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Chantada-Tirado P, Chantada-Abal V, Cózar-Ortiz JD, Chantada-Tirado C, Cózar-Olmo JM, Esteban-Fuertes M, Alvarez-Ossorio-Rodal A, Flores-Fraile J, Márquez-Sánchez MT, Padilla-Fernández BY, Lorenzo-Gómez MF. Relationship between Mental Disorders, Smoking or Alcoholism and Benign Prostate Disease. Clin Pract 2024; 14:250-264. [PMID: 38391406 PMCID: PMC10888384 DOI: 10.3390/clinpract14010020] [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: 01/02/2024] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION Mental disorders, smoking, or alcoholism and benign prostate disease are highly prevalent in men. AIMS To identify the relationship between mental disorders, smoking, or alcoholism and benign prostate disease. METHODOLOGY A prospective multicenter study that evaluated prostate health status in 558 men from the community. Groups: GP-men who request a prostate health examination and whose medical history includes a mental disorder, smoking, or alcoholism prior to a diagnosis of benign prostate disease; GU-men who request a prostate health examination and whose medical history includes a benign prostate disease prior to a diagnosis of mental disorder, smoking, or alcoholism. VARIABLES age, body mass index (BMI), prostate specific antigen (PSA), follow-up of the mental disorder, smoking or alcoholism, time elapsed between urological diagnosis and the mental disorder, smoking or alcoholism diagnosis, status of the urological disease (cured or not cured), concomitant diseases, surgical history, and concomitant treatments. Descriptive statistics, Student's t-test, Chi2, multivariate analysis. RESULTS There were no mental disorders, smoking, or alcoholism in 51.97% of men. Anxiety, smoking, major depressive disorder, pathological insomnia, psychosis, and alcoholism were identified in 19.71%, 13.26%, 5.73%, 4.30%, 2.87%, and 2.15% of individuals, respectively. Nonbacterial prostatitis (31.54%), urinary tract infection (other than prostatitis, 24.37%), prostatic intraepithelial neoplasia (13.98%), and prostatodynia (1.43%) were prostate diseases. Unresolved symptomatic benign prostate disease was associated with anxiety, depression, and psychosis (p = 0.002). Smoking was the disorder that men managed to eliminate most frequently. The dominant disorder in patients with symptomatic benign prostatic disease was alcoholism (p = 0.006). CONCLUSIONS Unresolved symptomatic benign prostatic disease is associated with anxiety, depression, and psychosis. Alcoholism is associated with a worse prognosis in the follow-up of symptomatic benign prostatic disease.
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Affiliation(s)
| | | | - José-David Cózar-Ortiz
- Department of Surgery, University of Salamanca, 37007 Salamanca, Spain
- Psychiatry Department, Gómez Ulla Defense Central University Hospital, 28047 Madrid, Spain
| | | | | | | | | | | | | | | | - María-Fernanda Lorenzo-Gómez
- Department of Surgery, University of Salamanca, 37007 Salamanca, Spain
- Urology Service, University Hospital of Salamanca, 37007 Salamanca, Spain
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Marsden DL, Boyle K, Birnie J, Buzio A, Dizon J, Dunne J, Greensill S, Hill K, Lever S, Minett F, Ormond S, Shipp J, Steel J, Styles A, Wiggers J, Cadilhac DAM, Duff J. Improving Practice for Urinary Continence Care on Adult Acute Medical and Rehabilitation Wards: A Multi-Site, Co-Created Implementation Study. Healthcare (Basel) 2023; 11:healthcare11091241. [PMID: 37174783 PMCID: PMC10178438 DOI: 10.3390/healthcare11091241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Many adult inpatients experience urinary continence issues; however, we lack evidence on effective interventions for inpatient continence care. We conducted a before and after implementation study. We implemented our guideline-based intervention using strategies targeting identified barriers and evaluated the impact on urinary continence care provided by inpatient clinicians. Fifteen wards (acute = 3, rehabilitation = 7, acute and rehabilitation = 5) at 12 hospitals (metropolitan = 4, regional = 8) participated. We screened 2298 consecutive adult medical records for evidence of urinary continence symptoms over three 3-month periods: before implementation (T0: n = 849), after the 6-month implementation period (T1: n = 740), and after a 6-month maintenance period (T2: n = 709). The records of symptomatic inpatients were audited for continence assessment, diagnosis, and management plans. All wards contributed data at T0, and 11/15 wards contributed at T1 and T2 (dropouts due to COVID-19). Approximately 26% of stroke, 33% acute medical, and 50% of rehabilitation inpatients were symptomatic. The proportions of symptomatic patients (T0: n = 283, T1: n = 241, T2: n = 256) receiving recommended care were: assessment T0 = 38%, T1 = 63%, T2 = 68%; diagnosis T0 = 30%, T1 = 70%, T2 = 71%; management plan T0 = 7%, T1 = 24%, T2 = 24%. Overall, there were 4-fold increased odds for receiving assessments and management plans and 6-fold greater odds for diagnosis. These improvements were sustained at T2. This intervention has improved inpatient continence care.
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Affiliation(s)
- Dianne Lesley Marsden
- Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Kerry Boyle
- Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Belmont Hospital, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
| | - Jaclyn Birnie
- Armidale Hospital, Hunter New England Local Health District, Armidale, NSW 2350, Australia
| | - Amanda Buzio
- Coffs Harbour Health Campus, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia
| | - Joshua Dizon
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Judith Dunne
- Rankin Park Centre, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
| | - Sandra Greensill
- Rockhampton Hospital, Central Queensland Hospital and Health Service, Rockhampton, QLD 4700, Australia
| | - Kelvin Hill
- Stroke Foundation, Melbourne, VIC 3000, Australia
| | - Sandra Lever
- Ryde Hospital, Northern Sydney Local Health District, Eastwood, NSW 2122, Australia
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW 2006, Australia
| | - Fiona Minett
- Manning Hospital, Hunter New England Local Health District, Taree, NSW 2430, Australia
- Wingham Hospital, Hunter New England Local Health District, Wingham, NSW 2429, Australia
| | - Sally Ormond
- Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
- Calvary Mater Newcastle, Waratah, NSW 2298, Australia
| | - Jodi Shipp
- Rankin Park Centre, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
| | - Jennifer Steel
- Port Macquarie Hospital, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia
| | - Amanda Styles
- Armidale Hospital, Hunter New England Local Health District, Armidale, NSW 2350, Australia
- Tamworth Hospital, Hunter New England Local Health District, Tamworth, NSW 2340, Australia
| | - John Wiggers
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Health Research and Translation, Hunter New England Local Health District, New Lambton Heights, NSW 2305, Australia
| | - Dominique Ann-Michele Cadilhac
- Stroke and Ageing Research, Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences at Monash Health, Clayton, VIC 3168, Australia
| | - Jed Duff
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- School of Nursing and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD 4001, Australia
- Royal Brisbane and Womens Hospital, Queensland Health, Brisbane, QLD 4029, Australia
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Chien CH, Huang XY, Hsu SP, Yen YH, Pan HS, Yen FC. Self-efficacy and positive thinking as predictors of health-related quality of life in women with stress urinary incontinence. BMC Womens Health 2022; 22:444. [DOI: 10.1186/s12905-022-02025-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Stress urinary incontinence (SUI), which causes involuntarily leakage of urine, has an impact on many women and may affect self-efficacy, which, in turn, can lead to poor health-related quality of life (QOL). This study aimed to explore the effects of sociodemographic and health information, symptom distress, self-efficacy, and positive thinking on the health-related QOL (general QOL and urinary incontinence-specific QOL) of women with SUI.
Methods
A cross-sectional study design was used. Women with SUI were recruited from the obstetrics and gynecology outpatient department and urodynamics examination room of a hospital by convenience sampling from August 2021 to March 2022. Participants were surveyed on the following questionnaires: Urogenital Distress Inventory, Geriatric Self-efficacy Index for Urinary Incontinence, Positive Thinking Scale, 12-Item Short-Form Health Survey (SF-12), and Incontinence Impact Questionnaire Short Form.
Results
Participants (N = 135) had a mean age of 53.76 years old. The mean SF-12 physical component summary score was 48.48 (physical QOL), and the mental component summary score was 46.56 (mental QOL). The urinary incontinence-specific QOL score was 16.01. Women with greater positive thinking and higher self-efficacy for urinary incontinence had better physical and mental QOL. Women with less symptom distress of urinary incontinence and higher self-efficacy for urinary incontinence had better urinary incontinence-specific QOL.
