Lower Urinary Tract Symptoms In Women Research Articles

The effects of gestational diabetes on lower urinary tract symptoms of pregnant women: a case-control study

Gestational diabetes mellitus (GDM) and lower urinary tract symptoms (LUTS) are common health problems in pregnant women. The aim of this case-control study was to evaluate the effects of GDM on LUTS in pregnant women. This study was conducted with 44 pregnant women diagnosed with GDM and 44 pregnant without GDM. Patients with GDM had significantly lower likelihood of experiencing urgency (7.069-fold lower likelihood); whereas they had significantly greater likelihoods for urinary incontinence (UI) during sexual intercourse (OR: 0.185; 5.4-fold higher), need for clothing change due to UI (OR: 0.268; 3.7-fold higher), and adverse effects on daily life due to UI (OR: 0.338; 2.9-fold higher) compared to women without GDM (p < .05 for all). Although pregnant women with GDM appear to have a lower likelihood of urgency, this may be associated with the adverse effects of GDM since the likelihoods for UI-related outcomes were increased and quality of life was reduced among pregnant women with GDM compared to those without GDM. Impact statement What is already known on this subject? Lower urinary tract symptoms (LUTS) are very common among pregnant women, and negatively affect social, sexual and working life. There are many risk factors that affect the development of LUTS in pregnant women. It is stated that gestational diabetes mellitus (GDM) may be a predisposing factor in the development of LUTS in women. What do the results of this study add? Women with GDM experienced storage symptoms at a lower frequency (especially urgency) compared to the control group. In addition, we determined worse quality of life among women with GDM who experienced a greater frequency of urinary incontinence. What are the implications of these findings for clinical practice and/or further research? It may be beneficial to provide training on the prevention and management of LUTS to all pregnant women, especially women with GDM, and to increase the sensitivity of health professionals on the subject.

RISE FOR HEALTH: Rationale and protocol for a prospective cohort study of bladder health in women.

The spectrum of bladder health and the factors that promote bladder health and prevent lower urinary tract symptoms (LUTS) among women are not well understood. This manuscript describes the rationale, aims, study design, sampling strategy, and data collection for the RISE FOR HEALTH (RISE) study, a novel study of bladder health in women conducted by the Prevention of Lower Urinary Tract Symptom (PLUS) Research Consortium. RISE is a population-based, multicenter, prospective longitudinal cohort study of community-dwelling, English- and Spanish-speaking adult women based in the United States. Its goal is to inform the distribution of bladder health and the individual factors (biologic, behavioral, and psychosocial) and multilevel factors (interpersonal, institutional, community, and societal) that promote bladder health and/or prevent LUTS in women across the life course. Key study development activities included the: (1) development of a conceptual framework and philosophy to guide subsequent activities, (2) creation of a study design and sampling strategy, prioritizing diversity, equity, and inclusion, and (3) selection and development of data collection components. Community members and cross-cultural experts shaped and ensured the appropriateness of all study procedures and materials. RISE participants will be selected by simple random sampling of individuals identified by a marketing database who reside in the 50 counties surrounding nine PLUS clinical research centers. Participants will complete self-administered surveys at baseline (mailed paper or electronic) to capture bladder health and LUTS, knowledge about bladder health, and factors hypothesized to promote bladder health and prevent LUTS. A subset of participants will complete an in-person assessment to augment data with objective measures including urogenital microbiome specimens. Initial longitudinal follow-up is planned at 1 year. Findings from RISE will begin to build the necessary evidence base to support much-needed, new bladder health promotion and LUTS prevention interventions in women.

