Female Lower Urinary Tract Symptoms Research Articles

Reliability of Uroflowmetry Pattern Interpretation in Adult Women.

Uroflowmetry is often used to assess lower urinary tract symptoms (LUTS). Criteria for characterization of flow patterns are not well established, and subjective interpretation is the most common approach for flow curve classification. We assessed the reliability of uroflowmetry curve interpretation in adult women. Uroflowmetry studies were obtained in 296 women who participated in an observational cohort study. Four investigators with expertise in female LUTS and urodynamics reviewed and categorized each tracing for interrater reliability. A random subset of 50 tracings was re-reviewed by each investigator for intrarater reliability. The uroflowmetry tracings were rated using categories of continuous, continuous fluctuating, interrupted, and prolonged. Other parameters included flow rate, voided volume, time to maximum flow, and voiding time. Agreement between raters is summarized with kappa (k) statistics and percentage where at least three raters agreed. The mean age of participants was 44.8 ± 18.3 years. Participant age categories were 18-24 years: 20%; 25-34 years: 17%; 35-64 years: 42%; 65+ years: 18%. Nine percent described their race as Asian, 31% Black, 62% White, and 89% were of non-Hispanic ethnicity. The interrater reliability was highest for the continuous flow category (k = 0.65), 0.47 for prolonged, 0.41 for continuous fluctuating, and 0.39 for interrupted flow curves. Agreement among at least three raters occurred in 74.3% of uroflow curves (69% for continuous, 33% for continuous fluctuating, 23% for interrupted, and 25% for prolonged). For intrarater reliability, the mean k was 0.72 with a range of 0.57-0.85. Currently accepted uroflowmetry pattern categories have fair to moderate interrater reliability, which is lower for flow curves that do not meet "continuous" criteria. Given the subjective nature of interpreting uroflowmetry data, more consistent and clear parameters may enhance reliability for use in research and as a screening tool for LUTS and voiding dysfunction. Parent trial: Validation of Bladder Health Instrument for Evaluation in Women (VIEW); ClinicalTrials.gov ID: NCT04016298.

Risk factors for long-term urination and sexual function impairment following laparoscopic resection of presacral lesions

BACKGROUNDPresacral cysts are rare congenital lesions predominantly affecting females. Surgery is often recommended after diagnosis due to the risk of malignant transformation and complications associated with cyst enlargement. Laparoscopic excision is increasingly favored due to its enhanced visualization and precision.AIMTo assess long-term urinary, sexual function outcomes and quality of life in female patients undergoing laparoscopic resection of presacral cysts.METHODSWe conducted a retrospective review of female patients who underwent laparoscopic resection of presacral cysts between August 2012 and May 2020. Patient demographics, surgical outcomes, and postoperative complications were analyzed. The urinary function was assessed using the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module (ICIQ-FLUTS), the sexual function was evaluated using the Female Sexual Function Index (FSFI), and quality of life was assessed using the 36-item Short-Form Health Survey (SF-36).RESULTSAmong the 32 female patients included, 10 experienced postoperative urinary incontinence, predominantly of the mixed type. The risk factors for urinary incontinence included abdominal distension and the proximity of the cyst to the rectum. Notably, urinary incontinence significantly impacted the overall lower urinary tract symptoms and quality of life. Additionally, seven patients reported postoperative sexual dysfunction, with previous abdominal or pelvic surgery and cyst location under S3 identified as risk factors, affecting the mental health aspects of their quality of life.CONCLUSIONLaparoscopic cyst resection in females poses risks of urinary and sexual dysfunction, potentially impacting quality of life. Thus, tailored management approaches are crucial.

HAP-PEE: A Danish National Study of Challenges Related to Urinating When Away from Home in Women with Neuromuscular Diseases, Impact on Activity and Participation and Prevalence of Lower Urinary Tract Symptoms.

