Presence Of Lower Urinary Tract Symptoms Research Articles

Prevalence of Lower Urinary Tract Symptoms in Women Planning to Undergo Hysterectomy for Uterine Leiomyoma and Abnormal Uterine Bleeding.

Introduction: Leiomyomas are associated with lower urinary tract symptoms (LUTS), but more specific characterization of their impact on LUTS is needed. Methods: This is a retrospective cohort study of 202 participants (101 per group) who underwent hysterectomy for leiomyomas versus abnormal uterine bleeding nonclassified (AUB-N) from July 2015 to May 2019. Baseline demographics, leiomyoma characteristics, and presence of baseline LUTS were collected. The main objective was to compare the prevalence of LUTS between these two groups. Secondary objectives were to analyze the association between leiomyoma characteristics and the prevalence of LUTS. Results: There was no difference in baseline prevalence of LUTS between the hysterectomy for leiomyoma versus AUB-N groups (42.6% vs. 45.5%, p = 0.67). When examining the entire study cohort of participants, irrespective of hysterectomy indication, leiomyoma size >6 cm was associated with an increased prevalence of LUTS when compared with leiomyoma <6 cm (64.9% vs. 40.4%, p = 0.02), and specifically difficulty passing urine (p = 0.02), nocturia (p = 0.04), and urinary frequency (p = 0.04). When controlling for age, body mass index, parity, chronic pelvic pain, and diabetes, leiomyomas >6 cm remained significantly associated with the presence of LUTS (odds ratio 3.1, 95% confidence interval = 1.2-8.3) when compared with leiomyoma <6 cm. Presence of >1 leiomyoma was associated with urinary frequency (67.9% vs. 32.1%, p = 0.02) when compared with ≤1 leiomyoma. Anterior location and uterine volume were not associated with a difference in LUTS. Conclusion: LUTS are prevalent in those planning hysterectomy for leiomyoma and AUB-N. Leiomyomas >6 cm are associated with the presence of LUTS. Future studies should evaluate change in LUTS following hysterectomy for leiomyomas.

Are Excessive Daytime Sleepiness and Lower Urinary Tract Symptoms the Triggering Link for Mental Imbalance? An Exploratory Post Hoc Analysis.

Both lower urinary tract symptoms (LUTS) and excessive daytime sleepiness (EDS) could negatively impair the patients' quality of life, increasing the sensitivity to psychological distress that results in mental health disorders. The relationships of both urinary and respiratory domains with psychological distress in obstructive sleep apnea patients is still underestimated. This study was a post hoc analysis of a web-based Italian survey, which included 1998 participants. Three hierarchical multiple linear regression analyses with psychological distress as dependent variable were performed on the study of 1988 participants enrolled in the final analysis. Cohen's f2 was used for the assessment of the effect size. From the hierarchical multiple linear regression analyses, it emerged that the final statistical model (including sociodemographic characteristics, comorbidities, perceived urinary function, and excessive daytime sleepiness) for all dimensions accounted for 16.7% of the variance in psychological distress, with a medium effect size (f2 = 0.15). People reported psychological distress was impaired by the presence of LUTS and EDS. Specifically, our study showed that higher levels of distress were scored especially in young women exhibiting urinary symptoms and with high values of daytime sleepiness.

The Effect of the Presence of Lower Urinary System Symptoms on the Prognosis of COVID-19: Preliminary Results of a Prospective Study

Purpose: To investigate the effectiveness of benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS), which occur as a natural result of aging and androgen exposure, in predicting disease prognosis in male patients diagnosed with COVID-19. Methods: The study was planned prospectively. The study included 63 male patients over 40 years of age diagnosed with COVID-19. The patients were diagnosed with COVID-19 based on the results of reverse transcription polymerase chain reaction tests of oropharyngeal and nasopharyngeal swabs obtained as per the World Health Organization guidelines. The presence of LUTS was assessed by the International Prostate Symptom Score (I-PSS), a subjective assessment, and the I-PSS was filled for the patients included in the study. The patients were divided into three groups based on their scores in the I-PSS survey: group 1: mild (0–7), group 2: moderate (8–19), and group 3: severe (20–35). The data of all three groups were statistically analyzed. Results: In the assessment performed between the groups, it was identified that for patients in group 3, the length of hospital stay was longer, intensive care requirement was more frequent, and their mortality rates were numerically higher. In the evaluation made regarding the time to intensive care admittance, this was identified to be the shortest in group 3. Conclusion: As a result of our study, we think that in patients with COVID-19, BPH-related LUTS can guide clinicians in predicting prognosis.

