous questionnaire. The questionnaire collected the information from the past six months. The relationships between the prevalence of nocturia and its relevant factors were evaluated. A total of 13,874 questionnaires were collected and 13,104 qualified for statistical analysis. A total of 659 students suffered from clinically relevant nocturia (CRN) (4.56% in male and 5.34% in female). Both univariate analysis and the logistic stepwise regression model showed that the prevalence of nocturia was significantly related to female, history of enuresis, ease of waking up, urgency, frequency and RUTI (P < 0.05). The sleep quality and the university entrance score of CRN group was significantly lower than that of control group (P < 0.05). Nocturia was common in Chinese university students and showed a negative impact on sleep and academic performance. Gender of female, history of enuresis, ease of waking up, urgency, frequency and RUTI were relevant factors for CRN.

Underactive Bladder and Detrusor Underactivity: New Advances and Prospectives

Underactive bladder (UAB) is a prevalent but under-researched lower urinary tract symptom that typically occurs alongside detrusor underactivity (DU). Unlike UAB, DU is a urodynamic diagnosis which the International Continence Society (ICS) defines as "a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span". Despite the widespread prevalence of UAB/DU, there are significant gaps in our understanding of its pathophysiological mechanisms, diagnosis, and treatment compared with overactive bladder (OAB) and detrusor overactivity (DO). These gaps are such that clinicians regard UAB/DU as an incurable condition. In recent years, the understanding of UAB has increased. The definition of UAB has been clarified, and the diagnostic criteria for DU have been considered more comprehensively. Meanwhile, a number of non-invasive diagnostic methods have also been reported. Clinical trials involving novel drugs, electrical stimulation, and stem cell therapy have shown promising results. Therefore, this review summarizes recent reports on UAB and DU and highlights the latest advances in their diagnosis and treatment.