OAB-q SF Research Articles

Overactive bladder symptom severity, bother, help-seeking behavior, and quality of life in patients with type 2 diabetes: a path analysis

BackgroundThis study aimed to investigate the relationships among overactive bladder (OAB) symptom severity, bother, help-seeking behavior, and quality of life (QOL) in patients with type 2 diabetes.MethodsA total of 127 diabetic patients, aged at least 18 years, with overactive bladder from a hospital in Shandong Province, China, were recruited for this study. Symptom severity, bother, and quality of life were assessed using the Overactive Bladder Symptom Score (OABSS), Patient Perception of Bladder Condition (PPBC), and Overactive Bladder Questionnaire Short Form (OAB-q SF), respectively. Help-seeking behavior was assessed by asking patients whether they consulted health care professionals or received treatment for their bladder problems. A two-step path analysis was performed to analyze the data.ResultsOAB symptom severity was directly associated with lower levels of QOL, and the strength of this association was no longer significant when taking bother and help-seeking behavior into account. Bother increased with OAB symptom severity, and patients with bothersome OAB tended to have lower levels of QOL. Moreover, bother increased help-seeking behavior; however, patients who sought help tended to have lower levels of QOL.ConclusionsOur findings highlight the role of bother and help-seeking behavior in the relationship between OAB symptom severity and QOL. To improve a patient’s QOL, health care providers should focus not only on symptom bother but also on dysfunctional help-seeking patterns.

Intravesical electrical stimulation treatment for overactive bladder: An observational study.

PurposeIntravesical electrical stimulation treatment (IVES) has been successfully used to treat neurogenic bladder. We report the results of an observational study regarding the use of IVES for women with overactive bladder syndrome (OAB) and/or urgency urinary incontinence (UUI).Materials and MethodsIVES was performed in women with OAB (defined by frequency ≥8/day, nocturia ≥2/night, or ≥3 episodes of UUI on 3-day voiding diary) who failed prior medical therapy. Subjects underwent 4 weeks of treatment with an 8-Fr Detruset™ IVES catheter. Primary outcome was Patient Global Impression of Improvement (PGI-I) at 3 months. Secondary outcomes included Visual Analog Scale (VAS), Short Form OAB Questionnaire (OAB-q SF), Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ), reduction in frequency and UUI on voiding diary, and adverse effects. Analysis was done with paired t-tests and Wilcoxon signed rank tests.ResultsSeventeen subjects completed the study. At 4 weeks post-treatment, 15 improved on PGI-I (11 subjects: ‘a little better’, 2: ‘much better’, 2: ‘very much better’). There were significant improvements in symptom bother and health-related quality of life as measured by OAB-q SF and pelvic organ prolapse and urinary distress as measured by PFDI. Frequency decreased from 10.3±4.3 at baseline to 8.9±2.3 (p=0.04) at 3 months. No pain was reported during treatment. There was one urinary tract infection during the study period. No other adverse events were reported.ConclusionsIVES appears to be a safe and effective novel treatment for OAB. Larger comparative studies are needed to investigate its potential for long-term treatment.

Effectiveness and durability of solifenacin versus percutaneous tibial nerve stimulation versus their combination for the treatment of women with overactive bladder syndrome: a randomized controlled study with a follow-up of ten months.

ABSTRACTPurposeTo assess effectiveness and durability of Solifenacin (SS) versus tibial nerve stimulation (PTNS) versus combination therapy (PTNS + SS) in women with overactive bladder syndrome (OAB).Materials and Methods105 women with OAB were divided randomly into three groups of 35 patients each. In group A women received SS, in group B women underwent PTNS, in group C women underwent combination of PTNS + SS. Improvements in OAB symptoms were assessed with OABSS questionnaire; patients’ quality of life was assessed with OAB-q SF questionnaire. Evaluation of effectiveness of treatments was performed with PGI-I questionnaire. OABSS and PGI-I were also assessed monthly for ten months.ResultsAll treatments were effective on symptoms. PTNS showed a greater effectiveness than SS, but PTNS + SS was more effective than SS and PTNS. Furthermore, PTNS + SS showed a greater duration of effectiveness than PTNS and SS.ConclusionsCombination of PTNS with SS showed more effectiveness and more durability than PTNS and SS alone.