Lower urinary tract symptoms and their relation to vaginal atrophy in women across the menopausal age span. Results from the ANGEL multicentre observational study

ObjectivesTo evaluate the relation between lower urinary tract symptoms (LUTS) and vaginal atrophy (VA) in 518 women across the menopausal age span (40–55 years of age). Study DesignMulticentre, cross-sectional study. Main Outcome MeasuresVA was evaluated by the contemporaneous presence of a pH > 5, vaginal dryness and at least one objective sign of VA (mucosal pallor, dryness, thinning, fragility or with petechiae)., LUTS were evaluated by the Urogenital Distress Inventory (UDI-6). Sexuality was evaluated by the Female Sexual Function Index (FSFI). ResultsWomen were categorized by age: group 1, 40–45 years; group 2, 46–48 years; group 3, 49–51 years; and group 4, 52–55 years. Similar rates of recurrent urinary infection (RUI) were present in different age groups. RUI rate was related to VA (OR 1.703, 95 %CI 1.037, 2.799) and dyspareunia (OR 2.060, 95 %CI 1.199, 3.539). The rates of LUTS were also similar in the different age groups or in the presence of VA. The LUTS rate was related to dyspareunia (OR 1.971, 95 %CI 1.020, 3.808). Distress from LUTS was similar among different age groups and in the presence of VA. It was related to RUI (CR 7.187, 95 %CI 3.532, 10.841; p < 0.0001) and being an ex-smoker (CR 5.189, 95 %CI 1.425. 6.952; p < 0.007), and was inversely related to FSFI score (CR -0.314, 95 %CI -0.478, -0.149; p < 0.0002), ConclusionsIn women across the menopausal age span, RUI, but not LUTS, is related to VA. The presence of LUTS is related to dyspareunia, and distress from LUTS is inversely related to sexuality. These results obtained in women across the menopausal age span are not applicable to older postmenopausal women.

MP31-20 URINARY INCONTINENCE AND QUALITY OF LIFE IN FEMALE-TO-MALE TRANSGENDER SUBJECTS ON HORMONE THERAPY

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction II (MP31)1 Apr 2020MP31-20 URINARY INCONTINENCE AND QUALITY OF LIFE IN FEMALE-TO-MALE TRANSGENDER SUBJECTS ON HORMONE THERAPY Austin Fernstrum*, Al Ray, Britt Conroy, David Sheyn, and Juan Pablo del Rincon Austin Fernstrum*Austin Fernstrum* More articles by this author , Al RayAl Ray More articles by this author , Britt ConroyBritt Conroy More articles by this author , David SheynDavid Sheyn More articles by this author , and Juan Pablo del RinconJuan Pablo del Rincon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000875.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To investigate whether lower urinary tract symptoms (LUTS) impact quality of life (QOL) in female-to-male transgender persons on chronic testosterone therapy. Secondarily, we aimed to identify patient-related physical and social factors that contribute to differences in QOL. METHODS: Transgender female-to-male subjects, 18 years or older, treated with testosterone for at least 12 months were recruited from a public health care system. Subjects were excluded if they had prior surgery for incontinence, pelvic organ prolapse, or gender affirmation or an active urinary tract infection. LUTS were assessed using the American Urologic Association Symptom Score (AUASS) and the International Consultation on Incontinence Questionnaire (ICIQ). The WHOQOL-BREF instrument was used to investigate QOL, and the CES-D 8 instrument was used to screen for depression. T-test and Chi-square were used to compare continuous and categorical variables, respectively. The relationship between patient factors and QOL was evaluated using multivariable logistic regression. RESULTS: Overall, 141 transmen were included in the study. Subjects were subdivided into two cohorts based on presence of urinary incontinence defined by the ICIQ score. In the incontinence group [n=49, (34.8%)], individuals were older [30.6 vs 26.2 years, p =0.01], had a higher body mass index (BMI) [p=0.015], and cigarette smoking history [p=0.01] compared to those without incontinence [n=92 (65.2%)]. The incontinence group had a higher prevalence of positive screening for depression [63.3 vs 39.1%, p=0.006] and were more frequently classified as having a poor QOL index [20.4 vs 3.3%, p=0.0008]. On multivariate analysis, limited medical transportation [aOR: 0.23, CI: 0.06-0.91], lack of money for food [aOR: 0.23, CI: 0.07-0.90], and increased BMI [aOR: 0.92, CI: 0.86-0.99] were factors influencing poor QOL. CONCLUSIONS: Presence of incontinence in female-to-male transgender persons is associated with increased age, higher BMI, and smoking history. Despite these findings, presence of LUTS was not found to be independently associated with QOL after adjusting for psychosocial factors. Source of Funding: National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) grant, 5K12DK100014 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e482-e483 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Austin Fernstrum* More articles by this author Al Ray More articles by this author Britt Conroy More articles by this author David Sheyn More articles by this author Juan Pablo del Rincon More articles by this author Expand All Advertisement PDF downloadLoading ...