Conclusion
The health-related QOL of women with SUI is affected by many factors, including positive thinking, self-efficacy, and symptom distress. Healthcare professionals can provide multifaceted programs to improve the health-related QOL of women with SUI.
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Reichert M, Popeneciu IV, Uhlig A, Trojan L, Mohr MN. Cognitive Ability as a Non-modifiable Risk Factor for Post-prostatectomy Urinary Incontinence: A Double-Blinded, Prospective, Single-Center Trial. Front Surg 2022; 8:812197. [PMID: 35083274 PMCID: PMC8784528 DOI: 10.3389/fsurg.2021.812197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Urinary incontinence (UI) is a wide-spread and feared side-effect of conventional or even robot-assisted laparoscopic prostatectomy (RALP) due to its high impact on patients' quality of life (QoL). Non-modifiable risk factors for UI have already been identified - on surgical and patient side. Yet, to our knowledge, focus thus far has not been placed on functional aspects regarding general cognitive ability. Materials and Methods: This is an observational single-center, prospective, double-blinded evaluation of 109 RALPs performed between 07/2020 and 03/2021. All patients underwent a Mini Mental State Examination (MMSE) prior to surgery to evaluate their cognitive ability. Early post-prostatectomy incontinence (PPI) was evaluated using a standardized 1 h pad test performed 24 h after removal of the urinary catheter. The association between MMSE results and PPI were evaluated using univariate and multivariate logistic regression models. Results: Multivariate logistic regression analyses identified MMSE results and nerve sparing (NS) as independent predictors for PPI in patients with an intermediate MMSE result (25-27 points) having a 3.17 times higher risk of PPI when compared to patients with a good MMSE result (≥28) (95% Confidence Interval (CI): 1.22-9.06, p = 0.023), while patients without NS had a 3.53 times higher risk of PPI when compared to patients with NS (95% CI: 1.54-11.09, p = 0.006). Conclusion: A lower cognitive ability should be treated as a non-modifiable risk-factor for early PPI. In the future it could find its place as a clinical screening tool to identify patients who require more attention especially in the pre-, but also in the postoperative phase.
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Affiliation(s)
- Mathias Reichert
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Annemarie Uhlig
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
| | - Lutz Trojan
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
| | - Mirjam Naomi Mohr
- Department of Urology, University Medical Center Göttingen, Göttingen, Germany
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Mental Health and Quality of Life among Women with Incontinence. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2021. [DOI: 10.30621/jbachs.884403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Psychometric evaluation of the Overactive Bladder Questionnaire (OAB-q) for measuring quality of life and clinical implications in Greek patients with overactive bladder. Int Urogynecol J 2021; 33:3035-3043. [PMID: 34626200 DOI: 10.1007/s00192-021-04991-9] [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: 07/12/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The Overactive Bladder Questionnaire (OAB-q) measures overactive bladder patients' severity of symptoms and their impact on health-related quality of life (HRQoL). The aim of this study was to validate the OAB-q in Greek patients with overactive bladder and report clinical implications of the disease. METHODS In total, 107 patients were recruited consecutively in our clinic. They completed the OAB-q and Short Form-36 Health Survey (SF-36) twice, 3 months apart. Simultaneously, they initiated lifestyle changes and drug therapy. The reliability of OAB-q was estimated by its internal consistency (Cronbach's α). Validity was estimated by criterion validity and concurrent validity by comparison with SF-36. RESULTS The sample's mean age was 62.1 years, and 74.8% were women. Cronbach's α exceeded the 0.7 threshold in all OAB-q subscales, implying good reliability of internal consistency for the OAB-q. In addition, moderate (Pearson's r > 0.3) or strong (r > 0.5) correlations were observed between OAB-q subscales and the relevant SF-36 subscales, implying concurrent validity. Clinically, urgency incontinence affected symptom bother (p = 0.001), concern/worry (p = 0.031) and social interaction (p = 0.027). Nocturia had the largest impact on HRQoL in patients with overactive bladder, as it affected all the OAB-q subscales (p < 0.001). CONCLUSIONS The Greek version of the OAB-q has shown strong psychometric properties of reliability and validity in our study. Urgency incontinence and especially nocturia seem to affect the HRQoL of patients with overactive bladder. OAB-q is valid for Greek patients with overactive bladder and can be used for clinical and academic purposes.
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Przydacz M, Chlosta M, Chlosta P. Population-Level Prevalence, Bother, and Treatment Behavior for Urinary Incontinence in an Eastern European Country: Findings from the LUTS POLAND Study. J Clin Med 2021; 10:jcm10112314. [PMID: 34073165 PMCID: PMC8199423 DOI: 10.3390/jcm10112314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/22/2021] [Accepted: 05/23/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Population-level data are lacking for urinary incontinence (UI) in Central and Eastern European countries. Therefore, the objective of this study was to estimate the prevalence, bother, and behavior regarding treatment for UI in a population-representative group of Polish adults aged ≥ 40 years. METHODS Data for this epidemiological study were derived from the larger LUTS POLAND project, in which a group of adults that typified the Polish population were surveyed, by telephone, about lower urinary tract symptoms. Respondents were classified by age, sex, and place of residence. UI was assessed with a standard protocol and established International Continence Society definitions. RESULTS The LUTS POLAND survey included 6005 completed interviews. The prevalence of UI was 14.6-25.4%; women reported a greater occurrence compared with men (p < 0.001). For both sexes, UI prevalence increased with age. Stress UI was the most common type of UI in women, and urgency UI was the most prevalent in men. We did not find a difference in prevalence between urban and rural areas. Individuals were greatly bothered by UI. For women, mixed UI was the most bothersome, whereas for men, leak for no reason was most annoying. More than half of respondents (51.4-62.3%) who reported UI expressed anxiety about the effect of UI on their quality of life. Nevertheless, only around one third (29.2-38.1%) of respondents with UI sought treatment, most of whom received treatment. Persons from urban and rural areas did not differ in the degrees of treatment seeking and treatment receiving. CONCLUSION Urinary incontinence was prevalent and greatly bothersome among Polish adults aged ≥ 40 years. Consequently, UI had detrimental effects on quality of life. Nonetheless, most affected persons did not seek treatment. Therefore, we need to increase population awareness in Poland about UI and available treatment methods, and we need to ensure adequate allocation of government and healthcare system resources.
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Seidel H, Bhattacharjee S, Pirkle S, Shi L, Strelzow J, Lee M, El Dafrawy M. Long-term rates of bladder dysfunction after decompression in patients with cauda equina syndrome. Spine J 2021; 21:803-809. [PMID: 33434651 DOI: 10.1016/j.spinee.2021.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/06/2020] [Accepted: 01/04/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Cauda equina syndrome (CES) occurs due to compression of the lumbar and sacral nerve roots and is considered a surgical emergency. Although the condition is relatively rare, the associated morbidity can be devastating to patients. While substantial research has been conducted on the timing of treatment, the literature regarding long-term rates of bladder dysfunction in CES patients is scarce. PURPOSE The aim of this study was to identify long-term rates of bladder dysfunction in CES patients and to compare those rates to non-CES patients who underwent similar spinal decompression. STUDY DESIGN/SETTING Retrospective database study. PATIENT SAMPLE The CES cohort was comprised of 2,362 patients who underwent decompression surgery following CES diagnosis with a 5-year follow-up. These patients were matched to 9,448 non-CES control patients who underwent spinal decompression without a diagnosis of CES. OUTCOME MEASURES Diagnosis of bladder dysfunction, surgical procedure to address bladder dysfunction METHODS: Using the national insurance claims database, PearlDiver, CES patients who underwent decompression surgery were identified and 1:4 matched to non-CES patients who underwent similar spinal decompression surgery. The 1-year, 3-year, and 5-year rates of progression to a bladder dysfunction diagnosis and surgical intervention to manage bladder dysfunction were recorded. The CES and non-CES groups were compared with univariate testing, and an analysis of risk factors for bladder dysfunction was performed with multivariate logistic regression analysis. RESULTS A total of 2,362 CES patients who underwent decompression surgery were identified and matched to 9,448 non-CES control patients. After 5 years, CES patients had a 10%-12% increased absolute risk of continued bladder dysfunction and a 0.7%-0.9% increased absolute risk of undergoing a surgical procedure for bladder dysfunction, as compared to matched non-CES patients. Multivariate analysis controlling for age, sex, obesity, tobacco use, and diabetes, identified CES as independently associated with increased 5-year risk for bladder dysfunction diagnosis (odds ratio [OR]: 1.72; 95% confidence interaval [CI] 1.56-1.89; p<.001) and procedure (OR: 1.40; 95% CI 1.07-1.81; p=.012). CONCLUSIONS Understanding the long-term risk for bladder dysfunction in CES patients is important for the future care and counseling of patients. Compared to non-CES patients who underwent similar spinal decompression, CES patients were observed to have a significantly higher long-term likelihood for both bladder dysfunction diagnosis and urologic surgical procedure.