Patient-perceived effectiveness and impact on quality of life of solifenacin in combination with an α-blocker in men with overactive bladder in Sweden: a non-interventional study

Treating male lower urinary tract symptoms (LUTS) by targeting the prostate would have limited effect on overactive bladder (OAB) symptoms. This study assessed perceived symptoms and quality of life (QoL) of male patients with OAB treated with an α-blocker plus solifenacin in daily clinical practice. Male patients aged ≥40 years were included after the decision was made to initiate treatment with an α-blocker for LUTS plus solifenacin for OAB symptoms. The primary endpoint was change in patient perception of bladder condition (PPBC) questionnaire score over 6 months. Other assessments included the OAB-questionnaire short form (OAB-q SF) and International Prostate Symptom Score (IPSS). Interpretation of the study data was hindered by not meeting the enrollment target and a high dropout rate. In 36 evaluable patients, mean (SD) PPBC score improved from 4.3 (0.93) at baseline (“moderate” to “severe” problems) to 3.5 (1.06) at month 6 (“minor” to “moderate” problems). OAB-q SF scores and total IPSS also improved. In this patient population, treatment with solifenacin and an α-blocker resulted in improvements in male patient perception of their LUTS and QoL, although the results should be interpreted with caution due to the low number of patients with complete data.

Adult Onset Nocturnal Enuresis: Identifying Causes, Cofactors and Impact on Quality of Life.

The objectives of the present study were: (i) Evaluate common co-pathologies associated with, and potentially contributing to adult onset Nocturnal enuresis (NE) in a tertiary referral population; and (ii) quantify its impact on QoL with validated questionnaires. Following Institutional Review Board approval, patients with adult onset NE were reviewed with history, physical examination, urodynamic studies, questionnaires: Overactive bladder questionnaire short-form (OAB-qSF), Urogenital Distress Inventory (UDI-6), AUA symptom score (AUA-SS) and Patient Global Impression scale (PGIS). Between 2004 and 2016, 45 NE patients (19 male, 26 female) were identified. Twenty-five patients (56%) had an associated diagnosis of neurogenic bladder (NGB). Five (11%) reported no other LUTS or associated conditions. Forty (89%) had at least one of the following contributing factors: sedative use, OAB (bothersome symptoms based on UDI-6), voiding dysfunction (also based on UDI-6 or AUA-SS), abnormal UDS finding, and/or confirmed obstructive sleep apnea (OSA). Overall, 20% had two contributing factors, and 31% each had three and four factors. Among all patients, 76% reported sedative use and of 36 patients with UDS, 75% had abnormal findings. Of the 41 questionnaire respondents, mean AUA-SS among men was 22.5 (range 8-35) and mean UDI-6 score among women was 9.3 (range 2-16). Mean PGI-S score was 3.1 (range 1-4) and mean Health Related Quality of Life (HRQL) subscale, as part of the OAB-q SF was 44 (range 22-78). Nocturnal enuresis is associated with multiple possible co-factors in all populations with majority reporting use of sedating medications. NE is associated with significant symptom bother and impacts greatly on QoL.

Retrospective analysis in 46 women with vulvovaginal atrophy treated with ospemifene for 12 weeks: improvement in overactive bladder symptoms

Aims: The aim of this study was to assess the effectiveness and safety of ospemifene in the improvement of overactive bladder (OAB) symptoms in postmenopausal women affected by vulvovaginal atrophy (VVA).Methods: Forty-six postmenopausal patients affected by VVA with OAB syndrome were enrolled for the study. All patients received Ospemifene 60 mg for 12 weeks. Clinical examination, 3-day voiding diary, urodynamic testing, ultrasound measurement of endometrial and bladder wall thickness (BWT) and the Vaginal Health Index (VHI) were performed at baseline and 12 weeks. Patients completed the OAB-Q SF and UDI-6.Results: After 12-weeks, the number of patients with detrusor overactivity decreased from 39% to 13% (p = 0.04). The reduction in the mean number in 24 h of voids (9.57 ± 2.12 vs. 6.63 ± 1.22, p < 0.0001), urgent micturition episodes/24 h (5.63 ± 1.46 vs. 1.44 ± 1.31, p < 0.0001), nocturia episodes (3.17 ± 0.85 vs. 1.11 ± 1.18, p < 0.0001), urinary incontinence episodes/24 h (0.85 ± 0.96 vs. 0.33 ± 0.64, p = 0.003) was observed. The UDI-6, OAB-Q symptoms, OAB-Q (HRQL) scores were 8.95 ± 0.91 vs. 5.56 ± 1.40, 62.60 ± 14.70 vs. 20.08 ± 10.83 and 18.71 ± 7.41 vs. 79.45 ± 14.47 (p < 0.001) before and after 12 weeks.Conclusion: Ospemifene is an effective potential therapy for postmenopausal women with VVA improving OAB symptoms and quality of life.