PD44-12 POSITIVE ASSOCIATION BETWEEN LOWER URINARY TRACT SYMPTOMS AND COITAL URINARY INCONTINENCE IN NULLIPAROUS WOMEN

INTRODUCTION AND OBJECTIVE: Coital urinary incontinence (CUI) is a clinical problem with significant impact on quality of life, yet continues to be infrequently studied and underdiagnosed. CUI has been shown to have a prevalence of 10-66% in women with urinary incontinence but it has not been well-studied in a nulliparous population, where the presence of CUI may be particularly distressing. The objective of our study was to examine the association of CUI and other lower urinary tract symptoms (LUTS) in nulliparous women (NW). METHODS: An IRB approved, cross-sectional electronic survey was administered to women ≥ 18 years old with a secondary analysis aimed to evaluate the association between LUTS and CUI. We included all non-pregnant, nulliparous, female participants who completed the survey. Using responses to validated questionnaires including the ICIQ-FLUTS, we queried the prevalence of urgency, urgency urinary incontinence (UUI), stress urinary incontinence (SUI), overactive bladder (OAB), and CUI. Descriptive summary statistics were tabulated and Chi-squared tests were used to identify associations. RESULTS: Our cohort included 1,533 NW, of which 121(7.9%) reported CUI. The mean age was 31.2 years (SD 10.9) and mean BMI 24.7 (SD 5.5). There were no significant differences in age, BMI, race, education, smoking, or hysterectomy status between NW with and without CUI. In NW women with diabetes, 21.05% reported CUI, compared to 7.56% of NW without diabetes (p=0.002). Compared to NP without CUI, NP with CUI were more likely to have stress urinary incontinence (10.91% vs 39.67%, p<0.001), urge urinary incontinence (8.36% vs 23.97%, p<0.001), overactive bladder (18.27% vs 42.15%, p<0.001), and urinary urgency (14.80% vs 32.23%, p<0.001). CONCLUSIONS: A low but significant percentage of nulliparous women experience CUI. The presence of LUTS with or without incontinence in NP was found to have a strong positive association with CUI. Further research is needed in this population in order to identify the degree of bother and treatment strategies for CUI in order to better address this under-diagnosed condition.Source of Funding: CTSA award No. UL1 TR002243 from the National Center for Advancing Translational Sciences

Evaluation of health-related quality of life and affecting factors in child with enuresis