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Affiliation(s)
- Henry Seidel
- Pritzker School of Medicine at The University of Chicago, 924 E. 57th St, Suite 104, Chicago, IL 60637, USA
| | - Sarah Bhattacharjee
- Pritzker School of Medicine at The University of Chicago, 924 E. 57th St, Suite 104, Chicago, IL 60637, USA
| | - Sean Pirkle
- Pritzker School of Medicine at The University of Chicago, 924 E. 57th St, Suite 104, Chicago, IL 60637, USA
| | - Lewis Shi
- The University of Chicago, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Hospitals, Duchossois Center for Advanced Medicine, MC 3079, 5758 S. Maryland Avenue, Dept 4B, Chicago, IL 60637, USA
| | - Jason Strelzow
- The University of Chicago, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Hospitals, Duchossois Center for Advanced Medicine, MC 3079, 5758 S. Maryland Avenue, Dept 4B, Chicago, IL 60637, USA
| | - Michael Lee
- The University of Chicago, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Hospitals, Duchossois Center for Advanced Medicine, MC 3079, 5758 S. Maryland Avenue, Dept 4B, Chicago, IL 60637, USA
| | - Mostafa El Dafrawy
- The University of Chicago, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Hospitals, Duchossois Center for Advanced Medicine, MC 3079, 5758 S. Maryland Avenue, Dept 4B, Chicago, IL 60637, USA.
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Chattrakulchai K, Manonai J, Silpakit C, Wattanayingcharoenchai R. Validation of the Thai version of the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Int Urogynecol J 2020; 31:2603-2610. [PMID: 32620979 DOI: 10.1007/s00192-020-04422-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/25/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND HYPOTHESIS To provide a validated Thai language version of the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) following a standardized procedure and to evaluate its psychometric properties. METHODS After IRB approval, the English ICIQ-FLUTS was translated into Thai according to the cross-cultural adaptation process for patient-reported outcome measures. The psychometric properties of the final version of the Thai ICIQ-FLUTS were tested for content validity, internal consistency, construct validity, and test-retest reliability. Patients attending an urogynecology clinic and women from two communities were recruited for this study. RESULTS The final Thai version of the ICIQ-FLUTS was developed and assessed by a panel of clinicians fluent in both languages including the content expert. Women with and without female lower urinary tract symptoms (FLUTS), in whom the translation was pretested, agreed that the final version made sense and was understandable. Among the 288 women who received the questionnaires, 283 (142 attending the clinic and 141 living in the communities) returned the completed questionnaire. The overall internal consistency of the Thai-version questionnaire was high, with a Cronbach's alpha score of 0.849. Symptom scores for filling, voiding, and incontinence in patients attending the clinic were significantly higher than in individuals from the community (p < 0.001). The correlation coefficients between the test and retest among 136 participants for symptoms of filling, voiding, and incontinence were 0.925, 0.769, and 0.921, respectively (p < 0.05). CONCLUSIONS The Thai ICIQ-FLUTS contained satisfactory content and exhibited construct validity, internal consistency, and test-retest reliability. It is equivalent to the original English version and will be a valuable tool for assessing LUTS in Thai-speaking women.
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Affiliation(s)
- Kitti Chattrakulchai
- Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Jittima Manonai
- Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand.
| | - Chatchawan Silpakit
- Department of Psychiatry, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Rujira Wattanayingcharoenchai
- Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
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Steibliene V, Aniuliene R, Aniulis P, Raskauskiene N, Adomaitiene V. Affective Symptoms and Health-Related Quality of Life Among Women with Stress Urinary Incontinence: Cross-Sectional Study. Neuropsychiatr Dis Treat 2020; 16:535-544. [PMID: 32158213 PMCID: PMC7047965 DOI: 10.2147/ndt.s236234] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 01/15/2020] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To evaluate the relationship between affective symptoms, clinical variables of uro-gynaecological history and health-related quality of life (QoL) among women with stress urinary incontinence (SUI) in comparison to healthy controls. PATIENTS AND METHODS In a cross-sectional study, 80 women 30 to 80 years of age diagnosed with SUI and 97 controls without symptoms of SUI provided sociodemographic data and answered the King's Health Questionnaire (KHQ) for assessing the QoL among individuals with urinary incontinence. Symptoms of anxiety and depression were assessed by Hospital Anxiety and Depression (HAD) scale with a threshold ≥7. A multiple regression was performed to reveal the cross-sectional predictors of affective symptoms and QoL among women with SUI. RESULTS Women with SUI had a significantly higher prevalence of symptoms of anxiety and depression than the controls (50% vs 11% and 29% vs 3.1%, respectively; both p<0.001) and worse health-related QoL on all domains of the KHQ. In multiple logistic regression models adjusted for sociodemographic and clinical variables of uro-gynaecological history, perceived symptoms of mild-to-severe depression were associated with a higher amount of leakage (OR=3.59; 1.04-12.4), older age (≥55 years old vs <55 years old) (OR=5.82; 1.47-23.1) and higher BMI (OR=1.13; 1.01-1.27). In addition, when controlled for all domains of the KHQ, perceived depressive symptoms were associated with the "emotions" domain of the KHQ (OR=1.06; 1.02-1.09). Perceived anxiety symptoms (independent of age) were related to shorter duration of SUI, low parity, absence of comorbidities and to higher scores on the "personal relationships" and "emotions" domains of the KHQ. CONCLUSION Women with SUI have a significantly poorer QoL than their counterparts without SUI. It was determined that one-half of women with SUI had anxiety symptoms, while one-third of women with SUI had depressive symptoms. In addition, this study indicated that QoL was associated with anxiety symptoms in middle-aged women and with depressive symptoms in older women, especially those with a shorter duration of SUI.
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Affiliation(s)
- Vesta Steibliene
- Clinic of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rosita Aniuliene
- Department of Obstetrics and Gynaecology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Povilas Aniulis
- Department of Urology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nijole Raskauskiene
- Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Avery JC, Moran LJ, Moore V, Fernandez RC, Whitrow M, Stocks N, Gill TK, Musker M, Davies M, Rumbold A. Prevalence of Self-reported Polycystic Ovary Syndrome and Profiles of Health Among Women of Different Generations: A Cross Sectional Study. FERTILITY & REPRODUCTION 2019. [DOI: 10.1142/s2661318219500154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: Although polycystic ovary syndrome (PCOS) is considered a lifelong disorder, very little is understood about the diagnosis and impact of this condition in women outside of the peak reproductive years. We examined the frequency of diagnosed PCOS and concurrent health conditions in women across the lifespan. Methods: Data were analysed from 1509 women aged 15–95 years participating in a cross-sectional, face-to-face population survey in South Australia, 2015. We assessed the prevalence of PCOS in 10-year age groups and the frequency of comorbidities in women with and without PCOS subgrouped by age (< 45, [Formula: see text] 45 years). The main outcome measures were Diagnosed PCOS and other chronic conditions; lifestyle factors. Logistic regression analyses determined the risk of comorbidities in women with PCOS adjusting for age and BMI. Results: Overall prevalence of PCOS was 5.6% (95% confidence interval (CI) 4.6–6.9%), peaking in the 35–44 year age group (9.1%), and lowest in those aged 15–24 (4.1%) or [Formula: see text] 65 (3.7%) years. Women with PCOS and aged <45 years were more likely to report diabetes (16.7% vs. 3.8%), cardiovascular disease (15.5% vs. 7.2%) and arthritis (15.5% vs. 7.2%) than their peers; these differences were diminished in the [Formula: see text] 45 year age group. The odds of diabetes and cardiovascular disease were more than doubled among women with PCOS (adjOR 2.23, 95% CI 1.49–4.31; adjOR 3.18, 95% CI 1.31–7.68). Conclusion: PCOS is underdiagnosed in young and post-menopausal women. Diabetes and cardiovascular disease are key comorbidities requiring greater attention in younger women with PCOS.
