Bladder Control Self-Assessment Questionnaire Research Articles

Electroacupuntura frente al entrenamiento muscular del suelo pélvico para la incontinencia urinaria en mujeres. Un análisis retrospectivo

Introduction and objectivesUrinary incontinence is highly prevalent. The problem is not always solved with medication and/or surgery and they are not without side effects, which has led to the use of acupuncture for the condition. We compare electroacupuncture with pelvic floor muscle training in women with urinary incontinence. MethodsThis is a retrospective, randomised study of 71 women with urinary incontinence and 2 groups: 37 women received electroacupuncture at R 7 points plus pelvic floor muscle training, and another group of 34 women received only pelvic floor muscle training. Electroacupuncture was performed in one session per week for 12 weeks. All participants performed the exercises at home after prior training. Follow-up was conducted over 1 year. Efficacy was assessed using the Spanish versions of the International Consultation on Incontinence Questionnaire-Short Form and the Bladder Control Self-Assessment Questionnaire. The questionnaires were conducted at baseline and at 3, 6, and 12 months. The safety of electroacupuncture was also assessed. ResultsThe reduced score in both questionnaires was clinically and statistically more significant in the electroacupuncture group. DiscussionElectroacupuncture at the R 7 point was identified as more effective than pelvic floor muscle training in women with urinary incontinence, and with very few side effects.

Is there concordance between overactive bladder and detrusor overactivity in men with predominant storage urinary symptoms referred to Functional Urology and Urodynamics Units?

ObjectivesTo assess the diagnostic concordance of overactive bladder (OAB) and detrusor overactivity (DO) in male patients with predominant storage lower urinary tract symptoms (LUTS) and evaluate their clinical and urodynamic profile according to DO presence and degree of obstruction. Material and methodsEpidemiological, cross-sectional multicenter study. A 3-day bladder diary (3dBD), International Prostate Symptom Score (IPSS) and Bladder Control Self-Assessment Questionnaire (B-SAQ) questionnaires were analyzed. Prostate volume was determined by ultrasound. Urodynamic study (UDS) tests were performed. The prevalence of OAB and DO and the degree of clinical concordance (kappa index) were investigated. Descriptive analysis of clinical variables and UDS results was performed, followed by comparisons based on the presence of DO and degree of obstruction. ResultsA total of 445 patients were included. The mean age was (SD) 54.8 (9.9) years. According to 3dBD, 89.9% presented increased urinary frequency, 87.9% nocturia, 72.1% urgency, and 31.9% urge urinary incontinence (UUI). Obstruction was present in 36.8%. Concomitant OAB and DO were present in 54.5%. The degree of diagnostic concordance between OAB and DO was low (κ = 0.1772). There were more patients with DO presenting urgency (3dBD and B-SAQ; p < 0.001), UUI (3dBD; p = 0.008) and nocturia (B-SAQ; p < 0.001). Differences were found in terms of prostate volume, IPSS-voiding, maximum flow (Qmax) and post-void residual (p < 0.05) according to the obstruction degree. ConclusionsApproximately 50% of male patients aged 18–65 years old with predominant storage LUTS, referred to specialized units, have both OAB and DO. Obstruction is present on 1/3. Diagnostic concordance between OAB and DO is poor.

¿Existe concordancia entre vejiga hiperactiva e hiperactividad del detrusor en varones con síntomas predominantemente de llenado derivados a Unidades de Urología Funcional y Urodinámica?