Enuresis is a common problem in children and distressing condition that can have an impact on the child's behavior and on their emotional and social life. Health-related quality of life (HRQoL) is defined as an individual's perception of the impact of the disease and treatment. The aim of this study was to evaluate the HRQoL in Turkish children with enuresis and to investigate the effect of independent sociodemographic and clinical variables on HRQoL in children with enuresis. 110 children with enuresis and their mothers and 120 healthy children and their mothers were included in the study. The German quality of life questionnaire (KINDL®) scales were used to assess the children's HRQoL. For comparing the data of children with enuresis and healthy children, a two-sided unpaired t-test and linear regression model were used. The total HRQoL score for the children with enuresis group was 63.14±21.98 and for the children in the control group was 75.6±10.1 (P<0.001). After adjusting for sex and age using the unstandardized coefficient of regression model, HRQoL score for the children with enuresis still remained statistically significant lower than that for healthy peers (64.21± vs 75.11± P<0.001). The HRQoL subscale scores showed that children with enuresis had lower emotional well-being scores (64.23±14.2 vs 78.9±11.4, P<0.001), self-esteem score (62.23±11 vs 68.6±17.4, P=0.001), family relationship score (76.23±2 vs 83.4±12.2, P=0.042), and friendship score (62.4±13.2 vs 68.8±15.3, P=0.023) compared to the control group. When the effects of independent sociodemographic factors and clinical variables on HRQoL were evaluated, it was seen that the presence of lower urinary tract symptoms (LUTS) negatively affected total HRQoL score (59.89±11.2 vs 69.29±10.9 P=0.028). Also the total HRQoL score was higher in treated children with enuresis than in nontreated children (65.96±12.1 vs 55.27±10.1 P=0.032). Among the treated children, complete treatment response group had higher total HRQoL score compared to partial treatment response group and nonresponse group (respectively, 70.98±9.7, 65.25±10.1, 60.45±10.9, P=0.034, P=0.01) (Summary Figure). Family income level affected total HRQoL score, low-income group had lower total HRQoL score compared to high-income group (62.17±11.9 vs 69.25±10 P=0.039). This study demonstrated that enuresis negatively affects the HRQoL of children and most affected domains in HRQoL were self-esteem, emotional well-being, and their relationship for family and friends. Our presented study showed that HRQoL was lower in non-primary monosymptomatic nocturnal enuresis (non-PMNE) children, nontreated patients. Also there were higher HRQoL scores in patients who had a total or partial response to treatment. Our study may indicate that, low-income children with enuresis, nontreated enuretic children, and presence of LUTS should be considered as a risk group for low HRQoL.

Analysis of Biological Factors Causing Urinary Incontinence After Radical Prostatectomy (Literature Review)

Purpose: analysis of various biological factors underlying the post-prostatectomy incontinence.Materials and methods. The studies were conducted on the basis of PubMed and EMBASE publications from January 1990 to May 2015. After the initial search, the database consisted of 32 articles that met the inclusion and exclusion criteria.Results. Anatomical elements and pelvic support significantly affect the frequency of post-prostatectomy incontinence (PPI). It has been proven that non-anatomical and surgical elements play an important role in the development mechanisms of PPI. Biological factors and preoperative parameters included: functional changes in the bladder, age, body mass index, presence of lower urinary tract symptoms (LUTS), prostate volume and length of the membranous urethra. Numerous studies have noted the impact of specific surgical factors, including the short length of the membranous urethra, extended dissection of the apex, and insufficient experience of the surgeon. Each of these factors had a negative impact on the status of the continent in patients after radical prostatectomy (RP). Today, research continues on the analysis of preliminary transurethral resection of the prostate gland, hyperactivity of the detrusor and salvage techniques and their impact on the status of the postoperative continent.Conclusion. Based on modern literature, it is proved that biological / preoperative factors, which included an advanced age before surgery, the presence of LUTS, a significant body mass index, the length of the membranous urethra and functional changes in the bladder negatively affect the state of the continent after RP. Excessive dissection of the apex of the prostate gland, large sizes of the prostate gland and hyperactivity of the detrusor are also significant negative factors in urinary retention in patients who underwent RP.

Incidence of Lower Urinary Tract Symptoms in Middle Aged Patients Visiting the Gynaecology Out Patient Department of Shalamar Hospital, Lahore, Pakistan

Objective: To determine the incidence of Lower Urinary Tract Symptoms (LUTS) among patients visiting the gynaecology Outpatients Department (OPD) of Shalamar Hospital.&#x0D; Material &amp; Methods: A cross sectional study was performed and 300 patients were recruited. Patients aged 40 to 60 years, visiting the Gynaecology OPD at Shalamar Hospital, Lahore were enrolled from 1st February 2018 to 30th September 2018. The participants were categorized in to two sets: Premenopausal (n=187) and Post-Menopausal (n=113). They were asked to fill the international Consultation and Incontinence Questionnaire-Short Form (ICIQ-UI Short Form).&#x0D; Results: Increased urinary frequency was found to be the most commonly reported symptoms (48%).Stress incontinence and urge incontinence were reported by 58% subjects amongst postmenopausal category and 42% in the premenopausal category. Presence of LUTS was observed to be directly proportional with age.&#x0D; Conclusion: A high incidence of LUTS was observed among patients visiting gynaecology OPD of Shalamar Hospital, Lahore. Risk factors of LUTS and incontinence, like obesity and multiparity were frequency reported. Further studies are required to understand the magnitude of this problem in general population of Pakistan.