Efficiency of enuresis prevention for 7-year-old children first entering school in the Russian Federation

Objective: To study the efficiency of enuresis prevention for 7-year-old children first entering school and having no experience of staying in preschool institutions. Method: The following groups among 7-year-old children (mean age 7.2 ± 0.6 years) who had a planned prophylactic medical examination were formed by means of random sampling: Group A included children diagnosed with primary monosymptomatic enuresis (PMNE) at the age of 5-7 years, but in whom at the time of admission to school, sleep urinations were not observed. This group had alarm intervention as a prophylactic measure. Group B similarly included children who diagnosed with PMNE at the age of 5-7 years, and in whom at the time of admission to school, sleep urinations were not observed. However, in this group there was no alarm intervention. Group C included children in whom after the age of 5 years no episodes of sleep urination were observed. According to the recommendations of International Children's Continence Society (ICCS), enuresis was established in the event of at least two episodes of urinary incontinence per week and the duration of symptoms was at least 3 months. All these children were admitted to the first class of secondary school one month after the beginning of observation. Patients of all three groups were laboratory tested and had uroflowmetry and questionnaire survey with OAB-q SF. The study design was approved by the Ethics Committee of the Far Eastern Federal University. Results: Mean number of dry nights was markedly less in group B (4.5 ± 0.7) compared to groups A (6.2 ± 0.8) and C (6.6 ± 0.8). This was statistically significant (p Mean number of enuresis episodes significantly increased in both groups A (p Conclusions: In this study, children without PMNE had a low risk of developing enuresis on school admission. In children with PMNE at the age of 5-7 years, who successfully overcame it and had no prophylactic alarm intervention, risk of developing enuresis on school admission was significantly higher than in children without PMNE. In children with PMNE at 5-7 years of age, who successfully overcame it and who had prophylactic alarm intervention, risk of developing enuresis on school admission did not differ significantly from that in children without PMNE. Sri Lanka Journal of Child Health, 2017; 46: 33-38

Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms.

PurposeThe prevalence of hyperactive-type lower urinary tract symptoms is 45.2%, with shares of overactive bladder (OAB) and urge incontinence (UI) symptoms of 10.7% and 8.2%, respectively. We investigated the possible impact of a wide range of social, economic, and medical factors on compliance with solifenacin treatment in the working population.MethodsSocial, economic, and medical factors as well as the Overactive Bladder questionnaire – the OAB-q Short Form (OAB-q SF), bladder diaries, and uroflowmetry of 1,038 people who were administered solifenacin for a year were gathered from employer documentation.ResultsAmong the subjects, 32% maintained their compliance with solifenacin treatment throughout the year. Only 65% of the patients had compliance exceeding 80%, and 17% of patients had compliance of ≥50%, yet less than 80% were still taking solifenacin 12 months after the beginning of this experiment. Working people whose compliance level was, at least, 80% had reliably higher (P≤0.01) average age, annual salary, and treatment efficacy, and a greater treatment satisfaction level, as well as a lack of satisfaction with other antimuscarinic treatments and higher rate of urge UI diagnosis. The same cohort also featured a lower level (P≤0.01) of caffeine abuse and lower share of salary spent purchasing solifenacin.ConclusionsThis study has shown that compliance with solifenacin treatment is associated with a number of significant medical, social, and economic factors. The medical factors included the type of urination disorder, severity of incontinence symptoms, presence of side effects, treatment efficacy and patients’ satisfaction with it, and experience using other antimuscarinic treatments. Among the social and economic factors, those with the strongest correlation to compliance were patient age, employment in medicine and education, annual income level, percentage of solifenacin purchase expenditures, and caffeine abuse. Factors with a weaker, but still significant, association were gender, employment in the transportation industry, and monthly income level.