ObjectiveTo assess the diagnostic concordance of overactive bladder (OAB) and detrusor overactivity (DO) in male patients with predominant storage lower urinary tract symptoms (LUTS) and evaluate their clinical and urodynamic profile according to DO presence and degree of obstruction. Material and methodsEpidemiological, cross-sectional multicenter study. A 3-day bladder diary (3dBD), International Prostate Symptom Score (IPSS) and Bladder Control Self-Assessment Questionnaire (B-SAQ) questionnaires were analyzed. Prostate volume was determined by ultrasound. Urodynamic study (UDS) tests were performed. The prevalence of OAB and DO and the degree of clinical concordance (kappa index) were investigated. Descriptive analysis of clinical variables and UDS results was performed, followed by comparisons based on the presence of DO and degree of obstruction. ResultsA total of 445 patients were included. The mean age was (SD) 54.8 (9.9) years. According to 3dBD, 89.9% presented increased urinary frequency, 87.9% nocturia, 72.1% urgency, and 31.9% urge urinary incontinence (UUI). Obstruction was present in 36.8%. Concomitant OAB and DO were present in 54.5%. The degree of diagnostic concordance between OAB and DO was low (κ=0.1772). There were more patients with DO presenting urgency (3dBD and B-SAQ; p<0.001), UUI (3dBD; p=0.008) and nocturia (B-SAQ; p<0.001). Differences were found in terms of prostate volume, IPSS-voiding, maximum flow (Qmax) and post-void residual (p<0.05) according to the obstruction degree. ConclusionsApproximately 50% of male patients aged 18-65 years old with predominant storage LUTS, referred to specialized units, have both OAB and DO. Obstruction is present on 1/3. Diagnostic concordance between OAB and DO is poor.

Urinary Incontinence Is Associated With Increased All-Cause Mortality in Older Nursing Home Residents: A Meta-Analysis.

Urinary incontinence is a syndrome common in older adults, but it is not clear whether urinary incontinence is associated with the risk for mortality in elderly nursing home residents. We conducted a systematic review and meta-analysis in PubMed, Cochrane, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. The meta-analysis was summarized using a random-effects or fixed-effects model, and the heterogeneity among studies was examined using the I2 statistic. Six cohort studies with 1,656 participants were included in the final analysis. The NOS score for each study was greater than 6. Urinary incontinence was significantly associated with a higher risk for mortality in nursing homes, with a hazard ratio (HR) of 1.20 (95% confidence interval [CI] 1.12-1.28, I2 = 41.6%). The significant association of urinary incontinence with increased mortality risk was observed in subgroup analysis according to region, status of dementia, and follow-up period, with a pooled HR of 2.02 (95% CI 1.32-3.11, I2 = 0%) for Asian countries, 1.18 (95% CI 1.11-1.26, I2 = 41.6%) for Western countries, 1.17 (95% CI 1.09-1.26, I2 = 0%) for patients with dementia, 1.35 (95% CI 1.13-1.60, I2 = 58.9%) for patients without dementia, 1.16 (95% CI 1.07-1.25, I2 = 43.2%) for studies with a follow-up period of 1 year, and 1.30 (95% CI 1.15-1.48, I2 = 24.5%) for studies with a follow-up period of more than 1 year. Urinary incontinence is associated with an increased risk for death among residents of care facilities. Therefore, it was necessary to screen the elderly dwelling in nursing homes who were experiencing or at risk for urinary incontinence with useful tools (e.g., overactive bladder symptom score, bladder control self-assessment questionnaire, three incontinence questions). In addition, early interventions strategies, such as weight loss, stopping smoking, pelvic floor muscle training, and medical and surgical treatments would contribute to decreasing the risk for urinary incontinence and preventing adverse outcomes in nursing home residents. In our study, we found that the elderly with urinary incontinence who resided in nursing homes had a higher risk for mortality than those without urinary incontinence. Therefore, urinary incontinence in the elderly residing in nursing homes is of particular concern. Early detection and intervention are important for the elderly with urinary incontinence, and caregivers should be made aware of this importance.

The Turkish Language and Psychometric Validation of the “Bladder Control Self-assessment Questionnaire” Evaluating the Lower Urinary Tract Dysfunction

The Turkish Language and Psychometric Validation of the “Bladder Control Self-assessment Questionnaire” Evaluating the Lower Urinary Tract Dysfunction

Do Older Adults with Overactive Bladder Demonstrate Impaired Executive Function Compared to Their Peers Without OAB?