8571 Prevalence of Baseline Lower Urinary Tract Symptoms in Women Planning to Undergo Hysterectomy for Uterine Fibroids

Study Objective Compare the prevalence of baseline lower urinary tract symptoms (LUTS) in women planning to undergo hysterectomy for fibroids versus abnormal uterine bleeding (AUB) and examine their association with fibroid characteristics Design This is a retrospective cohort study of 202 women planning to undergo hysterectomy for fibroids vs. AUB. The aim was to compare LUTS in those with vs without fibroids. Baseline demographics, fibroid characteristics, and urinary symptoms were collected. Urinary symptoms included stress and urge incontinence, dysuria, frequent bladder infections, hematuria, nocturia, incomplete emptying, urgency, and frequency. Fibroid characteristics included dominant fibroid size, location, and total uterine volume. A priori power analysis determined 97 participants were needed per group (194 total) to assess for a 20% difference in LUTS, with alpha = 0.05 and power = 0.8. 202 participants were included to account for missing data upon chart review. Setting N/A. Patients or Participants Participants were identified from a surgical database. They were eligible for inclusion if they were planning to undergo hysterectomy for fibroids or AUB from 2014-2019. Interventions N/A. Measurements and Main Results When assessing baseline LUTS in women planning to undergo hysterectomy for fibroids vs. AUB, there were no differences in individual symptoms (all p>0.05) or in prevalence of ‘any urinary symptom’ as a single variable (42.6 vs 45.5%, p=0.67). Dominant fibroid size >6cm was correlated with greater prevalence of ‘any urinary symptom’ (64.9% vs 40.4%, p=0.02), as well as difficulty passing urine (p=0.02), nocturia (p=0.04), and urinary frequency (p=0.04). When controlling for age, BMI, parity, chronic pelvic pain, and diabetes, fibroids >6cm remained significantly associated with the presence of lower urinary tract symptoms (OR 3.1, 95% CI 1.2-8.3). Conclusion Lower urinary tract symptoms are prevalent in women planning to undergo hysterectomy for fibroids, particularly in those with fibroids >6 cm. Future studies should evaluate how urinary symptoms change following hysterectomy. Compare the prevalence of baseline lower urinary tract symptoms (LUTS) in women planning to undergo hysterectomy for fibroids versus abnormal uterine bleeding (AUB) and examine their association with fibroid characteristics This is a retrospective cohort study of 202 women planning to undergo hysterectomy for fibroids vs. AUB. The aim was to compare LUTS in those with vs without fibroids. Baseline demographics, fibroid characteristics, and urinary symptoms were collected. Urinary symptoms included stress and urge incontinence, dysuria, frequent bladder infections, hematuria, nocturia, incomplete emptying, urgency, and frequency. Fibroid characteristics included dominant fibroid size, location, and total uterine volume. A priori power analysis determined 97 participants were needed per group (194 total) to assess for a 20% difference in LUTS, with alpha = 0.05 and power = 0.8. 202 participants were included to account for missing data upon chart review. N/A. Participants were identified from a surgical database. They were eligible for inclusion if they were planning to undergo hysterectomy for fibroids or AUB from 2014-2019. N/A. When assessing baseline LUTS in women planning to undergo hysterectomy for fibroids vs. AUB, there were no differences in individual symptoms (all p>0.05) or in prevalence of ‘any urinary symptom’ as a single variable (42.6 vs 45.5%, p=0.67). Dominant fibroid size >6cm was correlated with greater prevalence of ‘any urinary symptom’ (64.9% vs 40.4%, p=0.02), as well as difficulty passing urine (p=0.02), nocturia (p=0.04), and urinary frequency (p=0.04). When controlling for age, BMI, parity, chronic pelvic pain, and diabetes, fibroids >6cm remained significantly associated with the presence of lower urinary tract symptoms (OR 3.1, 95% CI 1.2-8.3). Lower urinary tract symptoms are prevalent in women planning to undergo hysterectomy for fibroids, particularly in those with fibroids >6 cm. Future studies should evaluate how urinary symptoms change following hysterectomy.

Is the first day of the bladder diary enough for symptom assessment in women with lower urinary tract symptoms?