Little is known about the challenges faced by women with a neuromuscular disease (NMD) when having to go to the toilet in other places than home; a topic that is highly important for participation and bladder health. The aim was to investigate whether women with NMD have problems in going to the toilet when not at home, the problems' impact on their social activities, education, and working life, which strategies they use to manage the problems, and the prevalence of lower urinary tract symptoms (LUTS). A national survey containing questions on type of NMD, mobility, impacts on social activities, education, working life, and bladder health was developed by women with NMD and researchers. LUTS were assessed by the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS). Female patients≥12 years (n = 1617) registered at the Danish National Rehabilitation Centre for Neuromuscular Diseases were invited. 692 women (43%) accepted the invitation; 21% were non-ambulant. 25% of respondents avoided going to the toilet when not at home. One third of respondents experienced that problems in going to the toilet impacted their social life. 43% of respondents refrained from drinking to avoid voiding when not at home, 61% had a low frequency of urinating, 17% had experienced urinary tract infections, and 35% had experienced urine incontinence. Problems were seldom discussed with professionals, only 5% of participants had been referred to neuro-urological evaluation. The results highlight the difficulties in urinating faced by women with NMD when not at home and how these difficulties impact functioning, participation, and bladder health. The study illustrates a lack of awareness of the problems in the neuro-urological clinic. It is necessary to address this in clinical practice to provide supportive treatment and solutions that will enable participation for women with NMD.

Female non-obstetric urogenital fistula repair: long-term patient-reported outcomes and a scoping literature review.

To investigate long-term and patient-reported outcomes, including sexual function, in women undergoing urogenital fistula (UGF) repair, addressing the lack of such data in Western countries, where fistulas often result from iatrogenic causes. We conducted a retrospective analysis at a tertiary referral centre (2010-2023), classifying fistulas based on World Health Organisation criteria and evaluating surgical approaches, aetiology, and characteristics. Both objective (fistula closure, reintervention rates) and subjective outcomes (validated questionnaires) were assessed. A scoping review of patient-reported outcome measures in UGF repair was also performed. The study included 50 patients: 17 (34%) underwent transvaginal and 33 (66%) transabdominal surgery. History of hysterectomy was present in 36 patients (72%). The median (interquartile range [IQR]) operating time was 130 (88-148) min. Fistula closure was achieved in 94% of cases at a median (IQR) follow-up of 50 (16-91) months and reached 100% after three redo fistula repairs. Seven patients (14%) underwent reinterventions for stress urinary incontinence after transvaginal repair (autologous fascial slings). Patient-reported outcomes showed median (IQR) scores on the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) of 5 (3-7) for filling symptoms, 1 (0-2) for voiding symptoms and 4.5 (1-9) for incontinence symptoms. The median (IQR) score on the ICIQ Female Sexual Matters Associated with Lower Urinary Tract Symptoms Module (ICIQ-FLUTSsex) was 3 (1-5). The median (IQR) ICIQ Satisfaction (ICIQ-S) outcome score and overall satisfaction with surgery item score was 22 (18.5-23.5) and 10 (8.5-10), respectively. Higher scores indicate higher symptom burden and treatment satisfaction, respectively. Our scoping review included 1784 women, revealing mixed aetiology and methodological and aetiological heterogeneity, thus complicating cross-study comparisons. Urogenital fistula repair at a specialised centre leads to excellent outcomes and high satisfaction. Patients with urethrovaginal fistulas are at increased risk of stress urinary incontinence, possibly due to the original trauma site of the fistula.

Validity and Reliability of the Thai version of the International Consultation on Incontinence Questionnaire – Female Lower Urinary Tract Symptoms Long Form (ICIQ-FLUTS LF) and Its Correlation with the IPSS

Objective: Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms Long form (ICIQ-FLUTS LF) is a robust psychometric tool to assess the severity of lower urinary tract symptoms (LUTS) in women. A Thai language version of the ICIQ-FLUTS LF is available, but it had not been validated yet. This study aimed to validate the ICIQ-FLUTS LF questionnaire in Thai and to identify the correlation between the ICIQ-FLUTS LF and the IPSS. Materials and Methods: We recruited 130 females, 50 with LUTS were recruited from patients visiting the Urology Clinic to assess the test with known group validity. They completed the ICIQ-FLUTS LF twice, two weeks apart, and the IPSS once. Meanwhile, 80 without LUTS (control group) were recruited from relatives of the patients to increase the consistency of the statistical analysis, completed the ICIQ-FLUTS LF. Then validity and reliability were determined using statistical analysis. Results: Convergent validity showed a moderate correlation between ICIQ-FLUTS LF and IPSS for both storage and voiding symptoms, with Pearson’s correlation coefficient 0.49, 0.66; P<0.001, respectively. Construct validity, using the Wilcoxon signed-rank test, demonstrated statistically significant difference between the target group and the control group (P<0.001). The Thai version of the ICIQ-FLUTS LF showed good internal consistency, with Cronbach’s alpha coefficients 0.76-0.79 and Test–retest reliability strong, with weighted kappa values 0.63 to 0.90. Conclusion: The Thai version of the ICIQ-FLUTS LF shows good validity and reliable measures of females with LUTS, and is simple to use. This questionnaire in the Thai version can be used in clinical practice and academic research.