BackgroundMaintaining urinary continence is not an automatic process, but relies on continuous processing of sensory signals from the bladder and suppression of the desire to void. Urinary incontinence (UI) and lower urinary tract symptoms (LUTS), including urinary urgency, frequency, and nocturia are highly prevalent among the general population. This prevalence rises in association with increasing age, and this may be in part due to changes in the central nervous system rather than the urinary tract. The aim of this study was to assess if older adults with overactive bladder (OAB) had demonstrable impairment in executive function.MethodsThis was a cross-sectional study comparing the performance of adults aged 65 and over with and without OAB on two cognitive tests, the Trail Making Test B (TMT-B) and simple reaction time (SRT). OAB was defined as urgency, with at least weekly urgency incontinence and a daytime urinary frequency of 8 or more. The control group were defined as a Bladder control Self-Assessment Questionnaire (B-SAQ) score of ≤4.Results56 participants were recruited, of whom 35 met criteria for OAB. The OAB group took significantly longer to complete the TMT-B than the control group (103s vs. 77s, p = .003). There was no difference in the SRTConclusionsIn this sample of older adults, OAB was associated with measurable slower performance on the TMT-B, suggesting that impaired executive function is associated with OAB.

Clinical and urodynamic impact of detrusor overactivity in women with overactive bladder

ObjectiveTo evaluate the clinical and urodynamic differences associated with the presence or absence of detrusor overactivity (DO) in women with overactive bladder (OAB) referred to Functional Urology and Urodynamic Units in Spain. Material and methodsObservational, cross-sectional, multicenter and prospective study conducted in Spain in women with clinical diagnosis of OAB, who had been referred to urodynamic study (UDS) of which centralized reading was performed. Patients completed the 3-day bladder diary (DM3d) with the PPIUS scale (Patient Perception of Intensity of Urgency Scale), the B-SAQ (Bladder control Self-Assessment Questionnaire) and the OABq-SF (Overactive Bladder Questionnaire Short Form). The questionnaires and UDS variables of women with OAB, with or without DO, were compared using the Mann-Whitney test (continuous variables) and the chi-square test (χ2) (categorical variables). ResultsA total of 247 women with OAB were evaluated, and 103 of them had DO. According to the presence or absence of DO, significant differences were observed in the number of episodes of urge urinary incontinence (UUI), urinary frequency, nocturia, mean micturition volume and number of pads (p<0.05 for all comparisons). A higher percentage of patients with OAB and DO presented reduced bladder capacity, urgency, urge urinary incontinence (UUI) and lower volume for first voiding desire, strong desire to void and maximum cystomanometric capacity in UDS compared with patients without DO (p<0.05 for all comparisons). The only significant differences between both groups were regarding the B-SAQ symptoms scale (p=0.011). ConclusionsThe presence of DO in women with OAB is related to a more severe alteration of the bladder storage phase.

Cognitive function assessment in elderly patients with overactive bladder treated with transdermal oxybutynin

Introduction and objectivesOlder patients with overactive bladder under antimuscarinic treatment are especially susceptible to cognitive impairment. The aim was to assess short term changes in cognitive function in elderly patients with overactive bladder treated with transdermal oxybutynin. Materials and methodsObservational, retrospective, multicentre study in patients with overactive bladder aged 65–80 years undergoing treatment with transdermal oxybutynin. Before and after one month of treatment, cognitive function using the Memory Alteration Test and Clock-Drawing Test, changes in symptoms with validated questionnaires, patient perception of treatment response using Treatment Benefit Scale and treatment adherence with the modified Morisky–Green test, were assessed. ResultsFrom 85 eligible patients, 70 completed the assessment (mean age: 71.4±4.5; BMI: 28.7±3.1kg/m2). No cognitive impairment was observed after one month with transdermal oxybutynin: Memory Alteration Test (+1 point; 95%CI: 0.0–1.5), Clock-Drawing Test (0 points; 95%CI: 0.0–0.0). A statistically significant improvement (p<0.001) was observed in all urinary storage symptoms, except stress urinary incontinence. There was an improvement in the Bladder Control Self-Assessment Questionnaire (symptom score: −2.27; 95%CI: −2.8, −1.7; p<0.001; bother score: −2.73; 95%CI: −3.3, −2.1; p<0.001). 70% of patients reported either a stable or improved bladder condition according to the Patient Perception of Bladder Condition questionnaire. 72.8% of patients reported that their urinary problems had improved or greatly improved with an 84.3% treatment adherence. ConclusionsNo cognitive impairment was observed in elderly patients after one month of treatment with transdermal oxybutynin; urinary urgency symptoms improved and there was adequate treatment adherence.