Introduction:The 3-Day Bladder Diary (3dBD) has good feasibility, reliability and validity for the assessment of Lower Urinary Tract Symptoms (LUTS) in women. This study aims to evaluate the reliability of the first day of the 3dBD (fdBD) in the assessment of the symptoms of women with LUTS. Materials and Methods:An epidemiologic, descriptive and cross-sectional study was conducted. Fourteen Functional Urology and Urodynamic Units participated, and one hundred thirty-six women with a mean age (SD) of 55.2 (13.8) years with LUTS filled in the 3dBD. Investigators completed the evaluation sheet based on the interpretation of the three patient-completed sheets. The authors did a centralized reading of the diaries. A descriptive analysis of 3dBD was performed. The intraclass correlation coefficient (ICC) was used to assess the agreement between fdBD and 3dBD global results. ICC<0 indicates no agreement, 0–0.4 poor agreement, 0.4–0.59 moderate agreement, 0.6–0.74 good agreement and >0.74 excellent agreement. Results:One hundred ten women completed the 3dBD. Day-time micturition frequency, nocturia, urgency, urgency urinary incontinence (UUI) and pads showed an excellent concordance (ICC 0.932; 0.883; 0.947; 0.958; 0.961 respectively). Stress urinary incontinence (SUI), fluid intake and 24-hour urine production had a good/excellent concordance (ICC 0.859; 0,884; 0.869 respectively). However, voiding volumes exhibited a moderate level of agreement with wide confidence intervals (day-time 0.730 [0.415-0.886]; night-time 0.770 [0.462-0.889]), which implies a high variability in the fdBD data. Conclusions:fdBD showed good reliability in the assessment of LUTS in women in all parameters except for the voided volume variables.

Impact of uterine fibroid surgery on lower urinary tract symptoms

ObjectiveUterine fibroids are often associated with lower urinary tract symptoms (LUTS), the exact prevalence of which has been underexplored. Our main objective was to evaluate the effect of surgical treatment of fibroids on LUTS. Our secondary objectives were to assess the prevalence of LUTS in women undergoing fibroid surgery and to analyze the relationship between the characteristics of fibroids and the severity of symptoms. MethodsThis was a prospective study of women conducted between 2019 and 2021. The main endpoint was the change in the total UDI-6, IIQ7, ICIQ-SF and CONTILIFE scores preoperatively and 6 weeks postoperatively. ResultsOf the 55 included women, 63.6% had frequency and 60% had urgency. Six weeks postoperatively, urinary symptoms had significantly improved for all scores. The presence of an anterior fibroid was significantly associated with higher urinary symptom scores for the UDI-6 (p = 0.007) and ICIQ-SF scores (p = 0.04). The size of the uterus or dominant fibroid was not significantly associated with the severity of urinary symptoms. ConclusionFibroids are often associated with symptoms of overactive bladder. An anterior location of the fibroid appears to be associated with greater severity scores. Surgical treatment appears to reduce urinary symptoms 6 weeks postoperatively.

Lower urinary tract symptoms in pre-menopausal women and its association with sexual dysfunction

Background: Sexual dysfunction (SD) is one of the common problems observed by premenopausal women and it frequently exists along with other associated lower urinary tract symptoms (LUTS).&#x0D; Aims and Objective: The present study was planned to evaluate the correlation between SD in pre-menopausal women with LUTS.&#x0D; Materials and Methods: This was a prospective observational study conducted between March 2018 to February 2019. All sexually active premenopausal women, who presented with complains of LUTS were enrolled in this study. All included patients were given two types of questionnaires (Bristol female lower urinary tract symptom [BFLUTS] and pelvic organ prolapse-urinary incontinence sexual function [PISQ-12]). These were for the assessment of LUTS and sexual function. Assessment of association between presence of LUTS and sexual dysfunction was done.&#x0D; Results: A total of 105 women were enrolled in the study. Their mean age was 43.70 years and BMI was 29.49. The total mean BFLUTS score recorded was 28.12. Their sub-dimension scores recorded for the filling, voiding, incontinence symptoms, sexual function and quality of life were 8.21, 34.32, 12.21, 4.49, and 10.65, respectively. Total mean score of PISQ-12 was 23.72 in all women and the mean values for the sub-dimension scores were 5.21 for the behavioural-emotive state, 11.78 for the physical state, and 6.2 for the partner-related state. There was Negative association observed between the total of PISQ-12 scores and total and sub-dimension of the BFLUTS scores (p&lt;0.01).&#x0D; Conclusion: This study observes the presence of LUTS in women with sexual dysfunction. LUTS directly or indirectly increase the sexual problems in premenopausal women. These results highlight the clinical importance of evaluating LUTS in premenopausal women with sexual dysfunction.