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Affiliation(s)
- Jodie C. Avery
- The University of Adelaide, Adelaide Medical School, Adelaide, SA 5005, Australia
| | - Lisa J. Moran
- The University of Adelaide, Robinson Research Institute, Adelaide Medical School, Adelaide, SA 5005, Australia
- Monash University, Monash Centre for Health Research & Implementation (MCHRI), Faculty of Medicine, Nursing and Health Sciences, School of Public Health & Preventive Medicine, Melbourne, VIC 3168, Australia
| | - Vivienne Moore
- The University of Adelaide, Robinson Research Institute, Adelaide Medical School, Adelaide, SA 5005, Australia
- The University of Adelaide, School of Public Health, Adelaide, SA 5005, Australia
| | - Renae C. Fernandez
- The University of Adelaide, Robinson Research Institute, Adelaide Medical School, Adelaide, SA 5005, Australia
| | - Melissa Whitrow
- The University of Adelaide, Robinson Research Institute, Adelaide Medical School, Adelaide, SA 5005, Australia
- The University of Adelaide, School of Public Health, Adelaide, SA 5005, Australia
| | - Nigel Stocks
- The University of Adelaide, Adelaide Medical School, Adelaide, SA 5005, Australia
| | - Tiffany K. Gill
- The University of Adelaide, Adelaide Medical School, Adelaide, SA 5005, Australia
- South Australian Health and Medical and Research Institute, Adelaide, SA 5000, Australia
| | - Michael Musker
- The University of Adelaide, Adelaide Nursing School, Adelaide, SA 5005, Australia
- South Australian Health and Medical and Research Institute, Adelaide, SA 5000, Australia
| | - Michael Davies
- The University of Adelaide, Robinson Research Institute, Adelaide Medical School, Adelaide, SA 5005, Australia
| | - Alice Rumbold
- The University of Adelaide, Robinson Research Institute, Adelaide Medical School, Adelaide, SA 5005, Australia
- South Australian Health and Medical and Research Institute, Adelaide, SA 5000, Australia
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12
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Te Brummelstroete GH, Loohuis AM, Wessels NJ, Westers HC, van Summeren JJGT, Blanker MH. Scientific evidence for pelvic floor devices presented at conferences: An overview. Neurourol Urodyn 2019; 38:1958-1965. [PMID: 31286567 PMCID: PMC6852158 DOI: 10.1002/nau.24099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/18/2019] [Indexed: 12/02/2022]
Abstract
Aims An increasing number of diagnostic and therapeutic medical devices are available to help patients and physicians manage pelvic floor symptoms in women. Many of these are presented at scientific conferences, and in the absence of a gold standard for evaluation, marketing has become more prominent than scientific evaluation. The goal of this study was to (a) provide an overview of pelvic floor devices for women that have been presented at recent annual meetings of leading scientific societies and (b) to summarize and review the scientific evidence underpinning these devices. Methods Manual searches were performed of all abstracts presented in 2016 and 2017 at annual meetings of the International Continence Society, the International Urogynecological Association, the European Association of Urology, and the American Urological Association. The exhibition floor of the 2017 International Continence Society was also searched. Subsequently, literature searches of both the MEDLINE and Embase databases were performed in November 2018 to identify original full‐text publications related to the identified devices. Results We identified 11 devices from these sources, which were mainly used for the control of urinary incontinence. Only seven of these pelvic floor devices were covered by publications, with no full‐text records identified for the remaining four devices. Conclusions Sample sizes were small and there was a lack of convincing evidence for most devices. Despite this, many devices were available in the market. Our findings indicate that the process for introducing these new devices is in stark contrast with the strict requirements for introducing new drug classes.
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Affiliation(s)
| | - Anne M Loohuis
- Department of General Practice and Elderly Medicine, University Medical Center, Groningen, The Netherlands
| | - Nienke J Wessels
- Department of General Practice and Elderly Medicine, University Medical Center, Groningen, The Netherlands
| | - Henriëtte C Westers
- Department of General Practice and Elderly Medicine, University Medical Center, Groningen, The Netherlands
| | | | - Marco H Blanker
- Department of General Practice and Elderly Medicine, University Medical Center, Groningen, The Netherlands
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13
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Martin SA. Re: Rhee et al. "Longitudinal study of the relationship between lower urinary tract symptoms and depressive symptoms". J Psychosom Res 2019; 116:113-114. [PMID: 30654987 DOI: 10.1016/j.jpsychores.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Sean A Martin
- Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia.
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If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers. J Am Board Fam Med 2018; 31:774-782. [PMID: 30201674 PMCID: PMC6170156 DOI: 10.3122/jabfm.2018.05.180045] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/17/2018] [Accepted: 04/22/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI. METHODS We conducted a cross-sectional electronic survey of PCPs within a Midwest academic institution to ascertain and compare PCPs' beliefs, attitudes, and behaviors regarding screening and treatment for UI and FI; determine factors associated with screening for FI; and identify potential barriers to and facilitators of FI screening and treatment. RESULTS Among 154 PCPs, the screening rate for UI (75%) was more than double that for FI (35%; P < .001). PCPs believed that both UI and FI screening were important but felt better informed to treat UI (P < .001). Screening for FI was associated with UI screening (OR, 11.27; 95% CI, 4.9-26.0; P < .001); feeling informed to treat FI (OR, 10.21; 95% CI, 1.2-90.0; P = .01); screening verbally (OR, 3.9; 95% CI, 1.9-8.0; P < .001); perceiving screening as important (OR, 3.7; 95% CI, 1.8-7.4; P < .001); using the term, "accidental bowel leakage" (OR, 2.9; 95% CI, 1.2-6.7; P = .02) or "bowel control issues" (OR, 2.2; 95% CI, 1.1-4.5; P = .03); and being a resident (OR, 0.37; 95% CI, 0.16-0.82; P = .02). PCPs reported high interest in patient and provider educational materials about UI and FI. CONCLUSIONS Most PCPs screen for UI but not FI. High reported interest in educational materials, coupled with high reported rates of perceived importance of screening for UI and FI, suggests that PCPs welcome informative interventions to streamline diagnosis and treatment.
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Wang JY, Liao L, Liu M, Sumarsono B, Cong M. Epidemiology of lower urinary tract symptoms in a cross-sectional, population-based study: The status in China. Medicine (Baltimore) 2018; 97:e11554. [PMID: 30142751 PMCID: PMC6112902 DOI: 10.1097/md.0000000000011554] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Lower urinary tract symptoms (LUTS) are reported to affect over half of all adults, and they are associated with significantly impaired quality of life (QOL). We performed a population-based study to evaluate the overall prevalence and impact of LUTS including overactive bladder (OAB) in adults aged ≥40 years in China.Adults aged ≥40 years were eligible to participate in this internet-based survey, provided that they had the ability to access the internet, to use a computer and to read the local language. The survey contained questions relating to International Continence Society (ICS) symptom definitions, the International Prostate Symptom Score (IPSS) and the Overactive Bladder Symptom Score (OABSS). The primary study objective was to determine the prevalence of LUTS using the ICS 2002 symptom definition.Among the 4136 respondents, 2080 (50.3%) were men and 1347 (32.6%) were aged ≥60 years. LUTS prevalence according to ICS criteria was 60.3% in men and 57.7% in women. All 3 ICS symptom groups (voiding, storage, and postmicturition) were present in 22.8% of women and 24.2% of men, making this the most common combination of ICS symptom groups. The most bothersome symptoms were terminal dribble and nocturia. According to IPSS scores, 32.9% of participants had at least moderate symptoms. The prevalence of OAB was 23.9%. The presence of LUTS-particularly all 3 ICS symptom groups-was associated with reduced sexual QOL in women, reduced satisfaction with erectile function in men, higher anxiety and depression scores, and reduced health-related QOL (physical health and mental health domains). The overall percentage of participants with LUTS visiting healthcare professionals for urinary symptoms was 38%.In conclusion, LUTS affect the majority of adults aged ≥40 years in China, and prevalence increases with increasing age. LUTS are associated with impaired QOL and mental health, but fewer than half of individuals in China with LUTS seek healthcare for their symptoms. There is therefore a need to improve awareness and treatment of the condition.ClinicalTrials.gov identifier: NCT02618421.