Evaluación de la función cognitiva en pacientes de edad avanzada con vejiga hiperactiva tratados con oxibutinina transdémica

Introduction and objectivesOlder patients with overactive bladder under antimuscarinic treatment are especially susceptible to cognitive impairment. The aim was to assess short term changes in cognitive function in elderly patients with overactive bladder treated with transdermal oxybutynin. Materials and methodsObservational, retrospective, multicentre study in patients with overactive bladder aged 65-80 years undergoing treatment with transdermal oxybutynin. Before and after one month of treatment, cognitive function using the Memory Alteration Test and Clock-Drawing Test, changes in symptoms with validated questionnaires, patient perception of treatment response using Treatment Benefit Scale and treatment adherence with the modified Morisky-Green test, were assessed. ResultsFrom 85 eligible patients, 70 completed the assessment (mean age: 71.4±4.5; BMI: 28.7±3.1kg/m2). No cognitive impairment was observed after one month with transdermal oxybutynin: Memory Alteration Test (+1 point; 95%CI: 0.0-1.5), Clock-Drawing Test (0 points; 95%CI: 0.0-0.0). A statistically significant improvement (P<.001) was observed in all urinary storage symptoms, except stress urinary incontinence. There was an improvement in the Bladder Control Self-Assessment Questionnaire (symptom score: −2.27; 95%CI: −2.8, −1.7; P<.001; bother score: −2.73; 95%CI: −3.3, −2.1; P<.001). 70% of patients reported either a stable or improved bladder condition according to the Patient Perception of Bladder Condition questionnaire. 72.8% of patients reported that their urinary problems had improved or greatly improved with an 84.3% treatment adherence. ConclusionsNo cognitive impairment was observed in elderly patients after one month of treatment with transdermal oxybutynin; urinary urgency symptoms improved and there was adequate treatment adherence.

Screening for Urinary Incontinence in Women: A Systematic Review for the Women's Preventive Services Initiative.

Urinary incontinence is infrequently addressed during routine health care despite its high prevalence and adverse effects on health. To evaluate whether screening for urinary incontinence in women not previously diagnosed improves outcomes (symptoms, quality of life, and function) and to evaluate the accuracy of screening methods and potential harms of screening. English-language searches of Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (1 January 1996 to 30 March 2018); ClinicalTrials.gov (April 2018); and reference lists of studies and reviews. Randomized trials, cohort studies, systematic reviews of studies that enrolled nonpregnant women without previously diagnosed urinary incontinence and compared clinical outcomes and adverse effects between women who were and were not screened, and diagnostic accuracy studies that reported performance measures of screening tests. Dual extraction and quality assessment of individual studies. No studies evaluated the overall effectiveness or harms of screening. Seventeen studies evaluated the diagnostic accuracy of 18 screening questionnaires against a clinical diagnosis or results of diagnostic tests. Of these, 14 poor-quality studies were based in referral clinics, enrolled only symptomatic women, or had other limitations. One good-quality and 2 fair-quality studies (evaluating 4 methods) enrolled women not recruited on the basis of symptoms. Areas under the receiver-operating characteristic curve for stress, urge, and any type of incontinence in these studies were 0.79, 0.88, and 0.88 for the Michigan Incontinence Symptom Index; 0.85, 0.83, and 0.87 for the Bladder Control Self-Assessment Questionnaire; and 0.68, 0.82, and 0.75 for the Overactive Bladder Awareness Tool. The Incontinence Screening Questionnaire had a sensitivity of 66% and specificity of 80% for any type of incontinence. Studies enrolled few participants, often from symptomatic referral populations; used various reference standards; and infrequently reported CIs. Evidence is insufficient on the overall effectiveness and harms of screening for urinary incontinence in women. Limited evidence in general populations suggests fairly high accuracy for some screening methods. Health Resources and Services Administration.