Videourodynamic Precision Diagnosis and Treatment of Lower Urinary Tract Symptoms in Women

Lower urinary tract symptoms (LUTSs) in women are common in urological practice but are usually uninformative for diagnosing the underlying lower urinary tract dysfunction. To obtain a precise diagnosis and devise a precise treatment strategy, a videourodynamic study (VUDS) is an essential tool for investigating the bladder and bladder outlet dysfunction, especially when LUTS cannot be relieved after initial medical treatment. An accurate VUDS diagnosis can guide effective treatment and prevent unnecessary or incorrect surgical intervention. This article reviews updated applications of VUDS in the diagnosis and treatment of LUTS in women.

Assessment of Female Sexual Dysfunction and Erectile Dysfunction and Its Association with Lower Urinary Tract Symptoms in Women and Men Over 18 Years Old: Results From the COBaLT Study

BackgroundFemale sexual dysfunction and erectile dysfunction (FSD/ED) have been linked with lower urinary tract symptoms (LUTS), from both epidemiological data and basic research studies, but few studies have been conducted in Latin America addressing these issues and most of them do not include the young population. AimTo determine the prevalence of FSD/ED and its association with LUTS in Colombia. MethodsSub-analysis of a cross-sectional, population-based study conducted in subjects ≥18 years old to evaluate LUTS/OAB. The estimated sample size was 1,054. ED was defined as ≤21 points in the SHIM and FSD as ≤19 in the FSFI-6. For LUTS/OAB, we used the 2002 ICS and 2010 IUGA/ICS definitions and validated questionnaires. Descriptive and inferential statistics were employed. OutcomesPrevalence of FSD/ED and association of FSD/ED and LUTS. ResultsWe included 1,060 participants; the median age was 40 (IQR 27–54) years. Fifty-seven (11.4%) men and 182 (32.7%) women were sexually inactive. The prevalence of FSD/ED in sexually active participants was 47% (men 52.9%, women 38.9%). The most common FSD/ED symptoms were diminished/absent lubrication in women (42%) and diminished erection maintenance after penetration in men (13%). Individuals with FSD/ED had higher rates of various LUTS. The multivariable logistic regression model found that the city of residence (OR = 0.4, 95% CI 0.2–0.9), diabetes mellitus (DM) (OR = 8.4, 95% CI 1.4–48.7), menopause (OR=3.5, 95% CI 1.9–6.2), urge urinary incontinence (UUI) (OR=1.9, 95% CI 1.1–3.3) and nocturia ≥2 (OR = 2.2, 95% CI 1.2–4.2) were associated with FSD. In men, age 40–59 (OR = 2.3, 95% CI 1.4–3.7) and ≥60 (OR = 5.5, 95% CI 2.4–12.5), the city of residence (OR = 0.2, 95% CI 0.1–0.3), less than a high-school diploma vs higher education (OR = 2.0, 95% CI 1.2–3.2), depression (OR = 4.6, 95% CI 1.8–11.5), UUI (OR = 3.2, 95% CI 1.1–10.2) and feeling of incomplete bladder emptying (OR = 2.1, 95% CI 1.3–3.5) were associated with ED. Clinical ImplicationsThis study underlines the importance of assessing LUTS in women and men of all affected age groups who present with symptoms of FSD/ED and vice versa, which could help achieve a better approach for these patients. Strengths & LimitationsThis is the first study in Colombia and one of the few in Latin America that addresses both FSD/ED and LUTS in men and women aged 18 years and older. Limitations include being a sub-analysis of a study aiming to determine the prevalence of LUTS/OAB and not FSD/ED. ConclusionsRegardless of age, LUTS were observed more frequently in patients with FSD/ED. Various LUTS were associated with FSD/ED.Bravo-Balado A, Trujillo CG, Caicedo JI, et al. Assessment of Female Sexual Dysfunction and Erectile Dysfunction and Its Association with Lower Urinary Tract Symptoms in Women and Men Over 18 Years Old: Results From the COBaLT Study. J Sex Med 2021;18:1065–1074.