Caffeine as a Probable Factor for Increased Risk of OAB Development in Elderly People

Objective: This study was conducted to compare overactive bladder (OAB) prevalence among people greater than 60 years of age who intake various doses of caffeine, as well as those who abstain from caffeine. Patients and Methods: A randomized observational study was carried out in Vladivostok Gerontological Hospital. A total of 1,098 retired people greater than 60 years of age (659 women and 439 men, average age 67.1 years) took part in the study. They were admitted to the in-patient department with the purpose of annual physical examination performed in accordance with the order of the Ministry of Public Health of the Russian Federation. People over age 60, who at the moment of examination were in satisfactory health condition, were included into the study. People in which OAB had been detected or who used to take antimuscarinic were excluded from the study. Assessment tools for examining the patients' lower urinary tract condition were as follows: OAB-q SF, urination diaries, and uroflowmetry. Results: In the course of the experiment conducted, we found that 1/3 of people, both men and women greater than 60 years of age, who did not previously seek medical advice due to urination troubles, had symptoms of detrusor overactivity. These symptoms were moderate and did not bother patients too much in most cases (63.4%). It was also found that most patients consumed no more than 300mg caffeine with beverages per day, with 30% and 10% of patients suffering from OAB or severe detrusor overactivity, respectively. At the same time, almost 50% of patients taking more than 300 mg of caffeine per day suffer from OAB. Conclusion: 48.1% of people over 60 years of age suffering from overactive detrusor symptoms consume greater than 300 mg caffeine daily, which is significantly higher than that of their peers who do not intake excessive amounts of caffeine.

The concomitant use of fesoterodine and topical vaginal estrogen in the management of overactive bladder and sexual dysfunction in postmenopausal women.

The objective of this study is to investigate the combination effect of anti-muscarinic medication and topical vaginal estrogen in the treatment of overactive bladder (OAB) and female sexual dysfunction in postmenopausal women. After IRB approval, 23 female subjects who met the entry criteria were randomized into two groups: (1) fesoterodine (Toviaz®, Pfizer, NY) with topical vaginal estrogen (Premarin®, Pfizer, NY) once daily or (2) fesoterodine once daily alone. If 4 mg fesoterodine was tolerated at 1-week, the dose was increased to 8 mg. Primary endpoints were improvement in OAB symptom severity (Overactive Bladder Questionnaire, OAB-Q SF), improvement in OAB health-related quality of life (HRQL) (OAB-Q SF), and sexual function (Sexual Quality of Life-Female, SQOL-F) after 12 weeks. Secondary endpoint was change in total number of micturitions. After 12-weeks, the combination group had a significant improvement in OAB symptom severity (p = 0.006), HRQL (p = 0.029), and SQOL-F (0.0003). The fesoterodine alone group also had significant improvement in OAB symptom severity (p < 0.0001), HRQL (p = 0.0002), and SQOL-F (p = 0.02). When compared directly to the fesoterodine alone group, the combination group after 12-weeks had a reduced OAB symptom severity (10 versus 23.3; p = 0.35), higher HRQL (96.9 versus 84.6; p = 0.75), and higher SQOL-F (99 versus 81; p = 0.098). The total number of micturitions over 3 d was significantly reduced in the combination group (45-26, p = 0.03) between baseline and 12-weeks. The combined effect of fesoterodine and topical vaginal estrogen improved OAB symptoms and sexual function in postmenopausal women.

The Clinical and Urodynamic Results of Percutaneous Posterior Tibial Nerve Stimulation on Neurogenic Detrusor Overactivity in Patients With Parkinson's Disease

To investigate the effect of percutaneous posterior tibial nerve stimulation (PTNS) treatment after 12 weeks on urodynamic and clinical findings in patients with Parkinson's disease (PD) with neurogenic detrusor overactivity. A total of 47 patients with PD with neurogenic detrusor overactivity were enrolled in the study. Urodynamic studies before and after 12-week PTNS treatment were performed. International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Overactive Bladder Questionnaire (OAB-V8), and Overactive Bladder Questionnaire Short Form (OAB-q SF) have been assessed before and after PTNS treatment. The mean first involuntary detrusor contraction volume (1st IDCV) on standard cystometry was 133.2 ± 48.1 (24-265) mL, whereas it was 237.3 ± 43.1 (145-390) mL after PTNS. The mean maximum cystometric capacity (MCC) on standard cystometry was 202.2 ± 36.5 (115-320) mL, whereas it was 292.1 ± 50.6 (195-395) mL after stimulation. The improvements in the first involuntary detrusor contraction volume and maximum cystometric capacity were statistically significant after stimulation. The mean Pdetmax at first involuntary detrusor contraction, maximal detrusor pressure at maximum cystometric capacity, PdetQmax, Qmax, and post-void residual volume were statistically significant after 12-week stimulation. Mean parametric improvements at 12-week PTNS treatment from baseline included daytime frequency decreased by 5.6 voids daily, urge incontinence decreased by 3.1 episodes daily, urgency episodes decreased by 6.3 episodes daily, nocturia decreased by 2.7 voids, and voided volume improved by a mean of 92.6 mL. The change from baseline on the ICIQ-SF, OABv8, and OAB-q at 12-week PTNS treatment demonstrated statistically significant improvements. These results have demonstrated that PTNS improves the lower urinary tract symptoms and urodynamic parameters in patients with PD.