Nursing Workloads and Lower Urinary Tract Symptoms Among Chinese Female Nurses: The Mediating Role of Delayed Voiding Behaviors.

Lower urinary tract symptoms (LUTS) are a challenge to the healthy nursing workforce. Nurses confront various objective and subjective nursing workloads which contribute to their LUTS, but less is known about how nursing workloads influence their LUTS. This study is designed to test hypotheses that delayed voiding behaviors mediate the relationships between nursing workloads and LUTS in female nurses. This study analyzed the baseline data collected from an ongoing cohort study named Nurse Urinary Related Health Study in China. LUTS of nurses in 20 tertiary hospitals were assessed with the International Consultation on Incontinence Questionnaire‒Female Lower Urinary Tract Symptoms. Objective nursing workloads including working environment, working hours, and working schedule were collected, and perceived stress, the proxy of the subjective nursing workload, was assessed with the Perceived Stress Scale. Delayed voiding behaviors were assessed with 3 questions adapted from the Taiwan Nurse Bladder Survey. Structural equation modeling was used to run the mediation model. More than half (51%) of 13,191 female nurses had LUTS. Median age was 31 years (IQR 27-37). When delayed voiding behaviors served as a mediator, the direct effects of subjective nursing workload rather than objective nursing workloads on LUTS were significant. Nursing workloads influence nurses' LUTS via delayed voiding behaviors. Strategies tailored to delayed voiding behaviors should be developed, and these may work with stress-reducing strategies as the gatekeepers for nurses' bladder health.

Uretroplastia femenina con injerto de mucosa oral en una etapa: resultados comunicados por las pacientes y tasas de éxito funcional a largo plazo

Introduction and objectivesFemale urethral strictures are a rare condition that significantly impacts patients’ quality of life. Patient-reported outcomes are crucial, yet data regarding sexual function and treatment satisfaction are scarce. We aimed to provide insights from a reconstructive referral center. Patients and methodsWe conducted a retrospective analysis of women treated with ventral onlay one-stage buccal mucosa graft urethroplasty for urethral strictures between 2009–2023. We assessed objective (retreatment-free survival, improvement in maximum flow rate) and subjective outcomes (validated patient-reported outcomes). ResultsOf 12 women, 83 and 17% had iatrogenic and idiopathic strictures, respectively. Median number of prior interventions was 6. Strictures were located meatal and mid-urethral in 25 and 75%, respectively, 22% had the bladder neck involved. Median graft length was 2cm. At median follow-up of 66 months, 33% of patients underwent stricture retreatment, but only one case occurred within the first 2 years postoperatively. The median improvement in maximum flow rate was 10ml/s. Median International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) scores were 8 for filling symptoms, 6 for voiding symptoms, and 3 for incontinence symptoms. Median ICIQ-FLUTSsex score was 4. Higher scores indicate a higher symptom burden. Median ICIQ-Satisfaction outcome and satisfaction scores were 18 and 7, respectively, reflecting high treatment satisfaction. ConclusionsBuccal mucosal graft urethroplasty by ventral onlay for female urethral strictures yields effective, durable, and positively received outcomes. However, larger studies across multiple institutions are necessary to further assess its efficacy, especially regarding patient-reported experiences and sexual function.