Polish versions of the ICIQ-FLUTS and the ICIQ-FLUTS LF: translation, adaptation, and validation of female-specific instruments for evaluation of lower urinary tract symptoms.

Previously, there was no specific questionnaire in the Polish language for overall assessment of lower urinary tract symptoms (LUTS) in women. The aim of this study was to translate, culturally adapt, and validate Polish versions of the International Consultation on Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS and ICIQ-FLUTS LF, short and long forms) for use in clinical practice and research in Poland. The original English ICIQ-FLUTS and ICIQ-FLUTS LF were adapted to Polish according to international standards and recommended procedures. Adult women with LUTS who were seen at the Department of Urology at the Jagiellonian University, Krakow, Poland, completed the ICIQ-FLUTS and ICIQ-FLUTS LF at baseline and 2weeks later. Control participants completed the questionnaires once. Validity and reliability were determined. One hundred and eighty Polish-speaking women who had LUTS completed the questionnaires. Content validity was high. Significant differences between women with LUTS and controls for both ICIQ-FLUTS and ICIQ-FLUTS LF confirmed optimal construct validity. An intercorrelation analysis revealed that internal consistency was good for ICIQ-FLUTS and ICIQ-FLUTS LF (Cronbach's alpha >0.7). Test-retest reliability (reproducibility) demonstrated strong stability (intraclass correlation coefficient > 0.7). Floor and ceiling effects were absent from women with LUTS, whereas a floor effect was detected in the control group. The Polish ICIQ-FLUTS and ICIQ-FLUTS LF are valid, reliable, and consistent measures of overall evaluation of LUTS in women. They are equivalent to the original English versions, and they retained the psychometric properties of the original questionnaires.

Urinary symptoms and quality of life in women living with HIV: a cross-sectional study.

To determine prevalence and quality of life impact of lower urinary tract symptoms (LUTS) in women living with HIV (WLWH). Cross-sectional urinary questionnaires were included in a multicenter national prospective study of the HPV vaccine in WLWH. Demographic and clinical information was abstracted from the parent study. The Urinary Distress Inventory (UDI-6) and Urinary Impact Questionnaire (UIQ-7) were administered. Wilcoxon rank sum, two-sample chi-square or Fisher's exact tests were used as appropriate to compare women with UDI-6 score ≥ 25 to those with lower UDI-6 scores on demographic and HIV-related factors. Significant categorical variables were followed up with logistic regression to estimate odds ratios (OR). One hundred seventy-seven women completed urinary questionnaires (85.5% of cohort). Median age was 44.1 (37.2-50.6). Mean CD4 count was 621 (410-785), and 132 women (74.6%) were virologically suppressed. Median UDI-6 score was 4.2 (0-25). Fifty-one women (28.8%) had a UIQ-7 score > 0. Among those with a UDI-6 score of at least 25, median UIQ-7 was 9.5 (0-47.6). UDI-6 ≥ 25 was significantly associated with increasing age, higher BMI, Canada as country of origin, peri-/postmenopausal status (OR 3.37, 95% CI = 1.71 to 6.75) and being parous (OR 2.92, 95% CI = 1.27 to 7.59) (all p < 0.05). HIV-related factors were not associated with UDI-6 ≥ 25. LUTS were common, but we did not demonstrate a negative impact on quality of life in this sample of WLWH. Large comparative studies are needed to determine whether HIV is a risk factor for bothersome LUTS in women.

Overactive Bladder in Women: an Update for Primary Care Physicians

Overactive bladder (OAB) is a widely prevalent urinary condition affecting women of all ages, with increasing incidence in advancing age. A primary care provider is likely to encounter a significant proportion of women experiencing lower urinary tract symptoms (LUTS). This review serves primary care physicians as a thorough reference for a common condition causing LUTS in women. Most emerging data addressing overactive bladder relates to the different treatment modalities available. The side effect profile of antimuscarinic drugs remains an ongoing concern among OAB patients, especially with recent data linking the use of this class of drugs with Alzheimer’s and future development of dementia. In addition, it was recently demonstrated that individuals taking medications of medium-to-high anticholinergic activity had reduced brain glucose metabolism and increased brain atrophy. Combination treatments seem to be more efficacious than monotherapies, as has been proven when using mirabegron with antimuscarinics. Many studies have also validated the use of neuromodulation as a safe and effective treatment for OAB. Overactive bladder is a widely prevalent urinary condition affecting women of all ages. It is regarded as multifactorial with several proposed theories to explain its occurrence. Several tests are available to aid in diagnosing OAB. Symptom severity and patient-related factors including patient preferences drive treatment.