Long term sustained therapeutic effects of percutaneous posterior tibial nerve stimulation treatment of neurogenic overactive bladder in multiple sclerosis patients: 12-months results.

The aim of this study is to determine the sustained therapeutic efficacy and treatment intervals for PTNS in NOAB with MS, offering periodic additional treatments during 1 year in patients who completed an initial course of 12 consecutive weekly sessions. A total of 34 patients enrolled to the PTNS treatment and 21 patients completed the 1 year PTNS treatment with a tapering protocol of 6, 9, and 12 months of therapy, respectively. After 12 weeks of therapy, PTNS was applied at 14 day intervals for 3 months, 21 day intervals for 3 months, and 28 day intervals for 3 months. The patients completed a 3-day voiding diary at 3rd, 6th, 9th, and 12th month. The patients requested to complete validated questionnaires (ICIQ-SF, OAB-V8, OAB-q SF) were carried out within 3-month intervals thereafter during their enrolment in the study. A total of 21 patients were enrolled in the study. Of these 5 (23.8%) were men and 16 (76.2%) women. The improvements for all voiding diary parameters were significant in the 6th, 9th, and 12th months when compared with baseline. Mean values between baseline and 12 month parameters suggested that daytime frequency decreased by 5.4 voids daily, urge incontinence decreased by 3.4 episodes daily, urgency episodes decreased by 7.4 episodes daily, nocturia decreased by 2.6 voids, and voided volume improved by a mean of 72.1 cc. These results have demonstrated NOAB symptom improvement in MS patients can be achieved with 12 weekly PTNS treatments which show excellent durability over 12 months. Neurourol. Urodynam. 36:104-110, 2017. © 2015 Wiley Periodicals, Inc.

Validation of a bladder symptom screening tool in women with incontinence due to overactive bladder.

Introduction and hypothesisThe Actionable Bladder Symptom Screening Tool (ABSST) was initially developed to identify patients with multiple sclerosis (MS) who could benefit from lower urinary tract assessment and treatment. Assessment of the measurement properties of the ABSST, including its ability to identify patients experiencing bladder symptoms related to overactive bladder (OAB), was undertaken in a general female population.MethodsOne hundred women completed the ABSST, OAB Questionnaire Short Form (OAB-q SF), and a patient global impression of severity (PGI-S) scale. Half of the sample had urgency urinary incontinence (UUI), while the other half did not. Descriptive statistics, reliability, and validity were examined, as was sensitivity and specificity of the previous cut-off score established in MS.ResultsFifty-three women with UUI/OAB and 47 controls took part (71.0 % Caucasian). Patients with UUI/OAB were older (54.6 vs 40.4 years), had a higher body mass index (31.1 vs 26.4 kg/m2), and more comorbid conditions. The Cronbach’s alpha reliability of ABSST was 0.90. High correlations with OAB-q SF Symptom Bother and Health Related Quality of Life (r = 0.83 and −0.81 respectively) supported concurrent validity. Using the PGI-S severity scores as a reference, the ABSST was able to distinguish patients with differing severity levels (known-group validity). Physician assessment of the need for further evaluation/treatment showed sensitivity (79 %) and specificity (98 %), supporting a cut-off score of ≥3.ConclusionsThe previous MS ABSST scoring algorithm was validated in a non-neurogenic female population. ABSST is a reliable, valid, and sensitive tool for screening women with UUI/OAB.