Long-term functional success and patient-reported outcomes after female one-stage buccal mucosal graft urethroplasty

Introduction and objectivesFemale urethral strictures are a rare condition that significantly impacts patients’ quality of life. Patient-reported outcomes are crucial, yet data regarding sexual function and treatment satisfaction are scarce. We aimed to provide insights from a reconstructive referral center. Patients and methodsWe conducted a retrospective analysis of women treated with ventral onlay one-stage buccal mucosa graft urethroplasty for urethral strictures between 2009–2023. We assessed objective (retreatment-free survival, ΔQmax) and subjective outcomes (validated patient-reported outcomes). ResultsOf 12 women, 83% and 17% had iatrogenic and idiopathic strictures, respectively. Median number of prior interventions was 6. Strictures were located meatal and mid-urethral in 25% and 75%, respectively, 22% had the bladder neck involved. Median graft length was 2 cm. At median follow-up of 66 months, 33% of patients underwent stricture retreatment, but only one case occurred within the first 2 years postoperatively. The median improvement in maximum flow rate (ΔQmax) was 10 ml/s. Median International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS) scores were 8 for filling symptoms, 6 for voiding symptoms, and 3 for incontinence symptoms. Median ICIQ-FLUTSsex score was 4. Higher scores indicate a higher symptom burden. Median ICIQ-Satisfaction outcome and satisfaction scores were 18 and 7, respectively, reflecting high treatment satisfaction. ConclusionsBuccal mucosal graft urethroplasty by ventral onlay for female urethral strictures yields effective, durable, and positively received outcomes. However, larger studies across multiple institutions are necessary to further assess its efficacy, especially regarding patient-reported experiences and sexual function.

Transobturator vaginal wall sling (Elgamasy technique) for the treatment of female stress urinary incontinence: a pilot study

BackgroundStress urinary incontinence (SUI) is a common social problem that affect about 4–35% of adult women adult. There are multiple surgical options for treatment of SUI but midurethral slings are the most effective and durable form of treatment. In this study, transobturator vaginal sling (TOT-VS, Elgamasy technique) was used to overcome the unique risks associated with synthetic mesh placement, as well as the higher rate of voiding dysfunction and harvest site complications associated with pubovaginal sling placement.Objective To assess the short-term outcome of transobturator vaginal wall sling (TOT-VS) for the treatment of SUI.Materials and MethodsThis is a prospective study included 20 females who underwent TOT-VS placement for SUI from January 2021 to March 2022 at Tanta Urology Department–Tanta University Hospitals. Two-parallel longitudinal vaginal mucosal incisions were performed 2 cm below the bladder neck, and 6 × 2 cm graft was harvested from the anterior vaginal wall, with a prolene suture on each side and fixed around the urethra via the transobturator rout. Patients were followed in the outpatient clinic after one week, two weeks, 3, 6 months and one year postoperatively. Outcomes were measured subjectively by the Bristol Female Lower Urinary Tract Symptoms (B-FLUTS) score comparing preoperative and postoperative scores and objectively by cough stress test.ResultsThe median age of patients was 42 years, and the median BMI was 30.0 kg/m2. The technique was performed, and the patient was discharged the next day after surgery. Mean operative time was 50.5 ± 9 min. All patients completed B-FLUTS at the last follow-up. Compared to preoperative scores, all patients showed significant improvement in all domains. Nineteen cases (95%) showed negative cough stress test 6 months postoperatively, and none of them suffered from severe (Clavien III-V) complications or required reoperation to release the sling. The procedure was failed in one case (5%). At one-year follow-up, no recurrence of SUI was recorded in any case.ConclusionIn the treatment of female stress urinary incontinence, transobturator vaginal wall slings can be a viable, autologous and cost-effective option with excellent short-term outcome, no recurrence, short operative periods, minor complications and short hospital stays.

Translation and validation of Bristol Female lower urinary tract symptoms (BFLUTS) questionnaire for Nepali speaking women.