Pelvic floor muscle training adapted for urinary incontinence in multiple sclerosis: a randomized clinical trial.

Lower urinary tract symptoms (LUTS) affect up to 80% of patients with multiple sclerosis (MS). The present randomized, open-label, clinical trial examines the effectiveness, as a conservative treatment for LUTS, of a physiotherapist-guided pelvic floor muscle training (PFMT) program adapted for patients with relapsing-remitting multiple sclerosis (RRMS) and urinary incontinence (UI). Forty-eight patients with RRMS were randomly assigned to a 12-week PFMT program with or without physiotherapist guidance. The primary endpoint was the reduction in urinary leakages after 12weeks of following the program. The secondary variables assessed were quality of life (QoL), UI severity, LUTS, and treatment adherence. Forty patients completed the program. No significant differences in baseline characteristics were seen between the two treatment groups. At 12weeks, both groups reported a significantly reduced number of leakages compared with baseline (P < 0.001), with no significant differences seen between groups (P =0.210). In the physiotherapist-guided group, significant differences were found in QoL, UI severity, and LUTS between baseline and 12weeks, for both male and female subjects. No significant differences in adherence were seen between the two treatment groups. No difference in leakage reduction was seen between physiotherapist-guided and unguided PFMT. However, the physiotherapist-guided program was associated with improvements in UI severity, QoL, and LUTS in women and men. The guided PFMT group also showed a trend towards better adherence to treatment. No. NCT03000647; Title: "Guided Versus Non-Guided Pelvic Floor Exercises for Urinary Incontinence in Relapsing-Remitting Multiple Sclerosis."

Does Pharmacological Treatment Reduce the Incidence of Lower Urinary Tract Symptoms (LUTS) after Transobturator Sling?

Aim Lower urinary tract symptoms (LUTS) frequently affect patients immediately after midurethral sling (MUS) placement. The objective of the study was to assess if solifenacin or mirabegron decreases incidence of LUTS in women who underwent transobturator MUS. Methods A prospective randomized trial was conducted on patients undergoing ambulatory transobturator midurethral sling due to stress urinary incontinence (SUI). All participants were questioned before and after surgery for occurrence of bothersome LUTS. A total of 328 patients who underwent transobturator MUS were randomly assigned to one of three groups: prophylaxis with 10 mg of solifenacin, prophylaxis with 50 mg of mirabegron, or without any additional treatment. LUTS evolution and efficacy of solifenacin and mirabegron were analyzed based on results of assessments made during follow-up visits at 1 and 6 weeks after surgery. Comparison of the prevalence of LUTS was done using chi2 test. Results Prevalence of urgency and frequency episodes increased notably 1 week after sling placement and then came down to baseline levels. Solifenacin and mirabegron significantly reduced the incidence of urgency after 1 week, but after 6 weeks the beneficial effect was observed only in case of solifenacin. Treatment with mirabegron reduced the percentage of patients suffering from frequency after 6 weeks. Although prevalence of nocturia did not raise after sling placement, both treatments significantly reduced the incidence of this complaint after 6 weeks. Pharmacological treatment did not modulate the course of hesitancy and terminal dribbling. Conclusions Treatment with solifenacin or mirabegron may significantly reduce the incidence of undesired LUTS after MUS.

Management of Lower Urinary Tract Symptoms After Pelvic Radiation in Females

To present the available literature pertaining to the management of lower urinary tract symptoms (LUTS) after pelvic radiation (RT) in female patients treated for pelvic malignancy. Recent publications have focused on isolating de novo RT-induced LUTS in women from other contributors to urinary symptoms such as pelvic surgery and chemotherapy. There is a paucity of literature on the treatment of RT-related changes to urinary function. The treatment of pelvic malignancies in women alters voiding function. RT contributes to the deterioration of voiding function. More study is needed to evaluate the efficacy of available therapies.