Impact of LUTS on treatment-related behaviors and quality of life: A population-based study in Brazil.

AimsTo report on the impact of lower urinary tract symptoms (LUTS) on treatment‐related behaviors and quality of life in Brazilian adults greater than or equal to 40 years.MethodsData were from a computer‐assisted telephone survey conducted in Brazil between 1 September and 31 December 2015 (Brazil LUTS study). Participants were adults greater than or equal to 40 years with landlines living in major cities from five geographical regions in Brazil. Participants rated how often they experienced individual LUTS during the previous month and associated bother, and the impact on quality of life (QoL), treatment seeking, treatment, treatment satisfaction, and treatment discontinuation. Multiple logistic regression models were adjusted to analyze the simultaneous effects of predictor variables on each dependent variable.ResultsWhen the presence of LUTS was defined as symptoms occurring less than half the time or more, one‐quarter of respondents sought treatment but 6% fewer actually received treatment. Of these, around 25% reported dissatisfaction with treatment and almost 10% reported treatment discontinuation. The occurrence of some symptoms and, in particular, the resultant bother were significantly related to worse QoL and to treatment‐related outcomes, such as treatment seeking, actual treatment, treatment dissatisfaction, and treatment discontinuation. Symptoms of all three categories were associated with all these domains for both sexes.ConclusionsThis is the first population‐based study carried out in South America showing that treatment seeking and treatment rates for LUTS are low. Since the LUTS prevalence is high, this reinforces the importance of a comprehensive medical assessment, focusing on the resulting bother, for more appropriate and personalized patient management.

Lower urinary tract symptoms and prostate cancer: is PSA testing in men with symptoms wise?

The best evidence to date shows that, overall, the harms of prostate cancer screening in asymptomatic men outweigh the benefits. A 2013 Cochrane review found that screening asymptomatic men did not save lives from the disease, and leads to detection of indolent prostate cancers that would not have gone on to cause harm in a man’s lifetime.1 This is known as overdiagnosis. Further weight was added to the results of the Cochrane review in the recent 10-year follow-up results from the cluster randomised trial of PSA testing for prostate cancer (CAP), which found that one-off PSA testing of asymptomatic men did not save lives from prostate cancer.2 For symptomatic men, however, the clinical situation is different. Current clinical guidelines from the National Institute for Health and Care Excellence (NICE) recommend that GPs consider a PSA test and digital rectal examination (DRE) in men presenting with lower urinary tract symptoms (LUTS) to investigate suspected prostate cancer.3 For the purposes of this article we defined LUTS as: nocturia, urgency, frequency, incomplete voiding, intermittency, terminal dribble, hesitancy, straining, weak or split stream, and/or post-micturation dribble. LUTS are very common in men, and have been estimated to be present in around 80% of men aged >60 years.4 The 2013 Cochrane review stated that ‘... the presence of LUTS, typically due to benign prostatic obstruction, are very common in the ageing male and are not considered to increase prostate …

The Association between Male Asthma and Lower Urinary Tract Symptoms Evaluated by the International Prostate Symptom Score: A Population-Based Study

