Presence Of Urinary Symptoms Research Articles

Predictors of Participation in Prostate Cancer Screening among Older Men in Jordan.

Participation is one of the major factors affecting the long-term success of population-based prostate cancer screening programs. The aim of this study was to explore strong factors linked to participation in prostate cancer screening among older Jordanian adults using the Health Belief Model (HBM). Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care center within the Ministry of Health. A pilot test was conducted to investigate the internal consistency of the the Champion Health Belief Model Scale for prostate cancer screening and the clarity of survey questions. Sample characteristics and rates of participation in prostate cancer screening were examined using means and frequencies. Important factors associated with participation in prostate cancer screening were examined using bivariate correlation and multivariate logistic regression analysis. About 13% of the respondents had adhered to prostate cancer screening guidelines over the previous decade. Four out of the seven HBM-driven factors (perceived susceptibility, benefits and barriers to PSA test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were more likely to participate in prostate cancer screening. Family history, presence of urinary symptoms, age, and knowledge about prostate cancer significantly predicted the participation in prostate cancer screening. Health professionals should focus more on the four modifiable HBM-related factors to encourage older adults to participate in prostate cancer screening. Intervention programs, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.

Urinary Tract Infections in the Elderly

Urinary tract infection is a common diagnosis made in both primary and secondary care, with a lifetime prevalence of 50 % in women. Although superficially simple to diagnose and manage, the diagnosis is often erroneous in older people. The majority of urinary tract infections are caused by enteric bacteria, specifically Escherichia coli and Enterobacteriaceae. In older people without symptoms directly attributable to the urinary tract, urinary tract infection (UTI) is unlikely yet often diagnosed. In the presence of urinary symptoms, urine dipstick is not a useful investigation and urine should be sent for culture to guide antibiotic treatment. This review summarises the current investigation and management of urinary tract infections in older men and women.

Free uroflowmetry for voiding dysfunction measurement in women with pelvic organ prolapse and urinary incontinence in primary care.

Free uroflowmetry for voiding dysfunction measurement in women with pelvic organ prolapse and urinary incontinence in primary care.

Symptoms of lower urinary tract in women who practice physical exercise regularly.

Introduction: The practice of regular physical exercise provides benefits to health and quality of life. However, these are seen as promoters of dysfunctions of the pelvic floor muscles (PFMs). Objective: Evaluate the level of physical activity and the presence of urinary symptoms in women who perform exercise regularly and check the relation between then. Method: Forty-seven women who practice regularly physical exercise were evaluated in two gyms in the State of São Paulo/Brazil. The participants were characterized in accordance with the age, number of pregnancies, parity, body mass index, waist circumference, duration of physical exercise, weekly frequency of exercise and time spent in physical exercise. The level of physical activity was assessed by the "International Physical Activity Questionnaire" (IPAQ) long, and the presence of urinary symptoms and their severity were assessed by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). Results: Approximately 51.9% of women were considered active (greater than 600 METs value) and 49.1% were considered highly active (more than 1500's MET value). It was observed the presence UI in 72.3% of study participants. Approximately 52% of women showed a moderate UI according to the ICIQ-SF. Conclusion: Women were considered active or very active according to the recommendations of the IPAQ. It was observed a high prevalence of urinary symptoms in women on efforts in women who perform any physical activity regulary. The severity of the incontinence was classified as moderate according the ICIQ-SF. No significant relation it was observed between the severity of the UI and the level of physical activity.

Symptoms of the lower urinary tract in pregnant women in prenatal care.

Introduction: During pregnancy, hormonal and mechanical factors responsible for the development and fetal growth causes changes in the genital and urinary tract of women. It is observed the appearance of urinary symptoms in pregnant women previously continents up to 74%. Evaluate urinary symptoms and knowledge of the region in this period are important because they impact negatively on the quality of pregnant women’s life. Objective: Evaluate the presence of urinary symptoms and knowledge of PFM in pregnant women. Method: This is a descriptive cross-sectional study that evaluated pregnant women in care at the Basic Health Unit of São Paulo/SP. The characterization of women was taken by the assessment form, to measure urinary symptoms was used the International Consultation on Incontinence Questionnaire - Short Form (ICIQ - SF). On the other hand, the knowledge of PFM was evaluated by a specific questionnaire. Results: We evaluated 37 pregnant women with a mean age of 26.3 (14 and 37) years, body mass index of 28.5 (20.8 and 45.8) kg/m2 and gestational age of 24.8 (5 e 40) weeks. We observed the presence of UI in 81.1% of pregnant women, with a mean severity of 9.9 points for the ICIQ - SF. And about 54% of them knew of the existence of PFM and only 20% could locate the muscles. Conclusion: We Observed a high prevalence of urinary symptoms in women with moderate severity. Half of the women reported knowing the PFM, but only one fifth of them were able to locate them.

Hypovitaminosis D and Low Urinary Tract Symptoms in a Female Population

An increasing number of studies have suggested a key role for low levels of vitamin D in the development of several chronic diseases and bacterial infections. In particular, its role in acute respiratory infection has been clarified, while the potential role of vitamin D for susceptibility to urinary tract infections still remains unexplored. Since the typical symptoms associated with urinary infections or with other conditions, like overactive bladder, include dysuria, urgency and frequency, the aim of this study was to investigate the association between these symptoms and vitamin D status. We conducted a retrospective study on 233 women who, in the previous year, had their serum levels of vitamin D measured. The subjects were queried about the presence of urinary symptoms and their frequency over the previous year. Women with low serum levels of vitamin D had a higher prevalence of symptoms than those with normal levels of vitamin D (p<0.001). In particular, women who reported high frequency of symptoms had a mean vitamin D level of ∼ 27 ng/mL, those with low frequency had a mean vitamin D level of ∼ 24 ng/mL, while asymptomatic women had mean levels of ∼ 37 ng/mL (p=0.004 among group). In this study hypovitaminosis D is associated with urinary symptoms in a population of women, and it may suggest a key role of this vitamin in the development of infections or other conditions affecting the urinary tract.