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Affiliation(s)
| | - Limin Liao
- Department of Urology, China Rehabilitation Research Center, Capital Medical University, Beijing, China
| | - Ming Liu
- Department of Urology, Beijing Hospital
| | | | - Min Cong
- Astellas Pharma China, Inc., Beijing, China
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Concepcion K, Cheng Y, McGeechan K, Robertson S, Stewart M, Bateson D, Estoesta J, Chiarelli P. Prevalence and associated factors of urinary leakage among women participating in the 45 and Up Study. Neurourol Urodyn 2018; 37:2782-2791. [DOI: 10.1002/nau.23770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/23/2018] [Indexed: 11/09/2022]
Affiliation(s)
| | - Yan Cheng
- Family Planning NSW; Ashfield New South Wales Australia
| | - Kevin McGeechan
- Family Planning NSW; Ashfield New South Wales Australia
- The University of Sydney; Sydney New South Wales Australia
| | | | - Mary Stewart
- Family Planning NSW; Ashfield New South Wales Australia
| | - Deborah Bateson
- Family Planning NSW; Ashfield New South Wales Australia
- The University of Sydney; Sydney New South Wales Australia
| | - Jane Estoesta
- Family Planning NSW; Ashfield New South Wales Australia
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Intra-, peri- and postoperative complications in pelvic organ prolapse surgery in geriatric women. Eur J Obstet Gynecol Reprod Biol 2018; 224:142-145. [PMID: 29605709 DOI: 10.1016/j.ejogrb.2018.03.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 02/28/2018] [Accepted: 03/22/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Pelvic organ prolapse is a common problem among geriatric women. Advanced age is associated with a high prevalence of comorbidities that can lead to restrictive use of surgical treatment. With rising life expectancy it is predicted that surgical treatment in these women will be seen more frequently. Inconsistently there is a lack of clinical trials giving attention to elderly women suffering from pelvic organ prolapse. The aim of this study was to quantify the rate of complications in elderly women undergoing surgery for pelvic organ prolapse. STUDY DESIGN 72 women aged ≥75 years who underwent surgical correction for pelvic organ prolapse were included in this study. Demographics, comorbidities, intra-, peri- and postoperative severe and non-severe complications were recorded. Additionally we compared the pre- and postoperative presence of symptoms linked to pelvic organ prolapse. Follow-up for the review of pelvic floor symptoms was six month. RESULTS The mean age was 81.4 years. Four (5.6%) of the patients had a severe intra-, peri- or postoperative complication (two bowel injuries, one bleeding requiring blood transfusion, one resuscitation). All women with severe complications showed no persistent problem at the time of discharge or during the follow-up period. There was a significant postoperative decrease in pelvic organ prolapse connected symptoms, such as stress urinary incontinence (p = .013), voiding dysfunction (p < .001), recurrent urinary tract infection (p = .001) and rectal outlet obstruction (p = .006). CONCLUSION Elderly women undergoing an operation for pelvic organ prolapse have a low risk of complication and benefit from surgery. Age alone should not be a contraindication to surgery.
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18
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Experiences Related to Urinary Incontinence of Stroke Patients: A Qualitative Descriptive Study. J Neurosci Nurs 2018; 50:42-47. [DOI: 10.1097/jnn.0000000000000336] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hahn SR, Bradt P, Hewett KA, Ng DB. Physician-patient communication about overactive bladder: Results of an observational sociolinguistic study. PLoS One 2017; 12:e0186122. [PMID: 29140974 PMCID: PMC5687746 DOI: 10.1371/journal.pone.0186122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 07/10/2017] [Indexed: 01/01/2023] Open
Abstract
Introduction Overactive bladder (OAB) and urinary incontinence are common problems that have significant impact on quality of life (QOL). Less than half of sufferers seek help from their physicians; many who do are dissatisfied with treatment and their physicians’ understanding of their problems. Little is known about the sociolinguistic characteristics of physician-patient communication about OAB in community practice. Methods An IRB-approved observational sociolinguistic study of dialogues between patients with OAB and treating physicians was conducted. Study design included semi-structured post-visit interviews, post-visit questionnaires, and follow-up phone calls. Conversations were analyzed using techniques from interactional sociolinguistics. Results Communication was physician- rather than patient-centered. Physicians spoke the majority of words and 83% of questions were closed-ended. The impact of OAB on QOL and concerns about and adherence to treatment were infrequently addressed by physicians, who were poorly aligned with patients in their understanding. These topics were addressed more frequently when open-ended questions successfully eliciting elaborated responses were used in ask-tell-ask or ask-tell sequences. Discussion Clinical dialogue around OAB is physician-centered; topics critical to managing OAB are infrequently and inadequately addressed. The use of patient-centered communication is correlated with more discussion of critical topics, and thus, more effective management of OAB.
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Affiliation(s)
- Steven R. Hahn
- Albert Einstein College of Medicine, Bronx, New York, United States of America
- Jacobi Medical Center, Bronx, New York, United States of America
| | - Pamela Bradt
- Medical Affairs, Americas Astellas Pharma Global Development, Inc., Northbrook, Illinois
| | - Kathleen A. Hewett
- Ogilvy CommonHealth Behavioral Insights, Parsippany, New Jersey, United States of America
- * E-mail:
| | - Daniel B. Ng
- Medical Affairs, Americas Astellas Pharma Global Development, Inc., Northbrook, Illinois
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20
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Bradley CS, Nygaard IE, Hillis SL, Torner JC, Sadler AG. Longitudinal associations between mental health conditions and overactive bladder in women veterans. Am J Obstet Gynecol 2017; 217:430.e1-430.e8. [PMID: 28645572 DOI: 10.1016/j.ajog.2017.06.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 06/07/2017] [Accepted: 06/13/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND One in 5 recently deployed US women veterans report overactive bladder symptoms. Mental health conditions such as depression and anxiety commonly co-occur in women with overactive bladder, but temporal relationships between these outcomes have not been well studied, and the mechanism behind this association is unknown. The Women Veterans Urinary Health Study, a nationwide longitudinal study in recently deployed women veterans, was designed to better understand relationships between overactive bladder and mental health conditions. OBJECTIVE We sought to estimate the 1-year incidence and remission of overactive bladder and to identify the impact of depression, anxiety, posttraumatic stress disorder, and prior sexual assault on 1-year overactive bladder incidence and remission rates. STUDY DESIGN Participants of this 1-year prospective cohort study were female veterans separated from military service who had returned from Iraq or Afghanistan deployment within the previous 2 years. Eligible women were identified through the Defense Manpower Data Center and recruited by mail and telephone. Telephone screening confirmed participants were ambulatory, community-dwelling veterans and excluded those with urinary tract fistula, congenital abnormality, or cancer; pelvic radiation; spinal cord injury; multiple sclerosis; Parkinson disease; stroke; or current/recent pregnancy. Data collection included computer-assisted telephone interviews performed at enrollment and 1 year later. The interview assessed demographic and military service characteristics; urinary symptoms and treatment; depression, anxiety, and posttraumatic stress disorder symptoms and treatment; and a lifetime history of sexual assault. Overactive bladder was identified if at least moderately bothersome urgency urinary incontinence and/or urinary frequency symptoms were reported on Urogenital Distress Inventory items. Exposures included depression, anxiety, posttraumatic stress disorder, and lifetime sexual assault, assessed at baseline using validated questionnaires (including the Patient Health Questionnaire and Posttraumatic Stress Disorder Checklist). Associations between exposures and overactive bladder incidence and remission were estimated using propensity score adjusted logistic regression models. RESULTS In all, 1107 (88.0%) of 1258 eligible participants completed 1-year interviews. Median age was 29 (range 20-67) years and 53% were nulliparous. Overactive bladder was identified at baseline in 242 (22%), and 102 (9.2%), 218 (19.7%), 188 (17.0%), and 287 (25.9%) met criteria for baseline depression, anxiety, posttraumatic stress disorder, and lifetime sexual assault, respectively. At 1 year, overactive bladder incidence was 10.5% (95% confidence interval, 8.6-12.8%), and remission of overactive bladder was 36.9% (95% confidence interval, 30.8-43.4%). New overactive bladder occurred more often in women with baseline anxiety (21% vs 9%), posttraumatic stress disorder (19% vs 9%) and lifetime sexual assault (16% vs 9%) (all: P < .01). After adjustment, anxiety (odds ratio, 2.4; 95% confidence interval, 1.4-4.1) and lifetime sexual assault (odds ratio, 1.7; 95% confidence interval, 1.0-2.8) predicted 1-year incident overactive bladder. Overactive bladder remission occurred less often in those with baseline depression (19% vs 41%, P < .01) and anxiety (29% vs 42%, P = .03). After adjustment, depression decreased 1-year overactive bladder remission risk (odds ratio, 0.37; 95% confidence interval, 0.16-0.83). Overactive bladder treatment was uncommon and not associated with remission. CONCLUSION Anxiety, depression, and prior sexual assault-common postdeployment problems for women veterans-influence the natural history of overactive bladder. Providers should screen for mental health conditions and sexual assault in women with newly diagnosed or persistent overactive bladder.