MP76-20 IMPACT OF BARIATRIC SURGERY ON OVERACTIVE BLADDER SYMPTOMS IN A COHORT OF OBESE PATIENTS: A PROSPECTIVE INVESTIGATION

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-neurogenic Voiding Dysfunction1 Apr 2014MP76-20 IMPACT OF BARIATRIC SURGERY ON OVERACTIVE BLADDER SYMPTOMS IN A COHORT OF OBESE PATIENTS: A PROSPECTIVE INVESTIGATION Giovanni Palleschi, Antonio Luigi Pastore, Luigi Silvestri, Andrea Fuschi, Yazan Al Salhi, Davide Moschese, Cristina Maggioni, Andrea Ripoli, and Antonio Carbone Giovanni PalleschiGiovanni Palleschi More articles by this author , Antonio Luigi PastoreAntonio Luigi Pastore More articles by this author , Luigi SilvestriLuigi Silvestri More articles by this author , Andrea FuschiAndrea Fuschi More articles by this author , Yazan Al SalhiYazan Al Salhi More articles by this author , Davide MoscheseDavide Moschese More articles by this author , Cristina MaggioniCristina Maggioni More articles by this author , Andrea RipoliAndrea Ripoli More articles by this author , and Antonio CarboneAntonio Carbone More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2413AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Epidemiological data show an association between obesity and lower urinary tract symptoms (LUTS), especially urinary frequency, urinary urgency and urinary incontinence. Patients with pathologic obesity satisfying specific criteria may be submitted to bariatric surgery which provides a significant reduction of body mass index (BMI) improving quality of life. The aim of this prospective pilot study was to assess the impact of bariatric surgery in a cohort of obese patients suffering from overactive bladder (OAB) symptoms. METHODS From December 2011 to June 2012, a preliminary cohort of 51 patients was enrolled in the protocol. The population was represented by 38 females and 13 males, aged between 19 and 58 years, mean age was 38□4.5 years. Mean BMI of patients was 43.96□8.3; 65.38% of patients had a BMI> 40. Inclusion criteria were considered: obesity (BMI 30) and OAB symptoms investigated by the short form OAB questionnaire (OAB-q SF). Exclusion criteria were represented by urinary infection (urinanalysis), previous urological or gynaecological surgery, suspicious of neurogenic diseases (neurological examination), genital prolapse, significant post-voiding residue (100 mls, evaluated by bladder ultrasound), evidence of chronic renal disease (serum creatinine 1,5 mg/dl). Patients were evaluated at: 1 week before surgery (baseline) and 90 days after surgery (control), represented by “sleeve gastrectomy”. All patients gave their informed consent to be enrolled in the protocol. Statistical analysis was performed to compare BMI and OAB-q SF scores between baseline and follow-up (Student’s T test). RESULTS 29/51 subjects resulted eligible for the protocol (56.8% of the preliminary cohort, 20 females, 9 males, range age 28-58 years, mean 39±3.7 years). Surgical time was 68±21 minutes. There were no intraoperative or postoperative significant complications. Mean hospital stay was 3±1.3 days. A significant reduction of BMI was provided by surgery (preoperative BMI = 43.9±54.5 vs post-operative BMI = 33.45±8,3; p 0,0001). Furthermore, a significant reduction of OAB-q score was observed at 90 days from surgery. CONCLUSIONS Obese patients present several comorbidities and most of these may differently contribute to develop LUTS, including OAB symptoms. Preliminary data coming from our pilot study show that also urinary symptoms may benefit from BMI reduction provided by bariatric surgery. This investigation shows that OAB is well represented in obese subjects and that symptoms significantly improve after bariatric surgery. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e890 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Giovanni Palleschi More articles by this author Antonio Luigi Pastore More articles by this author Luigi Silvestri More articles by this author Andrea Fuschi More articles by this author Yazan Al Salhi More articles by this author Davide Moschese More articles by this author Cristina Maggioni More articles by this author Andrea Ripoli More articles by this author Antonio Carbone More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...

Development and validation of the actionable bladder symptom screening tool for multiple sclerosis patients.

Bladder symptoms such as urinary urgency, frequency, and incontinence are common in people with multiple sclerosis (MS). These symptoms, which often result from neurogenic detrusor overactivity (NDO), can have a major impact on patients' day-to-day lives. However, in many cases they are over-looked in the clinical management of MS. The objective of this study was to develop and validate a reliable, sensitive, and specific screening tool for patients with bladder problems related to MS. We performed a literature review and then conducted a content validation study followed by a multisite observational study of a new screening tool, the Actionable Bladder Symptom Screening Tool (ABSST). All ABSST domains as well as the total score met the threshold for good internal consistency (Cronbach α ≥ 0.70), with a Cronbach α value of 0.95 for the total score and values ranging from 0.85 to 0.90 for the three domains. The validity of the ABSST was demonstrated by high correlation of the domains and total score with the Overactive Bladder Questionnaire Short Form (OAB-q SF) Symptom Severity and Total Health-Related Quality of Life (HRQOL) scores (Spearman correlation coefficient ≥ 0.782). The predictive validity of the ABSST total score to identify patients who might receive a recommendation to see a urologist was strong. This new instrument, which was developed with input from clinicians as well as MS patients, meets the current content validity and psychometric testing thresholds established by the US Food and Drug Administration, with high sensitivity and specificity.