Translation and validation of Bristol Female lower urinary tract symptoms (BFLUTS) questionnaire for Nepali speaking women Introduction: Bristol female lower urinary tract symptoms questionnaire (BFLUTS) was designed to identify the lower urinary tract symptoms (LUTS) in women. It aids in determining the severity of lower urinary tract symptoms and how they affect sexual function and quality of life.It can be employed in research and therapeutic practice. It is not available in Nepali version. As a result, our goal is to translate and validate the BFLUTS questionnaire in Nepali. The BFLUTS questionnaire has been translated into Nepali. From March 1, 2020 to February 28, 2021, 225 Nepalese patients with lower urinary tract symptoms were evaluated using a Nepali version of the BFLUTS questionnaire adapted from the English version. Internal consistency, test-retest reliability, validity, and change responsiveness were all assessed. A total of 225 patients were enrolled in the study. The missing data was less than 2%. The Nepali version of the BFLUTS questionnaire showed good reliability (? = 0.76; ICC= 0.934). Test-retest reliability was assessed with weighted kappa (?) ranging from 0.71 to 0.83.It showed good sensitive to change before and after the treatment. Mean BFLUTS scores correlated strongly with the symptomsof lower urinary tract symptoms reported in the bladder diary with ? ranging from 0.689to 0.859. The Nepali version of BFLUTS questionnaire is a reliable, valid and consistent for measuring lower urinary tract symptoms and their effect on sexual function and quality of life.

Incidence and risk factors of stress urinary incontinence after laparoscopic hysterectomy

ObjectiveTo observe the long-term effects of total hysterectomy on urinary function, evaluate the effects of preoperative nutritional status, urinary occult infection, and surgical factors on the induction of postoperative stress urinary incontinence (SUI), and explore the incidence and risk factors of SUI.Study designFrom January 2017 to December 2017, 164 patients with benign non-prolapsing diseases who underwent a laparoscopic total hysterectomy in the First People's Hospital of Taicang were selected as the analysis objects. The International Incontinence Standard Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Pelvic Floor Impact Questionnaire-short version 20 (PFDI-20) were used for telephone follow-up to subjectively assess the urinary function of patients, collect their medical records, and statistically analyze the number of postoperative SUI cases. Logistic multivariate analysis was used to analyze the influencing factors of postoperative female SUI, presented as adjusted odds ratios with 95% confidence intervals.ResultsOnly 97 out of 164 patients completed the ICIQ-FLUTS and PFDI-20 questionnaires. Among these participants, 28 patients (28.86%) were diagnosed with SUI (study group), while 69 patients (71.13%) were classified as women without SUI (control group). The age, menopause, parity ≥ 2 times, Body mass index (BMI) ≥ 28 kg/m2, neonatal weight ≥ 4000 g, history of chronic cough, preoperative hemoglobin ≤ 100 g/L, preoperative urine bacteria ≥ 100u/L, preoperative uterine volume ≥ 90 cm3, intraoperative blood loss, and operation time of the study group were compared with those of the control group. The differences were statistically significant (P < 0.05). Further Logistic multivariate analysis showed that menopause, preoperative hemoglobin ≤ 100 g/L, preoperative urine bacteria ≥ 100u/L, uterine volume ≥ 90 cm3, history of chronic cough, BMI ≥ 28 kg/m2 were risk factors for postoperative SUI in patients undergoing hysterectomy (P < 0.05).ConclusionsHysterectomy for benign non-prolapse diseases has a long-term potential impact on the urinary system of patients, and the risk of postoperative SUI increases. The main risk factors of SUI are parity, menopausal status, obesity, preoperative nutritional status, and occult infection of the urinary system.

Frequency of urinary incontinence in post-partum multiparous women

Background: Urinary incontinence (UI) is a widespread condition of uncontrollable urine leakage that has been strongly linked to natural delivery problem impacting one's wellbeing and quality of life. Objective: The objective of study was to determine frequency of urinary incontinence in postpartum multiparous women in Karachi. Methods: A descriptive cross-sectional study by using non-probability convenient sampling technique was conducted at different hospitals of Karachi in a duration of seven months, June 2020 to December 2020. A total of 267 women aged between 18 to 40 years, undergoing postpartum period after normal deliveries in last one year were included in the study. Ethical permission was taken from the Institutional review board of Hayat Institute of Rehabilitation Medicine. A consent form in their native language was taken before recruiting into the study. They were asked to fill the questionnaire Bristol Female Lower Urinary Tract Symptoms (BFLUTS). Data entry and analysis was done through SPSS version 26 and descriptive analysis was done. Data was presented in frequency and percentages, however, demographic information was presented in mean and standard deviation. Results: A total of 267 women were recruited, the mean ±SD of age in years was 30.6 ±5.087 while all women were housewives. Females experienced symptoms like urgency 13.48%, bladder pain occasionally at 80.15%, and frequent visits to the toilet to urinate 41.2%. The current study discloses that 61.16% experienced urinary incontinence. Conclusion: This study concludes that urinary incontinence is moderately found in postpartum multiparous women.