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Affiliation(s)
- Catherine S Bradley
- Comprehensive Access and Delivery Research and Evaluation Center, Iowa City Department of Veterans Affairs Health Care System, Iowa City, IA; Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA; Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA; Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA.
| | - Ingrid E Nygaard
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT
| | - Stephen L Hillis
- Comprehensive Access and Delivery Research and Evaluation Center, Iowa City Department of Veterans Affairs Health Care System, Iowa City, IA; Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA; Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA
| | - James C Torner
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA
| | - Anne G Sadler
- Comprehensive Access and Delivery Research and Evaluation Center, Iowa City Department of Veterans Affairs Health Care System, Iowa City, IA; Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA
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Huang CLC, Wu MP, Ho CH, Wang JJ. The bidirectional relationship between anxiety, depression, and lower urinary track symptoms: A nationwide population-based cohort study. J Psychosom Res 2017; 100:77-82. [PMID: 28789796 DOI: 10.1016/j.jpsychores.2017.07.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 07/15/2017] [Accepted: 07/16/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence has shown a positive correlation between lower urinary tract symptoms (LUTS) and anxiety/depression, but the direction and strength of the association are still unclear. We aimed to test the bidirectional association between LUTS and anxiety/depression using a longitudinal population database. METHODS Using claims data obtained from the Taiwan National Health Insurance Research Database, 17,489 patients with LUTS and 34,978 non-LUTS matched controls (cohort 1); and 45,707 patients with anxiety, 19,306 patients with depression, 91,414 non-anxiety, and 38,720 non-depression matched controls (cohort 2) were enrolled between 1999 and 2008. All subjects were followed at least three years or until the date of death or the end of 2011 to estimate the risk of developing anxiety/depression (cohort 1) or LUTS (cohort 2). RESULTS After controlling for age, gender, and medical comorbidities, LUTS patients were 2.12 (95%CI: 1.95-2.30) and 2.03 (95%CI: 1.76-2.33) times more likely to develop anxiety and depression, respectively. After controlling for age, gender, and medical comorbidities, patients with anxiety and depression were 2.01 (95%CI: 1.88-2.14) and 2.37 (95%CI: 2.13-2.65) times more likely to develop LUTS, respectively. LIMITATIONS The incidence of anxiety, depression, and LUTS may be under-estimated because only healthcare-seeking subjects were enrolled in our study. CONCLUSIONS Our findings suggested a bidirectional relationship between administrated anxiety/depression and LUTS in the cohorts. Further studies are warranted to clarify the underlying mechanisms.
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Affiliation(s)
- Charles Lung-Cheng Huang
- Department of Psychiatry, Chi Mei Hospital, Tainan, Taiwan; Department of Social Work, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
| | - Ming-Ping Wu
- Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Hospital, Tainan, Taiwan; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Hospital, Tainan, Taiwan; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Hospital, Tainan, Taiwan.
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Female urinary incontinence and wellbeing: results from a multi-national survey. BMC Urol 2016; 16:22. [PMID: 27216251 PMCID: PMC4877935 DOI: 10.1186/s12894-016-0140-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/16/2016] [Indexed: 01/06/2023] Open
Abstract
Background Previous research has shown that the severity of symptoms of urinary incontinence impacts on quality of life and wellbeing. The aim of this article is to investigate the relationship between female urinary incontinence and mental wellbeing. This involved analyses comparing those with UI and those without to determine whether any differences in wellbeing were modified by demographic factors, specific wellbeing domain, or exercise and frequency of sex. Following this, further analyses compared sub-groups of those with UI (based on the impact of the UI) to determine which characteristics were important in influencing wellbeing. Methods An internet survey of women with UI, aged between 45 and 60 years, has been previously reported and this article reports secondary analyses of that data. A sample from 4 countries: the UK, France, Germany and the USA. Two thousand four hundred three women completed the survey, 1203 with UI and 1200 who did not report UI. The main outcome measures were the scores from the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Results The results showed that lower wellbeing is observed in UI. This effect is observed in all aspects of wellbeing and most sub-groups of UI sufferers. Lifestyle influences wellbeing and those with UI who exercise less frequently or have sex infrequently are especially likely to report lower wellbeing. Wellbeing decreases as a function of the indirect measures of severity of UI and reductions in HRQol. Again, these changes reflect all aspects of wellbeing measured by WEMWBS. Conclusions The results show that women with UI, aged 45–60 years, report lower wellbeing. This effect was not modified by demographic factors and was apparent in most of the domains measured by the WEMWBS. The reduced wellbeing was related to the impact of the UI on behaviour, embarrassment associated with it, and frequency of leakage.
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Pierce H, Perry L, Chiarelli P, Gallagher R. A systematic review of prevalence and impact of symptoms of pelvic floor dysfunction in identified workforce groups. J Adv Nurs 2016; 72:1718-34. [PMID: 26887537 DOI: 10.1111/jan.12909] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2015] [Indexed: 11/27/2022]
Abstract
AIM To investigate the prevalence and impact of symptoms of pelvic floor dysfunction in identified workforce groups. BACKGROUND Productivity of workforce groups is a concern for ageing societies. Symptoms of pelvic floor dysfunction are associated with ageing and negatively influence psychosocial health. In the general population, lower urinary tract symptoms negatively influence work productivity. DESIGN A systematic review of observational studies. DATA SOURCES Electronic searches of four academic databases. Reference lists were scanned for relevant articles. The search was limited to English language publications 1990-2014. REVIEW METHODS The Centre for Reviews and Dissemination procedure guided the review method. Data extraction and synthesis was conducted on studies where the workforce group was identified and the type of pelvic floor dysfunction defined according to accepted terminology. Quality appraisal of studies was performed using a Joanna Briggs Institute critical appraisal tool. RESULTS Twelve studies were identified of variable quality, all on female workers. Nurses were the most frequently investigated workforce group and urinary incontinence was the most common subtype of pelvic floor dysfunction examined. Lower urinary tract symptoms were more prevalent in the studied nurses than related general populations. No included study investigated pelvic organ prolapse, anorectal or male symptoms or the influence of symptoms on work productivity. CONCLUSION Lower urinary tract symptoms are a significant issue among the female nursing workforce. Knowledge of the influence of symptoms on work productivity remains unknown. Further studies are warranted on the impact of pelvic floor dysfunction subtypes in workforce groups.
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Affiliation(s)
- Heather Pierce
- Faculty of Health, University of Technology Sydney, New South Wales, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, New South Wales, Australia.,Nursing Research and Practice Development, Prince of Wales Hospital & Sydney, Sydney Eye Hospitals, New South Wales, Australia
| | - Pauline Chiarelli
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robyn Gallagher
- Faculty of Health, University of Technology Sydney, New South Wales, Australia.,Charles Perkins Centre, Sydney School of Nursing, University of Sydney, New South Wales, Australia
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Gutshall D, Zhou S, Wang B, Farage MA, Hochwalt AE. Assessing the dermal compatibility of a new female incontinence product line. Cutan Ocul Toxicol 2015; 35:287-95. [PMID: 26621074 DOI: 10.3109/15569527.2015.1109519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT We have developed a line of products designed to better meet the overall needs of women suffering from urinary incontinence. The products are more discrete and contain a unique odor neutralizing technology (ONT). OBJECTIVE This paper describes the overall skin compatibility program for this product line in which the new products were compared to negative controls and/or commercially marketed reference products with an established history of safe use. MATERIALS AND METHODS Test products consisted of several product forms (light pads/pantiliners, moderate pads, briefs and taped diapers) with ONT and having various degrees of protection. Studies were conducted using standard protocols for 4-day and 21-day cumulative irritation, the Human Repeat Insult Patch Test (HRIPT), and the Behind-the-Knee (BTK) test for mechanical and chemical irritation. In one 4-day irritation study and one HRIPT, test subjects consisted of individuals with self-assessed sensitive skin. In addition, one 4-day study was conducted using normal skin sites, and sites compromised by tape stripping. Nonirritant controls were physiologic saline and/or current, commercially marketed incontinence products. All responses were evaluated by visual scoring of erythema. In addition, in the BTK, transepidermal water loss (TEWL) and adverse sensory effects collected from panelists' daily diaries were also evaluated. RESULTS AND DISCUSSION Two 4-day cumulative irritation studies and one 21-day study demonstrated that a wide range of product forms (liners, light and moderate pads, briefs and adult diapers) produced skin reactions similar to the nonirritant controls. The 4-day study conducted using sensitive skin subjects showed good skin compatibility, and the test products were comparable to the nonirritant controls. In the 4-day study with both normal and compromised skin sites, test products produced mean erythema scores similar to the nonirritant controls. Three HRIPT separate studies confirm that the products do not induce contact sensitization, including one study conducted on individuals with self-assessed sensitive skin. In the BTK, test and control products produced similar irritation, as assessed by erythema, TEWL and sensory effects. CONCLUSION The results from the patch tests and mechanical irritation test demonstrate good skin compatibility of the new line of products with the unique ONT. In addition, the forms of the product (i.e. liner, pad or brief), were equally compatible with skin.