Impact of overactive bladder symptoms on work activity: The ACTIVHA study

ObjectivesTo analyze the impact of overactive bladder (OAB) symptoms on the work activity of patients in Spain. MethodAn observational, multicentre cross-sectional study was conducted with 149 urologists and 131 gynecologists of Spain and included patients diagnosed with OAB, according to clinical judgment, who were of working age (18–65 years). We collected sociodemographic, clinical and work activity data. The patients filled out the Bladder Control Self-Assessment Questionnaire (B-SAQ) and the Work Productivity and Activity Impairment Questionnaire-General Health (WPAI-GH). The effect of each symptom on the daily and occupational activity was assessed. The results were stratified according to sex and the presence of urgency and urinary incontinence (UI) according to the B-SAQ. ResultsWe assessed 768 patients (89% women), with a mean (SD) age of 52.5 (9.3) years and 2.6 (2.6) years of OAB progression. The most common symptoms according to the patients urgency (89.8%), nocturia (75.7%), urge urinary incontinence (68.5%) and frequency (68.2%). Ninety-six percent of the patients adopted adaptive measures for their OAB. According to the B-SAQ, 543 patients (71%) presented urgency; of these, 294 (54%) showed UI. The symptom that most affected work activity was frequency (59.8%). According to the WPAI-GH, the patients reported an impact of 32% during the workday (41% in patients urgency and UI) and a work time missed due to OAB of 6.5% (9.9% in patients with urgency and UI). ConclusionsThe symptoms of OAB negatively affect work activity, especially in patients who have urgent urination and UI.

Impacto de los síntomas de vejiga hiperactiva sobre la actividad laboral: estudio ACTIVHA

ObjectivesTo analyse the impact of overactive bladder (OAB) symptoms on the work activity of patients in Spain. MethodAn observational, multicentre cross-sectional study was conducted with 149 urologists and 131 gynaecologists of Spain and included patients diagnosed with OAB, according to clinical judgment, who were of working age (18-65 years). We collected sociodemographic, clinical and work activity data. The patients filled out the Bladder Control Self-Assessment Questionnaire (B-SAQ) and the Work Productivity and Activity Impairment Questionnaire-General Health (WPAI-GH). The effect of each symptom on the daily and occupational activity was assessed. The results were stratified according to sex and the presence of emergency and urinary incontinence (UI) according to the B-SAQ. ResultsWe assessed 768 patients (89% women), with a mean (SD) age of 52.5 (9.3) years and 2.6 (2.6) years of OAB progression. The most common symptoms according to the patients were urgent urination (89.8%), nocturia (75.7%), urge incontinence (68.5%) and frequent urination (68.2%). Ninety-six percent of the patients adopted adaptive measures for their OAB. According to the B-SAQ, 543 patients (71%) presented urgent urination; of these, 294 (54%) showed UI. The symptom that most affected work activity was frequent urination (59.8%). According to the WPAI-GH, the patients reported an impact of 32% during the workday (41% in patients with urgent urination and UI) and a loss of work time of 6.5% (9.9% in patients with urgent urination and UI). ConclusionsThe symptoms of OAB negatively affect work activity, especially in patients who have urgent urination and UI.

Clinical characteristics, beliefs, and coping strategies among older patients with overactive bladder.

To describe clinical characteristics and assess beliefs and coping strategies in older patients with overactive bladder (OAB) attending urology and gynecology clinics in Spain. This non-interventional, multicenter, cross-sectional study collected demographic and clinical details from individuals aged ≥60 years with a diagnosis of OAB and score ≥3 on the Patient Perception of Intensity of Urgency Scale. Symptoms were assessed using the Bladder Control Self-Assessment Questionnaire (B-SAQ) and Health-Related Quality of Life (HRQoL) rated using a simple visual analogue scale. Coping strategies and OAB beliefs were assessed using two specially designed questionnaires. Patients (n = 786) reported a mean (±SD) of 4.9 ± 2.9 urinary urgency episodes and 2.9 ± 2.3 urgency urinary incontinence (UUI) episodes per 24 hr. Mean times since diagnosis and symptom onset were 18 ± 34 and 38 ± 46 months, respectively. B-SAQ symptom and bother scores were 7.5 ± 2.3 and 8.3 ± 2.5, respectively. Most patients (92%) reported worse HRQoL after symptom onset. Approximately, 50% of patients considered their symptoms normal for their age/gender and most (71.5%) expected symptoms to worsen with age/time. However, 80% believed that symptoms would improve with treatment. For coping strategies, 81% of patients changed their urinary frequency, 71% controlled fluid intake, and 64% used pads. Use of coping strategies was associated with UI severity. Many older individuals view their OAB symptoms as a normal feature of age, which may delay diagnosis. Reduced HRQoL and adoption of coping strategies are also common. The results support the need for improved patient education, earlier recognition, and effective intervention in the older OAB population. Neurourol. Urodynam. 36:774-779, 2017. © 2016 Wiley Periodicals, Inc.