Objectives: We explored the association between asthma severity and lower urinary tract symptoms (LUTS) using the International Prostate Symptom Score in a population-based study of males (aged ≥19 years) and evaluated voiding and urine storage symptoms. Methods: This was a cross-sectional study of 101,848 males, 2,544 of whom had asthma, who participated in the 2011 Korean Community Health Survey. All subjects were assessed in terms of sociodemographic data, pre-existing conditions, and the presence of LUTS. Logistic regression was used to identify risk factors for LUTS in asthmatics. Results: Urine storage symptoms (frequency, urgency, and nocturia) and voiding symptoms (straining, a weak stream, intermittency, and incomplete emptying) were significantly higher in the asthma group than in the non­asthma group (all p < 0.001). Moderate and severe LUTS were significantly more common in the asthma group (moderate, 24.3%; severe, 22.5%) than in the nonasthma group (moderate, 9.5%; severe, 2.9%). Compared to the mild LUTS group, the odds ratio (OR) for asthma was 2.21 (95% confidence interval [CI] 1.99–2.46) in the moderate LUTS group, and 3.04 (95% CI 2.64–3.51) in the severe LUTS group. In a model evaluating multiple variables, the OR for asthma in the moderate LUTS group was 1.95 (95% CI 1.74–2.16) and that in the severe LUTS group was 2.17 (95% CI 1.87–2.53). Asthma was associated with both voiding and storage symptoms. Conclusions: Male asthma was associated with moderate-to-severe LUTS. More aggressive urological diagnosis and treatment are needed for patients with asthma.

The Association Between Tetrahydrocannabinol and Lower Urinary Tract Symptoms Utilizing the National Health and Nutrition Examination Survey

ObjectiveTo further define the relationship between tetrahydrocannabinol (THC) and lower urinary tract symptoms (LUTS), specifically how THC use associates with the frequency of LUTS in young community-dwelling men in the United States. Materials and MethodsThe National Health and Nutrition Examination Survey database was queried (2005-2008). Men ages 20-59 who completed the urinary and substance abuse questionnaires were included. The presence of LUTS was defined as having ≥2 of the following: nocturia (≥2), hesitancy, incomplete emptying, or incontinence. THC use was self-reported, and participants were considered regular smokers if they endorsed smoking at least once per month. Multivariable logistic regression was performed to analyze the relationship between THC and LUTS. ResultsAmong 3,037 men who met inclusion criteria, 14.4% (n = 477) of subjects reported THC use. In multivariable analyses, adjusting for clinical variables, regular THC users remained significantly less likely to report LUTS (odds ratio of 0.55; confidence interval 95% 0.408-0.751, P <.01) compared to nonusers. ConclusionObesity, diabetes, and multiple comorbidities are well-established risk factors for LUTS within the National Health and Nutrition Examination Survey. Regular THC use, however, appears to be protective from LUTS in young community-dwelling men.

Central obesity indicating a higher prevalence of lower urinary tract symptoms: A case-control matching analysis from a Chinese cross-sectional study in males.

The aim of this study was to explore the association between central obesity and lower urinary tract symptoms (LUTS) among men in southern China, and test the hypothesis that central obesity measured by the waist-to-hip ratio (WHR) is a predictor of the severity of LUTS. In all, 4303 men from the Fangchenggang Area Male Healthy and Examination Survey (FAMHES) were included in this study. LUTS were assessed by the International Prostate Symptom Score (IPSS), whereas central obesity was evaluated by the WHR. The association between WHR and LUTS was tested using logistic and Cox regression analyses. After screening, 2917 participants were in the study. Univariate analysis indicated significant differences in WHR in the presence of LUTS (P = .012). After stratification by age, logistic regression indicated that LUTS were more frequent in 60-year-old men with a higher WHR (odds ratio [OR] 2.89, 95% confidence interval [CI] 1.21-6.89) compared with participants <40 years old. Cox regression analysis after pairing of 252 LUTS cases and 252 control subjects from the 2917 eligible participants according to age (±5 years), indicated that central obesity (WHR ≥0.9) may be significantly associated with moderate or severe LUTS (OR 1.95, 95% CI 1.16-3.26). The associations between central obesity and straining (OR 2.44, 95% CI 1.40-4.24) and weak stream (OR 2.37, 95% CI 1.27-4.45) were significant after multivariate adjustment. Males with central obesity are at increased risk of LUTS, and increased WHR is associated with worsened straining and weak stream. Further investigations are needed to confirm these associations.