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Affiliation(s)
| | | | | | | | - Anne E Hochwalt
- d Fem Care Global Product Stewardship , Procter & Gamble , Cincinnati , OH , USA
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Greater Independence in Activities of Daily Living is Associated with Higher Health-Related Quality of Life Scores in Nursing Home Residents with Dementia. Healthcare (Basel) 2015; 3:503-18. [PMID: 27417776 PMCID: PMC4939554 DOI: 10.3390/healthcare3030503] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/16/2015] [Accepted: 06/24/2015] [Indexed: 11/16/2022] Open
Abstract
Health-related quality of life (HRQL) for nursing home residents is important, however, the concept of quality of life is broad, encompasses many domains and is difficult to assess in people with dementia. Basic activities of daily living (ADL) are measured routinely in nursing homes using the Resident Assessment Instrument-Minimum Data Set Version 2.0 (RAI-MDS) and Functional Independence Measure (FIM) instrument. We examined the relationship between HRQL and ADL to assess the future possibility of ADL dependency level serving as a surrogate measure of HRQL in residents with dementia. To assess ADL, measures derived from the RAI-MDS and FIM data were gathered for 111 residents at the beginning of our study and at 6-month follow-up. Higher scores for independence in ADL were correlated with higher scores for a disease-specific HRQL measure, the Quality of Life-Alzheimer's Disease Scale. Preliminary evidence suggests that FIM-assessed ADL is associated with HRQL for these residents. The associations of the dressing and toileting items with HRQL were particularly strong. This finding suggests the importance of ADL function in HRQL. The RAI-MDS ADL scales should be used with caution to evaluate HRQL.
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Lung-Cheng Huang C, Ho CH, Weng SF, Hsu YW, Wang JJ, Wu MP. The association of healthcare seeking behavior for anxiety and depression among patients with lower urinary tract symptoms: a nationwide population-based study. Psychiatry Res 2015; 226:247-51. [PMID: 25623018 DOI: 10.1016/j.psychres.2014.12.056] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 11/09/2014] [Accepted: 12/29/2014] [Indexed: 12/13/2022]
Abstract
Lower urinary tract symptoms (LUTS) have a negative impact on the quality of life, and may relate to anxiety and depression. The objective of this study was to test the hypothesis that LUTS are associated with anxiety and depression using a nationwide population-based database in Taiwan. Data were obtained from a random population sample of about one million enrollees in the National Health Insurance program from 2001 to 2009, and consisted of 22,980 LUTS patients and 45,960 matched controls. The records of healthcare seeking for anxiety and depression were collected 2 years before and after the diagnosis of LUTS. The results showed that patients with LUTS had a significantly higher prevalence of anxiety or depression than the matched controls (11.45% vs. 5.72%). After controlling for sociodemographic variables and other major systemic diseases, the odds ratios for anxiety, depression, either anxiety or depression, and both anxiety and depression, were 2.05, 2.19, 2.14, and 2.56, respectively. There was an association between LUTS and the stress-related common mental disorders, and there seemed to be an additive effect of anxiety and depression on the association with LUTS. These findings imply a psychological role in the pathogenesis or sequelae of LUTS.
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Affiliation(s)
- Charles Lung-Cheng Huang
- Department of Psychiatry, Chi Mei Hospital, Tainan, Taiwan; Department of Social Worker, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Hospital, Tainan, Taiwan; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Medical Research, Chi Mei Hospital, Tainan, Taiwan; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Ya-Wen Hsu
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Hospital, Tainan, Taiwan
| | - Ming-Ping Wu
- Division of Urogynecology and Pelvic Floor Reconstruction, Department of Obstetrics and Gynecology, Chi Mei Hospital, Tainan, Taiwan; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
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Pierce H, Perry L, Gallagher R, Chiarelli P. Pelvic floor health: a concept analysis. J Adv Nurs 2015; 71:991-1004. [PMID: 25675895 DOI: 10.1111/jan.12628] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2015] [Indexed: 12/01/2022]
Abstract
AIM To report an analysis of the concept 'pelvic floor health'. BACKGROUND 'Pelvic floor health' is a term used by multiple healthcare disciplines, yet as a concept is not well defined. DESIGN Rodger's evolutionary view was used to guide this analysis. DATA SOURCES Academic literature databases and public domain websites viewed via the Internet search engine Google. REVIEW METHODS Literature in English, published 1946-July 2014 was reviewed. Websites were accessed in May 2014, then analysed of presentation for relevance and content until data saturation. Thematic analysis identified attributes, antecedents and consequences of the concept. RESULTS Based on the defining attributes identified in the analysis, a contemporary definition is offered. 'Pelvic floor health' is the physical and functional integrity of the pelvic floor unit through the life stages of an individual (male or female), permitting an optimal quality of life through its multifunctional role, where the individual possesses or has access to knowledge, which empowers the ability to prevent or manage dysfunction. CONCLUSION This analysis provides a definition of 'pelvic floor health' that is based on a current shared meaning and distinguishes the term from medical and lay terms in a complex, multifaceted and often under-reported area of healthcare knowledge. This definition provides a basis for theory development in future research, by focusing on health rather than disorders or dysfunction. Further development of the meaning is required in an individual's social context, to ensure a contemporaneous understanding in a dynamic system of healthcare provision.
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Affiliation(s)
- Heather Pierce
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
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Vrijens D, Drossaerts J, van Koeveringe G, Van Kerrebroeck P, van Os J, Leue C. Affective symptoms and the overactive bladder - a systematic review. J Psychosom Res 2015; 78:95-108. [PMID: 25499886 DOI: 10.1016/j.jpsychores.2014.11.019] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 11/17/2014] [Accepted: 11/20/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Overactive bladder syndrome (OAB) is characterised by urgency symptoms, with or without urgency incontinence, usually with frequency and nocturia. Although literature suggest an association between OAB, depression and anxiety, no systematic review has been presented. OBJECTIVE Systematically review the literature on the association of affective conditions with OAB. METHODS Systematic review according to the PRISMA guidelines. This review is registered in the PROSPERO register (CRD4201400664). RESULTS Forty-three articles were included, describing more than 80,000 subjects. Depression and OAB were positively associated in 26 studies, anxiety and OAB in 6 studies. Longitudinal studies reported: a) OAB subjects who developed depression/anxiety or b) depressed/anxious subjects developing OAB, or c) both. The quality of evidence in studies reporting an association between the co-occurrence of OAB and depression was rated level 3 in accordance with the GRADE framework. Evidence reporting on the co-occurrence of anxiety and OAB was rated GRADE level 2. Longitudinal associations between new onset of OAB in depressive subjects was GRADE level 2. Evidence reporting association of OAB with anxiety in longitudinal studies was of GRADE level 1. CONCLUSION To our knowledge, this systematic review is the first to give a comprehensive qualitative overview on the association between OAB and affective symptoms. Many evaluated studies failed to note longitudinal changes and lacked evidence of causality. Still, results revealed an association between OAB and affective symptoms and there is evidence for new onset of OAB in depressive subjects, but further research is necessary to examine the strength of the effect.
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Affiliation(s)
- Desiree Vrijens
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands; Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Jamie Drossaerts
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands; Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Philip Van Kerrebroeck
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands; Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
| | - Jim van Os
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands; King's College London, King's Health Partners, London, Institute of Psychiatry, United Kingdom.
| | - Carsten Leue
- Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.