Estimulación transcutánea del nervio tibial posterior versus darifenacina para el tratamiento de vejiga hiperactiva refractaria en mujeres

AimTo compare the results of transcutaneous posterior tibial nerve stimulation vs. darifenacin for the treatment of refractory overactive bladder in women. Material and methodsA quasi-experimental clinical trial was conducted on 30 women diagnosed with refractory overactive bladder. Twenty-two patients received 7.5mg of oral darifenacin daily and 8 patients had 12 30-min weekly sessions of transcutaneous electrostimulation of the posterior tibial nerve. The patients kept a 3-day urinary diary, underwent pad tests, and the quality of life Bladder Control Self-Assessment Questionnaire and International Consultation on Incontinence Questionnaire were applied at the baseline, at 6 weeks, and at 12 weeks of the study. ResultsAt 6 weeks, the patients treated with darifenacin presented with a reduction in urinary frequency (8.27 vs. 11.5, p=0.236), in nocturia (1.36 vs. 4.25, p=0.017), and in incontinence episodes (1.32 vs. 3.62, p=0.041), compared with the patients that received stimulation treatment. In regard to the quality of life questionnaires, at 6 weeks the patients that received darifenacin treatment had a lower score on the self-assessment questionnaire (7.13 vs. 10.14, p=0.045). In relation to the pad test, after comparing the measurements at the beginning and end of treatment, there was reduced urine leakage in grams with darifenacin (69.32 vs. 2.09, p=0.041) and with stimulation (42.25 vs. 2.62, p=0.012), with no statistical significance between the 2 groups (p=0.753). ConclusionsDarifenacin was superior to transcutaneous stimulation of the posterior tibial nerve in relation to symptom reduction, urine leakage, and questionnaire scores at 6 weeks. There was no statistically significant difference between the 2 groups at 12 weeks.

How should we address the diagnosis of overactive bladder in women?

ObjectiveDetermine the degree of completion, agreement and diagnostic performance of various instruments for assessing the presence and intensity of urgency and other symptoms of idiopathic overactive bladder (OAB) and determine which is the best diagnostic combination. Material and methodsObservational, noninterventional, cross-sectional multicentre study on 247 women aged 18 years or older, with a clinical diagnosis of OAB, evaluated in 55 functional urology and urodynamic units. The women completed the Patient Perception of Intensity of Urgency Scale questionnaire, an independent bladder control self-assessment questionnaire (B-SAQ), the Overactive Bladder Questionnaire Short-Form and a 3-day voiding diary (VD3d), and they underwent a urodynamic study (UDS). The degree of completion and agreement among the instruments was assessed using the Kappa index (95% CI) and Cramér's V. The diagnostic performance of each tool and their combination was studied using absolute frequencies of positive cases for each OAB symptom. ResultsThe patients mean age was 57.66 years (SD, 13.43). There was a high degree of completion (>85%). The agreement among the instruments was poor or moderate, and there was no agreement with the UDS. The best combination of tools for the diagnosis of OAB in women was the B-SAQ and VD3d. ConclusionsThe degree of completion of all instruments was high, the agreement between them was poor-moderate and not significant for the UDS. The instruments that had the best diagnostic performance for assessing urgency and other OAB symptoms, providing data on their severity and discomfort, were the B-SAQ and the VD3d.

¿Cómo debemos abordar el diagnóstico de la vejiga hiperactiva en mujeres?