Urodynamic Abnormalities in Patients with Relapsing Remitting Multiple Sclerosis

Background: Multiple sclerosis (MS) is a disease with wide variability in clinical presentation. Bladder dysfunctions are very common in MS patients. Early detection of bladder abnormalities is important to improve the outcome in MS patients. Objectives: The aim of this study is to evaluate the urodynamic detected bladder dysfunctions in relapsing remitting MS patients with mild or without lower urinary tract symptoms. Methods: This is a prospective study for 32 patients with relapsing remitting Multiple Sclerosis from January 2017 to June 2018. We included patients with mild or without lower urinary tract symptoms (LUTS) who had mild to moderate disability. Urodynamic studies were performed for all patients. Results: Urodynamic abnormalities were detected in 22 patients (68.75%). Detrusor overactivity (DO) was present alone in 8 patients (25%); DO combined with detrusor external sphincter dyssynergia in 8 patients (25%); DO with low compliant bladder and impaired contractility in another 4 patients (13%) while DO with low complaint bladder in 2 patients (6%). Bladder dysfunction was correlated to high disability score; longer duration of illness; frequent relapses and the presence of LUTS. Conclusion: Urodynamic abnormalities were found in 68.75% of our patients. This highlights the importance of urodynamic studies in the early evaluation of relapsing remitting Multiple Sclerosis.

Analyse des prescriptions de PSA total et libre en France entre 2012 et 2014

In 2010, the French Haute Autorité de santé (National Health Authority) confirmed the limited value of prostate cancer (PCa) screening by total prostate-specific antigen (PSA) assay. This study was designed to determine the modalities of ordering total PSA or free PSA assays (in the absence of PCa) according to various parameters and the corresponding sums reimbursed. Men aged 40years and older covered by the national health insurance general scheme (73% of the French population) between 2012 and 2014 were selected. Data were derived from the Système national d'information inter-régimes de l'assurance maladie (Sniiram) (National health insurance information system) database. In 2014, 27% of the 11.6million men 40years and older underwent at least one total PSA assay and 5.6% underwent at least one free PSA assay, with marked variations according to the presence or absence of treated lower urinary tract symptoms (LUTS) (53% and 15% vs 24% and 5%) and from one administrative department to another. The peak total PSA assay rate was observed between the ages of 65 and 74years: 64% of men with LUTS, 46% without LUTS. Between 2012 and 2014, men in whom at least one PSA assay had been performed underwent a mean of 1.8 total PSA assays and 1.7 free PSA assays, with means of 2.3 and 2, respectively, in the presence of LUTS. General practice specialists ordered 91% of the PSA tests reimbursed in 2014 (92% for total PSA and 87% for free PSA) and urologists ordered 4% of reimbursed tests. The total sum reimbursed was €28.5million, comprising €8.7million for free PSA. An average of 10laboratory tests was performed at the same time as the PSA assay in the absence of treated LUTS. Total PSA and free PSA assays are performed in a large number of men, although the value of these tests as first-line test before biopsy remains controversial. These PSA assays are associated with many other laboratory tests looking for possible abnormalities, especially in younger men, and their relevance may therefore not be specifically discussed with the patient.

High risk of lower urinary tract symptoms in patients with irritable bowel syndrome.

The aim of the present study was to investigate the prevalence of urinary tract infection (UTI) and the risk of lower urinary tract symptoms (LUTS) in women with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhea, and mixed) compared to women in the general population. Between January 2014 and December 2015, consecutive adult female patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy women with regular bowel habits were enrolled in the study. At baseline, we checked for UTI with a dipstick test and questioned patients about the presence of LUTS in the previous 24h. We enrolled 141 IBS patients and 91 healthy controls in the study. There was no difference in the prevalence of UTI between IBS patients and healthy controls (4.9 vs 3.3%, p=0.5). When we excluded patients with UTI, we found a 2.79 higher risk of increased urinary frequency [odds ratio (OR) 2.79, 95% confidence interval (CI) 1.37-5.68], a 2.68 higher risk of urinary urgency (OR 2.68, 95% CI 1.04-6.91), and more than three times the risk of having dysuria (OR 3.25, 95% CI 1.06-9.97) in IBS women compared to healthy controls. The risk of having at least one urinary symptom was independent of IBS subtype and IBS severity. Our study shows that IBS women have a similar risk of UTI compared to healthy women even if they complain more of LUTS, independently of IBS subtype and severity.

LUTS in MTF Sex Reassignment Surgery: Is It Possible to Evaluate the Outcome?