Lower Urinary Tract Symptoms in Greek Women After Menopause: The LADY Study.

The genitourinary syndrome of menopause (GSM), apart from symptoms related to vulvovaginal atrophy (VVA), also consists of lower urinary tract symptoms (LUTS). Based on the common embryological origin of the genital and lower urinary system, the presence of estrogen receptors, and the high prevalence of VVA and LUTS in the menopausal population, the two conditions can coexist. This study is aimed at investigating the prevalence and risk factors of LUTS in a sample of Greek peri- and postmenopausal women. Four hundred and fifty (450) women, aged 40-70 years, attending three outpatient gynecology clinics for routine examination, completed a structured interview and responded to a validated questionnaire (International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms, ICIQ-FLUTS). Urinary urgency or frequency affected 51.6% and dysuria 43.6% of the participants. Mild urgency or frequency was described by 25.6%, moderate by 14.4%, and severe by 11.6% of the women. Mild dysuria was reported by 26.26%, moderate by 5.8%, and severe by 11.6%. Age, weight, BMI, and number of pregnancies and abortions correlated with a higher ICIQ-FLUTS score. Women with moderate/severe symptoms of VVA, such as irritation, a burning sensation, and pruritus of the vulva or vagina, had a higher ICIQ-FLUTS score than women without such symptoms (beta coefficient 2.42, CI 1.204, 3.635, p < 0.001). Lower urinary tract symptoms are very common among peri- and postmenopausal women and are linked to symptoms of VVA. Our data support the need for prompt evaluation of women transitioning to menopause, as these symptoms compromise the quality of life.

ChatGPT’nin kadınlarda alt üriner sistem semptomları ile ilgili soruları yanıtlama performansının değerlendirilmesi

OBJECTIVE: ChatGPT is a language model developed by OpenAI. As a language model, ChatGPT can be used for various natural language processing tasks, such as answering questions, providing information, engaging in conversations, and more. We aimed to evaluate ChatGPT’s suitability to accurately inform patients and medical students by analyzing the reliability and accuracy of lower urinary tract symptoms (LUTS) information in women. MATERIAL and METHODS: Systematically organized frequently asked questions from urology association websites, hospitals, and social media platforms regarding lower urinary tract symptoms (LUTS) in women, along with questions compiled from European Association of Urology (EAU) recommendations, were analyzed. All questions were systematically submitted to ChatGPT 3.5 and 4.0 versions. Two expert urologists independently evaluated the data and answers to the questions and assigned scores from 1 to 4 to each answer. RESULTS: A hundred and three frequently asked questions and 36 questions compiled from EAU guideline recommendations regarding LUTS in women were included in the study. 83.50% of the frequently asked questions (85.44% for version 4.0) and 80.56% of the questions compiled from EAU recommendations (80.56% for version 4.0) were rated as ‘completely correct’ (Grade 1). The rate of completely incorrect answers to the questions (Grade 4) was 0.97% in the frequently asked questions group (0.97% for version 4.0) and 2.78% in the guide-based questions group (2.78% for version 4.0). The success rate of both versions in answering questions was found to be close to each other. CONCLUSION: ChatGPT provided acceptable responses to the posed questions. Despite its limitations, we believe that utilizing this continuously evolving platform under the guidance of urologists in urology clinics will contribute to the diagnosis and treatment processes for patients and their families. Keywords: artificial intelligence, ChatGPT, education, female LUTS

Effect of Transcutaneous Tibial Nerve Stimulation on the Overactive Bladder in Women with Type 2 Diabetes