ObjectiveDetermine the degree of completion, agreement and diagnostic performance of various instruments for assessing the presence and intensity of urgency and other symptoms of idiopathic overactive bladder (OAB) and determine which is the best diagnostic combination. Material and methodsObservational, noninterventional, cross-sectional multicentre study on 247 women aged 18 years or older, with a clinical diagnosis of OAB, evaluated in 55 functional urology and urodynamic units. The women completed the Patient Perception of Intensity of Urgency Scale questionnaire, an independent bladder control self-assessment questionnaire (B-SAQ), the Overactive Bladder Questionnaire Short-Form and a 3-day voiding diary (VD3d), and they underwent a urodynamic study (UDS). The degree of completion and agreement among the instruments was assessed using the Kappa index (95% CI) and Cramér's V. The diagnostic performance of each tool and their combination was studied using absolute frequencies of positive cases for each OAB symptom. ResultsThe patients mean age was 57.66 years (SD, 13.43). There was a high degree of completion (>85%). The agreement among the instruments was poor or moderate, and there was no agreement with the UDS. The best combination of tools for the diagnosis of OAB in women was the B-SAQ and VD3d. ConclusionsThe degree of completion of all instruments was high, the agreement between them was poor-moderate and not significant for the UDS. The instruments that had the best diagnostic performance for assessing urgency and other OAB symptoms, providing data on their severity and discomfort, were the B-SAQ and the VD3d.

Validation of the bladder control self‐assessment questionnaire (B‐SAQ) in men

To validate the Bladder Control Self-Assessment Questionnaire (B-SAQ), a short screener to assess lower urinary tract symptoms (LUTS) and overactive bladder (OAB) in men. This was a prospective, single-centre study including 211 patients in a urology outpatient setting. All patients completed the B-SAQ and Kings Health Questionnaire (KHQ) before consultation, and the consulting urologist made an independent assessment of LUTS and the need for treatment. The psychometric properties of the B-SAQ were analysed. A total of 98% of respondents completed all items correctly in <5 min. The mean B-SAQ scores were 12 and 3.3, respectively for cases (n = 101) and controls (n = 108) (P < 0.001). Good correlation was evident between the B-SAQ and the KHQ. The agreement percentages between the individual B-SAQ items and the KHQ symptom severity scale were 86, 85, 84 and 79% for frequency, urgency, nocturia and urinary incontinence, respectively. Using a B-SAQ symptom score threshold of ≥4 alone had sensitivity, specificity and positive predictive values for detecting LUTS of 75, 86 and 84%, respectively, with an area under the curve of 0.88; however, in combination with a bother score threshold of ≥1 these values changed to 92, 46 and 86%, respectively. The B-SAQ is an easy and quick valid case-finding tool for LUTS/OAB in men, but appears to be less specific in men than in women. The B-SAQ has the potential to raise awareness of LUTS. Further validation in a community setting is required.

Assessment of the psychometric properties of the Spanish language version of questionnaire ICIQ-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS)

ObjectivesTo evaluate the psychometric properties of the Spanish version of the ICIQ-Male Lower Urinary Tract Symptoms Questionnaire (ICIQ-MLUTS): feasibility (% of completion and ceiling/ground effects), reliability (test-retest), convergent validity (vs. Bladder Control Self-Assessment Questionnaire [BSAQ] and vs. International Prostate Symptom Score [I-PSS]) and criterion validity (according to presence or absence of symptoms). Materials and methodsThis was an observational, non-interventionist and multicenter study. 223 male patients with lower urinary tract symptoms (LUTS), predominantly storage symptoms and aged 18–65, took part in the study. Patients completed the ICIQ-MLUTS (test), I-PSS and BSAQ questionnaires and referred their urinary symptoms in a single visit, with the exception of a subgroup composed by 49 patients who completed the questionnaire again 15 days after initial visit to evaluate test-retest reliability. The questionnaire includes 13 items divided in 2 sub-scales: Voiding symptoms (V) from 0 to 20 and Incontinence symptoms (I) from 0 to 24. ResultsPercentage of patients who completed all items: 98.84%. Ground effect is 0 and ceiling effect was under 6% in both sub-scales. Test-retest reliability: Intraclass correlation coefficient (ICC) ranged from 0.68 to 0.88, except on Delay. Kappa shows a good agreement, between 0.60 and 0.81, except for Nocturia. Convergent validity: Correlation (Spearman) between the questionnaire sub-scales scores and the rest of measures is statistically significant (p<.01 and p<.05). Criterion validity: Statistically significant differences (p<.05) between scores on ICIQ-MLUTS, from patients who refer experiencing symptoms and those who do not. ConclusionThe Spanish version of the ICIQ-MLUTS questionnaire shows adequate feasibility, reliability and validity.