Lower urinary tract symptoms (LUTS) refer to a group of medical symptoms, that affect approximately 40% of old men. It is a term used to describe a range of symptoms related to problems of the lower urinary tract (bladder, prostate and urethra). Although it is known that in MTF transsexuals, LUTS may be common problems, little research effort has been devoted to use the correct instruments fot symptoms evaluation. Is it possible to evaluate the surgical outcome and the presence of LUTS by using the existing questionnaieres?

The relationship between the presence of lower urinary tract symptoms and waist circumference.

PurposeThe aim of the study is to evaluate the pressure of the pelvic floor muscles (PFM) according to waist circumference (WC) and correlate the presence of urinary tract symptoms (UTS) with WC.Patients and methodsThe study was observational and cross-sectional. One-hundred and sixty-four females between 45 and 65 years of age were evaluated. The sample was divided into two groups, according to WC: Group ≤80 (G≤80) was composed of females in whom WC was up to 80 cm; and Group >80 (G>80) was composed of females with WC above 80 cm. The subjects were assessed in terms of sociodemographic data, pre-existing conditions, urogynecological and obstetric history, and the presence of lower UTS (LUTS), as well as physical examination, measurement of WC, height, and weight. The PFM assessment was made by perineometry. To compare the mean between groups, the independent samples t-test was applied, and to correlate the WC with perineometry and LUTS, the Pearson’s correlation test was used.ResultsThe final sample was composed of 156 patients. The average age of participants was 55.21 (±24.5) years in G≤80 and 57.23 (±6.12) years in G>80. There were significant differences regarding the presence of LUTS between the groups (P<0.05); as to the perineometry, there was a significant difference (P=0.03) between the groups: 38.68±13.63 cmH2O for G≤80 and 30.11±11.20 cmH2O for G>80. There was a correlation between the presence of urinary urgency (r=0.7; P=0.00), nocturia (r=0.7; P=0.00), and urinary incontinence (r=0.9; P=0.00) with WC.ConclusionFemales with larger abdominal diameter have a higher prevalence of LUTS such as urinary incontinence, nocturia, and urinary urgency, as well as a lower PFM pressure. Furthermore, a relationship between LUTS with WC was also observed.

MP74-13 DIABETES SEVERITY, DIABETES BIOMARKERS AND LUTS: FINDINGS FROM NHANES

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction I1 Apr 2016MP74-13 DIABETES SEVERITY, DIABETES BIOMARKERS AND LUTS: FINDINGS FROM NHANES Christopher Tam and Bradley Erickson Christopher TamChristopher Tam More articles by this author and Bradley EricksonBradley Erickson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1710AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Type 2 Diabetes (DM2) has been implicated in the development of numerous conditions, including lower urinary tract symptoms (LUTS). The purpose of this study is to characterize the relationship between the severity of DM2 and presence of LUTS. METHODS The 2005-2008 cycles of the National Health and Nutrition Examination Survey (NHANES) were queried for men who completed both a DM2 and a kidney/prostate questionnaire. Men with LUTS were defined as those experiencing at least 1 out of 3 of the following: nocturia, hesitancy, or incomplete emptying. Men with DM2 were defined as having been diagnosed by a physician and being actively treated. Multivariate logistic regression with sample weighting was performed controlling for age, race, BMI, and smoking status to assess effects of biomarker levels (HgbA1c, fasting glucose), medication use, and surrogates of disease progression on the presence of LUTS. RESULTS Of the 2980 male participants, those with DM2 were more likely to experience at least one LUTS symptom (adjusted OR 1.64, p < 0.0001). In DM2 patients, diabetic retinopathy and frequent visits to a physician were associated with reporting symptoms, but not the DM2 treatment type, fasting glucose, or lifestyle factors such as exercise (Table 1). Work with a non-physician DM2 specialist decreased the risk. HgbA1c correlated with the number of LUTS in the general population, but not in diabetics (Figure 1). CONCLUSIONS Markers of poorly controlled diabetes (retinopathy, more frequent physician visits) were associated with increased prevalence of LUTS in the diabetic population. However, HgbA1c levels in actively treated DM2 patients do not correlate with LUTS, implying that improving HgbA1c levels alone may not reverse DM2 urologic sequelae. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e974 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Christopher Tam More articles by this author Bradley Erickson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...