Background and Aims Diabetes mellitus is one of the most prevalent metabolic conditions in the world. One of its consequences is overactive bladder (OAB), which is a syndrome whose symptoms appear during the urine storage phase in the form of increased urinary frequency or urinary urgency. The prevalence of this disorder is estimated to be 22.5-24.2 % in people with type 2 diabetes (T2D). Recently, a useful technique for the treatment of OAB, named transcutaneous tibial nerve stimulation (TTNS), has been introduced. This study aims to investigate the effect of TTNS in women with T2D and OAB. Methods This randomized, double-blind clinical trial was conducted on 40 women with T2D and OAB symptoms, who were divided into two control and intervention groups. The control group performed pelvic floor muscle (PFM) training daily for one month, while the intervention group received 12 sessions of TTNS combined with PFM training. Before and after the intervention, the lower urinary tract symptoms were recorded using the Persian version of the International Consultation on Incontinence Modular Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Independent t-test, paired t-test, Wilcoxon test, Mann-Whitney U test, and chi-square test were performed for data analysis using SPSS software, version 24. Results There was no significant difference between the two groups in the ICIQ-FLUTS score, incontinence quality of life, or PFM strength, and endurance (P&gt;0.05). However, their scores were significantly different after treatment in each group compared to the pre-treatment phase (P≤0.05). Conclusion The combination of TTNS and PFM training has no advantage over PFM training alone in managing OAB symptoms and improving PFM strength and quality of life in women with T2D.

Psychometric Properties and Cutoff Value of the Turkish Overactive Bladder Symptom Score.

The Overactive Bladder Symptom Score (OABSS) measures all overactive bladder (OAB) symptoms with graded answers, evaluates urgency symptoms, and reveals the subjective bladder control. However, the Turkish version and the cutoff value of the questionnaire have not yet been studied. The aims of this study were to determine the psychometric properties of the 7-item OABSS and to estimate the cutoff value of the scale. This was an observational study. The internal consistency (Cronbach α) and test-retest reliability were analyzed, and exploratory factor analysis was performed. For the criterion validity, the correlations between the OABSS, the Overactive Bladder Questionnaire, the Bristol Female Lower Urinary Tract Symptoms questionnaire, and outcomes of a bladder diary were used. The cutoff value of the OABSS was analyzed by the receiver operating characteristics curve analysis. Participants with (n = 49) and without (n = 38) OAB were included. The internal consistency was very strong (Cronbach α = 0.95). The test-retest reliability was very strong (intraclass correlation coefficients = 0.93-0.95, P = 0.001). The percentage of explanation of the total variance was calculated as 78%. There was a strong to very strong correlation between the OABSS and the Overactive Bladder Questionnaire and Bristol Female Lower Urinary Tract Symptoms scores and outcomes of the bladder diary. The cutoff value for the OABSS was determined as 10.5. The Turkish OABSS was found to be a valid and reliable scale to determine OAB symptoms and severity. Those who score more than 10.5 on the questionnaire can be considered as at risk of OAB syndrome.

Fluid intake behavior in women with refractory overactive bladder undergoing third line therapy.

Fluid intake has been shown to be related to urinary symptoms, but no studies to date have investigated the effect of fluid intake on urinary symptoms in women with refractory overactive bladder (OAB). As this group of women are considered to have a possible unique pathophysiologic mechanism of OAB, we investigated the relationship between fluid intake, fluid intake behavior, and urinary symptoms in women with refractory OAB. A prospective cross-sectional study of women with refractory OAB was conducted by assessing the relationship between fluid intake and lower urinary tract symptoms (LUTS) in women undergoing third line OAB therapies. Fluid intake and behavior were measured by the questionnaire based voiding diaryand urinary symptoms were measured by the International Consultation on Incontinence Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). The relationship between fluid intake and symptom severity was assessed using Spearman's rankcorrelation and χ2 tests. Of the 126 individuals undergoing third line therapy for OAB, 60 (48%) underwent intradetrusor onabotulinumtoxinA injection (BTX) injection, 42 (33%) peripheral tibial nerve stimulation,and 24 (19%) sacral neuromodulation.The mean total daily fluid intake was 2567.0 ± SD 1292.4 mL and did not differ significantly across treatment groups. Total fluid intake was weakly correlated with worse filling-type LUTS (r = 0.241, p = 0.007), and there was no relationship between LUTS and caffeinated fluid intake. Half (52%) of the subjects reported current fluid restricting behavior to control urinary symptoms, but this behavior was not correlated with LUTS severity (all p > 0.05). Patients that currently use tobacco have greater LUTS (current = 25.8 ± SD 9.5, former = 14.8 ± SD 6.1, never = 15.0 ± SD 6.1; p < 0.001). BMI was also positively correlated with worse incontinence symptoms (r = 0.351, p < 0.001). Fluid intake along with other lifestyle factors, including tobacco use and weight, are minimally related to the symptomatology seen in women with refractory OAB. Further studies are needed to assess if behaviors change during treatment with third line therapies, and if these behavioral changes may affect treatment response.