The 3-day bladder diary is a feasible, reliable and valid tool to evaluate the lower urinary tract symptoms in women

To evaluate the feasibility (% of completion), reliability (test-retest and inter-observer) and validity (convergent vs. questionnaires and vs. urodynamic study-UDS) of the 3-day bladder diary (3dBD) in women with lower urinary tract symptoms (LUTS). Epidemiological, descriptive, cross-sectional and prospective study. Fourteen Functional Urology and Urodynamic Units participated. One hundred thirty-six women with mean age (SD) 55.2 (13.8) years with LUTS, without bladder catheterization and who were able to fill in the 3dBD were included. An UDS was performed. They filled in the 3dBD in two times separated by 15 days (test and retest), the International Consultation on Incontinence-Short Form (ICIQ-UI SF) and the Bladder Control Self-Assessment Questionnaire (BSAQ). One hundred ten women completed 3dBD for test and retest. Feasibility: each 3dBD has 42 variables, 77.2% women completed 80%. Test-retest reliability: there were not differences in the proportion of patients classified as positive for each symptom (urgency: P = 0.3173; incontinence: P = 1; nocturia: P = 0.0522; frequency: P = 0.4386). The Intraclass Correlation Coefficient (ICC) ranged from 0.67 to 0.92, except for night time VVmax which was lower (0.54). Inter-observer reliability: ICC ranged from 0.64 to 0.99, except for day time VVmax (0.29) and the number of urgency episodes (0.45). Spearman correlation coefficients for ICIQ-UI SF and BSAQ ranged from 0.4 to 0.6 (P < 0.0001) and for UDS were lower (P < 0.05). The 3dBD showed good feasibility, reliability and validity to be used in the assessment of LUTS in women.

Evaluación de las propiedades psicométricas de la versión en español del cuestionario ICIQ-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS) en España

ObjectivesTo evaluate the psychometric properties of the Spanish version of the ICIQ-Male Lower Urinary Tract Symptoms Questionnaire (ICIQ-MLUTS): Feasibility (% of completion and ceiling/ground effects), reliability (Test-retest), convergent validity (vs Bladder Control Self-Assessment Questionnaire [BSAQ] and vs International Prostate Symptom Score [I-PSS]) and criterion validity (according to presence or absence of symptoms). Material and methodsThis was an observational, non-interventionist and multicenter study. 223male patients with lower urinary tract symptoms (LUTS), predominantly storage symptoms and aged 18-65, took part in the study. Patients completed the ICIQ-MLUTS (test), I-PSS and BSAQ questionnaires and referred their urinary symptoms in a single visit, with the exception of a subgroup composed by 49patients that completed the questionnaire again 15days after initial visit to evaluate test-retest reliability. The questionnaire includes 13items divided in 2sub-scales: Voiding symptoms (V) from 0-20 and Incontinence symptoms (I) from 0-24. ResultsPercentage of patients that completed all items: 98.84%. Ground effect is 0 and ceiling effect was under 6% in both sub-scales. Test-retest reliability: Intraclass correlation coefficient (ICC) ranged from 0.68 to 0.88, except on Delay. Kappa shows a good agreement, between 0.60 and 0.81, except for Nocturia. Convergent validity: Correlation (Spearman) between the questionnaire sub-scales scores and the rest of measures is statistically significant (P<.01 and P<.05). Criterion validity: Statistically significant differences (P<.05) between scores on ICIQ-MLUTS, from patients that refer experiencing symptoms and those who do not. ConclusionThe Spanish version of the ICIQ-MLUTS questionnaire shows adequate feasibility, reliability and validity.