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Wheeler TL, Illston JD, Markland AD, Goode PS, Richter HE. Life Space Assessment in Older Women Undergoing Non-Surgical Treatment for Urinary Incontinence. ACTA ACUST UNITED AC 2014; 4:809-816. [PMID: 25525562 DOI: 10.4236/ojog.2014.414112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Urinary incontinence (UI) impacts all aspects of life activities. This study aims to characterize change in mobility within the community utilizing the Life Space Assessment (LSA) questionnaire in women undergoing non-surgical UI treatment. DESIGN Prospective cohort study, performed from July 2007 to March 2009, which followed women seeking non-surgical UI treatment and assessed their mobility and symptoms using LSA, Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7) at baseline and 2, 6, and 12 months post-treatment. Estimated Percent Improvement (EPI) and Patient Satisfaction Question (PSQ) were obtained post-treatment. SETTING Outpatient tertiary-care clinic. PARTICIPANTS 70 ambulatory, community-dwelling women, aged 65 years or older, seeking non-surgical care for UI. INTERVENTION Multi-component behavioral and/or pharmacologic therapies. MEASUREMENTS We hypothesized LSA would improve with treatment. Repeated measures analysis with Tukey's HSD and backwards selection linear regression model were performed. RESULTS LSA score decreased from baseline to 2 months (mean±SD; 63±29 to 56±28, p<0.001) and was sustained at 6 and 12 months (54±28, 54±28). UDI scores improved from 36±23 to 25±24, p<0.001, at 2 months, and improvement persisted at 6 and 12 months (22±22, 21±24). Improvements in UDI and patient perceived improvement in UI were not associated with LSA change. Age, race, and depression impacted LSA, which decreased 1-point for each additional year of age (p=0.004), 6-points for each point higher on the Geriatric Depression Scale (GDS) (p=0.002), and 6-points for African American race (p=0.048). CONCLUSION Decreased mobility represented by LSA was related to age, depression, and race, but not UI symptom improvement.
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Affiliation(s)
- Thomas L Wheeler
- Department of Obstetrics and Gynecology, University of South Carolina School of Medicine-Greenville, Greenville, SC
| | - Jana D Illston
- Department of Obstetrics and Gynecology, University of South Carolina School of Medicine-Greenville, Greenville, SC
| | - Alayne D Markland
- Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL
| | - Patricia S Goode
- Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL
| | - Holly E Richter
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL
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White AJ, Reeve BB, Chen RC, Stover AM, Irwin DE. Coexistence of urinary incontinence and major depressive disorder with health-related quality of life in older Americans with and without cancer. J Cancer Surviv 2014; 8:497-507. [PMID: 24770937 PMCID: PMC4127347 DOI: 10.1007/s11764-014-0360-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 03/31/2014] [Indexed: 01/01/2023]
Abstract
PURPOSE This study evaluates the prevalence and factors associated with major depressive disorder (MDD) in a population of cancer survivors and the impact of co-occurring MDD and urinary incontinence (UI) on health-related quality of life (HRQOL). METHODS The prevalence of MDD risk among cancer survivors (breast, prostate, bladder, colorectal, lung, and endometrial/uterine cancers) and those without cancer was estimated using the Surveillance, Epidemiology and End Results Program-Medicare Health Outcomes Survey (SEER-MHOS) linked database (n = 9,282 with cancer/n = 289,744 without cancer). Risk for MDD was measured using three items from the Diagnostic Interview Schedule, and HRQOL was measured by the SF-36. UI was defined as self-reported leakage of urine causing a problem in previous 6 months. Factors associated with MDD were investigated using logistic regression, and the impact of co-occurring MDD and UI on HRQOL scores was determined using linear regression. RESULTS The prevalence of MDD risk ranged from 19.2 % for prostate to 34.1 % for lung. Lung cancer diagnosis was associated with risk of MDD. Being ≥5 years from diagnosis was associated with decreased risk of MDD (prevalence odds ratio (POR) = 0.82, 95 % confidence interval (95 % CI) 0.71, 0.95). The coexistence of both UI and MDD was associated with a decrease across HRQOL subscales; including 40 points on role-emotional (RE) score. CONCLUSIONS Cancer survivors reporting co-occurrence of UI and MDD experienced significant decrements in HRQOL. IMPLICATIONS OF CANCER SURVIVORS Understanding the combined effect of UI and MDD may help clinicians to better recognize and alleviate their effects on cancer survivors' HRQOL.
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Affiliation(s)
- Alexandra J White
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599-7435, USA,
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Choi EPH, Lam CLK, Chin WY. The health-related quality of life of Chinese patients with lower urinary tract symptoms in primary care. Qual Life Res 2014; 23:2723-33. [PMID: 24920054 DOI: 10.1007/s11136-014-0725-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to evaluate the health-related quality of life (HRQOL) of Chinese primary care patients with lower urinary tract symptoms (LUTS). METHODS Five hundred and nineteen primary care subjects with LUTS completed a structured questionnaire containing the International Prostate Symptom Score, the adapted Incontinence Impact Questionnaire-7, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Chinese (HK) SF-12 Health Survey Version 2 (SF-12 v2) and the Depression, Anxiety and Stress Scale-21. RESULTS LUTS patients had poorer HRQOL for the General Health and the Vitality domains and lower Physical Component Summary scores, but better HRQOL for the Role Emotion domain than the adjusted Hong Kong population norms. Clinical factors associated with poorer HRQOL measured by the SF-12 v2 included having more severe LUTS and having more severe depressive, anxiety and stress symptoms. Socio-demographic factors associated with poorer SF-12 v2 were consistent with those found in the general populations. Clinical and socio-demographic factors associated with poorer HRQOL assessed by condition-specific measures included having more severe LUTS (excluding intermittency and straining), the presence of mixed urinary incontinence, having more severe anxiety and stress symptoms, younger age, being not married, being in employment and having a lower household income. CONCLUSIONS LUTS had substantial negative impact on patients' overall health perception and global well-being in Chinese population. A decline in HRQOL might be a key determinant for Chinese patients with LUTS to seek treatment. Patients with nocturia, frequency, urgency or mixed urinary incontinence and younger patients deserve more treatment attention because they appear to have poorer HRQOL.
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Affiliation(s)
- Edmond P H Choi
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong,
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Cai W, Wang J, Wang L, Wang J, Guo L. Prevalence and risk factors of urinary incontinence for post-stroke inpatients in Southern China. Neurourol Urodyn 2013; 34:231-5. [PMID: 24375823 DOI: 10.1002/nau.22551] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 11/26/2013] [Indexed: 11/09/2022]
Abstract
AIMS The prevalence and risk factors of urinary incontinence (UI) for post-stroke inpatients remain unclear. In this study, we aimed to investigate the risk factors associated with the development of UI for post-stroke inpatients in southern China. DESIGN Cross-sectional survey. SUBJECTS AND METHODS A total of 711 post-stroke patients from neurological units at 8 different hospitals in Guangzhou, a city in southern China, were interviewed face to face. Data were collected by a self-designed questionnaire which includes sociodemographic variables, characteristics of stroke, and medical history. RESULTS The prevalence of UI among post-stroke inpatients was 44.3%. By multivariate logistic regression, we found that major risk factors for UI included health care assistant care (OR = 3.935), hemorrhagic stroke (OR = 1.755), mixed stroke (OR = 2.802), parietal lobe lesion (OR = 1.737), chronic cough (OR = 2.099), aphasia (OR = 3.541), and post-stroke depression (OR = 3.398). CONCLUSIONS The prevalence of UI among post-stroke inpatients is high. Stroke inpatients looked after by health care assistant, hemorrhagic stroke, mixed stroke, parietal lobe lesion, chronic cough, aphasia, and post-stroke depression were high-risk groups for UI. These patients should be targeted when planning intervention programs.
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Affiliation(s)
- Wenzhi Cai
- School of Nursing, Southern Medical University, Guangzhou, China; Nanfang Hospital, Southern Medical University, Guangzhou, China
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Abstract
BACKGROUND Tethered cord syndrome is a well-defined condition, the management of which is fairly uniform. In contrast, occult tethered cord syndrome is a recently defined entity, where the management is still controversial. The pathophysiology is unclear and may be conceptually incongruent with current understanding of typical tethered cord syndrome. Presentation, investigation, and management of this condition are reviewed, and current understanding is presented. PURPOSE The aim of this study is to review the presentation, pathophysiology, investigation, and management of occult tethered cord syndrome. METHODS Literature review. RESULTS Patients with occult tethered cord syndrome presents predominantly with urologic symptoms. Adult and pediatric patients vary slightly in their presentation with a higher incidence of pain in the former and incontinence in the latter. Operative management for these patients is associated with consistent improvement in urologic function in particular, although surgery is also associated with risk of worsening symptoms. The natural history of untreated patients is unknown. CONCLUSIONS As occult tethered cord syndrome becomes increasingly recognized, it is important to be aware of the potential benefits of operative intervention for appropriately selected patients. Given that the natural history of this entity remains unknown, a clinical trial is currently underway that may assist in defining the role for operative management in treating this condition.
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