Lower urinary tract symptoms in patients with inflammatory bowel diseases: A cross-sectional observational study

BackgroundInflammatory Bowel Diseases (IBD), Crohn's Disease (CD), and Ulcerative Colitis (UC) may have extraintestinal manifestations, including disorders of the urinary tract. The prevalence of lower urinary tract symptoms (LUTS) in IBD patients remains unclear. AimsAssess the prevalence of LUTS in patients with CD or UC, evaluate the variables implicated in any difference in LUTS prevalence between CD or UC, and assess any relationship between disease activity and LUTS MethodsLUTS were evaluated in 301 IBD patients through standardised questionnaires: Bristol Female Lower Urinary Tract Symptoms (BFLUTS), NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), and International Prostate Symptom Score (IPSS). IBD activity was determined through the Crohn's Disease Activity Index (CDAI), Partial Mayo Score (PMS), and Total Mayo Score (TMS). ResultsBFLUTS total score for females was 6 (3–11). Patients with a higher age at diagnosis had worse filling symptoms (p = 0.049) and a worse quality of life (p = 0.005). In males, 67.1% had mild, 28.5% moderate, and 4.4% severe IPSS symptom grades. The overall NIHCPSI prevalence of chronic prostatitis-like symptoms was 26.8%. The questionnaires revealed some significant differences in the subgroups analysed. ConclusionLUTS should be evaluated in IBD patients by urologic-validated questionnaires for prompt diagnosis and early treatment.

PE008 - ‘Here’s my take...’; A survey on clinician prescribing and self administration preferences for management of female Lower Urinary Tract Symptoms (LUTS)

PE008 - ‘Here’s my take...’; A survey on clinician prescribing and self administration preferences for management of female Lower Urinary Tract Symptoms (LUTS)

Urinary Incontinence, Quality of Life, and Risk Factors in a Geriatric Cohort

Introduction: The aim of the study was to evaluate the prevalence of urinary incontinence (UI) and its subtypes, associated clinical factors, and impact on quality of life (QoL) in a geriatric population aged 80 years or older. Methods: Male and female residents (inclusion criterion: 80 years or older) of three Viennese senior citizen homes were personally interviewed with the aid of a structured questionnaire based on the Bristol Female Lower Urinary Tract Symptom Questionnaire within a 12-month period. UI was defined as any involuntary loss of urine during the past 4 weeks. Several demographic parameters were obtained additionally. Results: 434 participants with a mean age of 86.8 years (women: 87.6 years; men: 86.1 years) were included. UI was present in 52.5% (57% female vs. 23% male, p < 0.001), stress UI affected 36% (41% female vs. 5% male, p < 0.001), urge UI 38% (40.5% female vs. 23% male, p < 0.01), and mixed UI 28% (24% female vs. 5.0% male, p < 0.01). While the overall prevalence of UI remained rather stable in the four age cohorts (80–84 years, 85–89 years, 90–94 years, >94 years), there was a constant decline of SUI paralleled by an increase of UI and – to a lesser extent – of MUI with age. 36.5% (33% female vs. 57% male) participants did not report any negative impact on QoL, while a severe reduction of QoL was present in 31% of cases (35% female vs. 10.0% male). Risk factors for UI and its subtypes included female sex, reduced/no mobility, hysterectomy, and number of births. Conclusion: This study provides data on the high prevalence of UI in a low-morbid geriatric cohort and evaluates gender-specific differences in UI prevalence, associated risk factors, and QoL.