1037 USE OF A NEW PELVIC DIARY TO DETECT UROGENITAL AND BOWEL DYSFUNCTIONS IN HEALTHY FEMALE ATHLETES

INTRODUCTION AND OBJECTIVES: The frequency-volume chart or micturition diary records a patientias voiding pattern during normal daily activities. The aim of this study was to formulate a comprehensive pelvic diary testing it on a selected population of healthy young female athletes in order to discover possible hidden pelvic dysfunctions. METHODS: The pelvic diary was designed after a structured literature review carried out from 1966 to December 2010 using MEDLINE via PubMed. In order to test this 7-day pelvic diary in a healthy control group a pilot observational prospective cohort study was planned, involving healthy young female athletes. Moreover all participants had to fill out the following validated symptom and healthrelated quality of life (HR-QoL) questionnaires: ICI-Q SF, OAB-q Short Form, P-QOL, Wexner score. RESULTS: From January 2012 to March 2012 a 7-day pelvic diary and the validated questionnaires were mailed to 422 female athletes by post. Replies were received from 284 of them. The mean age was 24.9 years with a mean body mass index of 20.9. Most of them were either volleyball (60.4%) or basketball (26.4%) players. Mean urinary frequency was 5.4 1.7. Mean compiled days were 6.4 1.5 days. Mean daily urine volume was 1119 600.9. Overall 46 subjects reported urinary incontinence episodes and 66 urgency. Moreover 12 athletes reported voiding problems. Concerning bowel symptom, 18 had faecal incontinence (77.8% gas incontinence) and 6 complained of pain during defecation. Regarding sexual and genital problems, 6 complained of dyspareunia and 10 had a feeling of heaviness in the vaginal area. The mean Wexner score was 6.01; the mean OAB-q SF score was 6.2. Concerning P-OQL domains we recorded the following mean score values: general health 30.1 10.18; prolapse impact 15.8 12.4; role limitation 15.2 13.0; physical limitation 14.9 12.8; personal relationships 6.5 11.2; emotions 15.4 14.3; sleep/energy 14.5 12.6; severity measures 15.6 14. CONCLUSIONS: Our comprehensive pelvic diary allowed us to detect hidden pelvic dysfunctions in young healthy women like validated symptom questionnaries. Because a validated urinary diary does not currently exist, in order to corroborate our preliminary results future steps will be to compare our pelvic questionnaire against an adequate gold standard such as the above mentioned validated symptom questionnaires.

Predicting self-perceived antimuscarinic therapy effectiveness on overactive bladder symptoms using the Overactive Bladder 8-Question Awareness Tool

This work was designed to explore the ability of the self-administered Overactive Bladder 8-Question Awareness Tool (OAB-V8) to predict patient self-assessed effectiveness of antimuscarinic therapy on OAB symptoms in daily practice. Also, the ability of the tool to predict clinician evaluation of improvement was explored. Patients of both genders, >18 years, with symptomatic OAB (score >8 on OAB-V8), and able to understand patient-reported outcome instruments were enrolled in this 3-month study. Patients were prescribed treatment with an antimuscarinic drug according to usual practice. Treatment effectiveness was assessed by the clinician and patient using the Clinical Global Impression of Improvement and Treatment Benefit Scale and by improved self-perceived quality of life using the Overactive Bladder Questionnaire Short Form (OAB-q SF) 3 months after initiating or changing an antimuscarinic therapy. Multivariate linear and logistic regression models were applied to explore the predictive validity of OAB-V8 scores at the baseline visit. A total of 246 patients (57.7 years, 67 % women) were analyzed. Based on baseline OAB-V8 scores, logistic regression models were capable of predicting clinical improvement and patient self-perceived treatment benefit in 70 % of cases. OAB-V8 scores significantly correlated with OAB-q SF domains at baseline: 0.790 and - 0.659 for symptom bother and health-related quality of life domains, respectively (p < 0.001 in both cases). Baseline OAB-V8 score was able to predict changes in both domains of the OAB-q SF: R (2) = 0.212 and 0.162 for symptom bother and health-related quality of life, respectively. The OAB-V8 scale showed evidence of predictive validity for antimuscarinic effectiveness in daily practice based on physician assessment and patient self-assessment of improved quality of life and treatment benefit.