Lower Urinary Tract and Pelvic Floor Symptoms and their Correlation with Fibroid Characteristics [39M

INTRODUCTION: Lower urinary tract symptoms (LUTS) are prevalent in women with uterine fibroids. Research suggests that increased fibroid volume and uterine bulk is associated with more severe LUTS and pelvic floor symptoms, however the correlation between fibroid size/location, adenomyosis, and symptoms has been under-studied. We sought to investigate this correlation using MRI which provides detailed information on fibroid characteristics. METHODS: A retrospective chart review was conducted for patients seen at the Stanford Fibroid Clinic. Patient demographics, medical history and pelvic MRI data were collected on 60 patients with completed Uterine Fibroid Symptom (UFS) and Pelvic Floor Distress Inventory (PFDI) validated symptom surveys. Primary outcome was scaled symptom scores and sub-scores including the Urogenital Distress Inventory (UDI-6). RESULTS: Dominant fibroid volume correlated negatively with urinary frequency (r=-0.307, P=.030), urgency (r=−0.287, P=.043), and pelvic pain or discomfort (r=-0.281, P=.049). Longest fibroid dimension also negatively correlated with UDI-6 (r=-0.304, P=.028). Number of fibroids and uterine volume were not significantly associated with LUTS. However, higher PFDI score was significantly associated with presence of adenomyosis on MRI (mean 82.9 vs 159.6, P=.018) and serosal fibroid location (mean 139.3 vs 69.0, P=.011). Patient BMI correlated positively with UDI-6 (r=0.415, P=.002) and PFDI (r=0.371, P=.005). CONCLUSION: Contrary to common belief, dominant fibroid size was inversely associated with LUTS, suggesting that fibroid dimensions may not predict bulk-related symptom severity. Adenomyosis should be considered in the evaluation of LUTS in women with uterine fibroids. In accordance with current literature, BMI is associated with LUTS including incontinence, urgency, and frequency.

Strategy of clinical diagnosis and treatment in women with lower urinary tract symptoms

Lower urinary tract symptoms (LUTS) are common in women. The etiology , clinical manifestation, diagnosis and management of LUTS in women are different from those in men. A detailed history, a physical examination and a urine analysis are essential components of the initial evaluation of lower urinary tract symptoms in the female. Thoroughly treating urinary tract infection is very important in management of frequency . In addition, management of fluid intake, behavioral and drug therapies are often used in combination to optimize patient symptom and the quality of life. Intravesical injection of onabotulinumtoxinA is highly effective, but often requires repeated treatments. Sacral neuromodulation is an effective, minimally invasive surgical treatment for refractory overactive bladder in carefully selected, cognitively capable patients. Detrusor underactivity is a common cause of LUTS in women. Female bladder outlet obstruction was divided into two categories, anatomical and functional obstruction. So far, there is no uniform urodynamic standard for diagnosing bladder outlet obstruction in women . The clinical manifestations are various in different types of obstruction , so is the management. It is important to find out the causes of obstruction, and only in this way can we get correct diagnosis, thus treating patients successfully. Key words: Lower urinary tract symptoms; Female; Diagnosis; Treatment

Self-reported toileting behaviors in employed women: Are they associated with lower urinary tract symptoms?

To describe toileting behaviors working women habitually use and investigate behaviors associated with lower urinary tract symptoms (LUTS), especially urinary urgency with or without leakage. Non-pregnant female employees of a large academic medical center 18 years and over were eligible to complete an online survey about bladder health and toileting behaviors. One hundred eighty-two women participated in the survey. The majority were white (83.52%), married (52.49%), had ≥1 pregnancy (54.40%), and in excellent health (93.41%). The average age and body mass index were 47.28 ± 13.56 years and 27.92 ± 6.78, respectively. The sample was further sub-divided into two groups: urinary urgency (N = 119) or no urinary urgency symptoms (N = 51). Habitual toileting behaviors for these groups (N = 170) included: sitting to urinate at home (98.24%), emptying the bladder completely (88.82%), emptying the bladder before leaving home (80.00%), and sitting to urinate when away from home (68.82%). Logistic regression analysis showed age increased the odds of urinary urgency (aOR 1.06, 95%CI 1.02-1.09). Women who waited too long to urinate at work (aOR 7.85, 95%CI 1.57-39.24) and wore panty liners for urinary leakage (aOR 2.86, 95%CI 1.25-6.56) had greater odds of urinary urgency than women who did neither. Most habitual toileting behaviors were not associated with urinary urgency except waiting too long to urinate when at work. Logistic regression revealed significant relationships among health-related factors, personal characteristics, behaviors, and urinary urgency. LUTS in women is both a women's health and occupational health issue.

Vulvar lichen sclerosus in women is associated with lower urinary tract symptoms.

Lichen sclerosus (LS) is thought to be primarily a disease of postmenopausal women. Little is reported about lower urinary tract symptoms (LUTS) in association with LS. The aims of this study were to evaluate the odds of having LS-associated LUTS and to identify the predominant type of LS-associated bladder dysfunction. This was a cross-sectional study with two cohorts investigating the association between LS and LUTS and the predominant type of LS-associated bladder dysfunction. The odds of LUTS in women with LS were more than four times higher than in women without LS (OR 4.5, 95% CI 2.6-8.0; p<0.0001). There was no significant difference in the occurrence of LUTS between women who experienced the first LS symptoms before and after the age of 50years (36% and 53%, respectively, p=0.14), or in the occurrence of the different types of LUTS between women with and without LS (p=0.3). The most common type of LUTS was overactive bladder (OAB) in both women with LS (67.3%) and without LS (60%). The most prevalent type of LS-associated LUTS was OAB. The odds of developing LUTS (self-reported) are four times higher in women with LS than in those without. The predominant type of LUTS in women with and without LS is OAB.

Tamsulosin for treatment of lower urinary tract symptoms in women: a systematic review and meta-analysis.

Tamsulosin has been used for the off-label treatment of lower urinary tract symptoms (LUTS) in women. Over the past few years, several randomized controlled trials (RCTs) have reported the clinical effectiveness and safety of tamsulosin for LUTS in women. Therefore, the aim of the present study was to perform a meta-analysis to evaluate the safety and efficacy of tamsulosin in treating LUTS in women, which may resolve some of the current controversies over use of the drug and provide more reliable evidence for the use of tamsulosin. A literature review was performed to identify all published RCTs of tamsulosin for the treatment of LUTS in women. The search included the following databases: PUBMED, EMBASE, the Cochrane Controlled Trail Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Science and Technique Journals Database (VIP) and Wanfang Database. A systematic review and meta-analysis were conducted. Six RCTs studies involving 764 female participants were included in the analysis. Four out of the six RCTs compared tamsulosin with placebo, one RCT compared tamsulosin with prazosin and the other study compared tamsulosin with tamsulosin combined with tolterodine. Two RCTs evaluated total International Prostate Symptom Score (IPSS) and improved total IPSS compared with the placebo (standardized mean difference=-4.08, 95% confidence interval=-5.93 to -2.23, P<0.00001). IPSS (storage symptom score), IPSS (voiding symptom score) and quality-of-life score also showed the similar effects. In addition, tamsulosin improved the Overactive Bladder Questionnaire score when compared with placebo in only one RCT. For urodynamic parameters, tamsulosin improved the average flow rate and the post-void residual volume when compared with prazosin and tolterodine combined with tamsulosin, respectively. Beyond that, the other parameters showed no significant difference between the treatment and control groups. On the basis of the present evidence, tamsulosin is an effective treatment for the relief of LUTS in women when compared with placebo. However, the safety of the tamsulosin remains unknown. Further, well-conducted trials that examine long-term outcomes are required.

A guide to lower urinary tract symptoms in women

Lower urinary tract symptoms (LUTS) are common in women and affect quality of life. This article aims to enable readers to recognise, investigate and, whenever possible, address LUTS in women. It also aims to enable readers to recognise red flag symptoms and to act on these. A stepwise approach is normally utilised. This article outlines the role of the practice nurse and explains when onward referral is appropriate.