Quality of Life in Patients with Overactive Bladder

Overactive bladder (OAB) is characterized by the symptoms of urinary urgency or urge incontinence, which appear without a local pathological or metabolic explanation. OAB is defined by symptoms and the evaluation of treatment effectiveness should be based upon patient perceptions. The Overactive Bladder Questionnaire-Short Form (OAB-q SF) is a brief, self-administered patient-reported outcomes tool with two scales assessing symptom bother and health-related quality of life (HR-QOL) in patients with OAB. This study aimed to adapt the OAB-q SF into Spanish and to estimate its psychometric properties in patients with symptomatic overactive bladder. The Spanish version of the OAB-q SF was administered on two occasions, 3 months apart, to a set of patients of both sexes, over 18 years of age, diagnosed with OAB, scoring ≥8 on the OAB-V8 scale (a self-reported 8-item OAB screening and awareness tool), and able to understand patient-reported-outcome instruments written in Spanish. Patients were recruited consecutively at urology clinics. Feasibility, internal consistency (Cronbach's alpha), test-retest reliability, structure of instrument, criteria and construct validity and responsiveness were examined using classic test theory statistics. Data from 246 OAB patients (mean age 57.7 years, 76% women, 99% Caucasian, 37% workers and 36% with a primary education) were evaluated. Floor and ceiling effects ranged between 0.8% and 33%, and missing items were below 2%. Cronbach's alphas attained 0.811 and 0.922 for symptom-bother and HR-QOL domains, respectively. These two subscales matched the original structure and explained variances above 50%, which correlated moderately with EQ-5D (EuroQol) [r = -0.28 and r = +0.31, respectively (p < 0.001 in both cases)]. A significant change in OAB-q SF mean domain scores (-23.8; 95% CI -26.3, -21.3; and +17.7; 95% CI 15.4, 20.6; p < 0.001 in both cases; [effect sizes: 1.32 and 0.98]) was observed after 3 months of medical treatment. The Spanish version of the OAB-q SF demonstrated sufficiently strong psychometric properties of reliability, validity and responsiveness to be used in the measurement of OAB symptom severity and HR-QOL.

Quality of Life in Patients with Overactive Bladder

Background: Overactive bladder (OAB) is characterized by the symptoms of urinary urgency or urge incontinence, which appear without a local patho logical or metabolic explanation. OAB is defined by symptoms and the evaluation of treatment effectiveness should be based upon patient perceptions. The Overactive Bladder Questionnaire-Short Form (OAB-q SF) is a brief, self-administered patient-reported outcomes tool with two scales assessing symptom bother and health-related quality of life (HR-QOL) in patients with OAB.

The prevalence of probable overactive bladder, associated risk factors and its effect on quality of life among Turkish midwifery students

To evaluate the associated risk factors of probable overactive bladder (OAB) and to determine the effect of OAB on quality of life through validated questionnaires in Turkish midwifery students. 279 midwifery students were invited to participate, and 265 (95.0%) were included in the study, which was approved by the local ethics committees. The relationship between quality of life and probable OAB was evaluated using Turkish language-validated questionnaires (OABq SF, NQOL). Chi-square test, t-test and logistic regression were used for the statistical analysis, and p<0.05 was considered significant. The participants' mean age was 21.74 ± 2.15 years. The prevalence of OAB was 35.4%. There was a significant relationship between the presence of probable OAB and familial urinary incontinence history and childhood nocturnal enuresis. In the logistic regression analysis, family history was associated with an OR of 2.11 (95% CI: 1.08-4.10) for OAB, and nocturia with an OR of 2.69 (95% CI: 1.16-6.21) for OAB. Drinking moderate amounts of tea and carbonated drinks daily did not affect OAB, but extreme consumption of these beverages was associated with an OR of 2.98 (95% CI: 1.26-7.03) for OAB. OAB significantly worsens quality of life according to all the quality of life indices. OAB is not a rare condition among young people. It appears that the quality of life was adversely influenced by OAB among both younger and older people. Familial urinary incontinence and childhood nocturnal enuresis were found to be risk factors for OAB. There is insufficient evidence to restrict tea or carbonated drinks consumption in young people with OAB unless their consumption is extreme.