Lower urinary tract symptoms and urodynamic dysfunction in clinically isolated syndromes suggestive of multiple sclerosis

Urinary symptoms associated with multiple sclerosis (MS) are common and negatively impact on quality of life, representing a considerable psychosocial and economic burden, often requiring care and hospitalization. Although the importance of identifying and adequately treating urinary symptoms in MS is now well recognized, there is no information, to date, about the real prevalence and impact of bladder symptoms in patients with clinically isolated syndromes (CISs) suggestive of MS. The aim of the present study was to investigate, in a cohort of patients with a diagnosis of CIS suggestive of MS, the prevalence of urinary tract symptoms, their impact on quality of life measures and their association with functional urodynamic dysfunctions. Patients underwent a complete neurological and urological visit, urodynamic investigation and the MSQoL-54 questionnaire. Twenty-eight consecutive patients presenting with CISs were enrolled in the study; 53.6% of CIS patients reported urinary symptoms, 46.7% reporting irritative symptoms, 33.3% both irritative and obstructive symptoms and 20% obstructive symptoms alone. Urodynamic abnormalities were observed in 57.1% of the CIS patients. In 17.9% of the CIS patients urodynamic dysfunctions were asymptomatic. The presence of urinary symptoms was associated with lower scores on specific quality of life domains, particularly in women with obstructive symptoms. A high prevalence of urinary symptoms and urodynamic dysfunctions in patients with CISs and an association of urinary symptoms with quality of life measures were found. These results highlight the importance of identifying and optimally treating urinary symptoms also at the very early stages of MS.

The contribution of genes polymorphism of thrombophilia in clinical variability of hemorrhagic vasculitis

The article is devoted to the study of clinical and laboratory characteristics of the current of hemorrhagic vasculitis in children in the Republic of Buryatia. The study included 27 patients aged 7.6 +/- 4.02 years, who conducted clinical and laboratory tests, immunological study of antiphospholipids of antibodies, genetic testing for thrombophilia markers of candidate genes. The results showed that hemorrhagic vasculitis often affects children of Buryat nationality. In 96% of cases there are mixed clinical forms of the disease. 63% of children of hemorrhagic vasculitis preceded by various factors, a higher percentage of infectious diseases. The first clinical symptom in 63% of patients is a typical purpura hemorrhagic rash. Results of clinical laboratory blood tests revealed no significant deviations. Circulation of lupus anticoagulant was detected in 37% of subjects. The alphaCL IgM detected in 3 children, alphabeta2-GP-I IgA--in 4, alphabeta2-GP-I IgM--in 1 patient. Carriers of thrombophilia polymorphisms were in 95% of children. Noted that homozygous variants of genes polymorphisms of methylenetetrahydrofolatered reductase and plasminogen activator inhibitor-1 correlate with the presence of urinary symptoms and recurrence of the rash. The study shows the risk of recurrent flow of hemorrhagic vasculitis and nefritis of Henoch-Schonlein in children with thrombophilia gene polymorphism.

Correlations Among Urinary, Sexual, and Testicular Functions and Health-Related Quality of Life

Background: We investigated how urinary, sexual, and testicular functions and generic health-related quality of life (HR-QOL) affect each other in aged men. Methods: Ninety patients who were negative for cancer on prostate biopsies were enrolled in this study. The mean patient age was 66±7 years (mean±s.d.). The mean prostate volume was 44.3±21.9 mL, and the mean serum total testosterone (TT) level was 3.63±1.18 ng/mL. Before conducting the prostate biopsies, the patients were asked to complete questionnaires, including the International Prostate Symptom Score (I-PSS), UCLA Prostate Cancer Index (UCLA-PCI), and the Rand Medical Outcome Study 36-Item Short Form (SF-36), to evaluate urinary symptoms, sexual function, and generic HR-QOL. The relationships between these parameters were analyzed. Other objective variables, such as the prostate volume, maximal urinary flow (Qmax), postvoid residual urine volume, and age, were also evaluated. Results: The TT level was found to be related to the I-PSS Q6 (r=−0.23108, p=0.03230) and Qmax (r=0.44210, p=0.00073). The mental component summary (MCS) score exhibited a significant negative relationship with the presence of urinary symptoms (sum of I-PSS Q1–7). When each I-PSS question was analyzed separately, nocturia (Q7) was found to have the most significant impact on SF-36; the physical component summary (PCS) and MCS were also worsened by nocturia. The UCLA-PCI sexual function was positively related to the SF-36 MCS, SF-36 PCS, and TT level and negatively related to the I-PSS Q3, Q5, Q6, and Q7. Aging also showed a negative impact on nocturia, sexual function, and the SF-36 PCS. Conclusions: TT levels are correlated with the parameters of urination. Urinary symptoms, sexual function, and generic HR-QOL were found to have close relationships. In the management of the health of aged men, physicians should consider urinary function together with testicular and sexual functions as well as overall QOL.

Systematic review of the relationship between bladder and bowel function: implications for patient management

The complex relationship between bladder and bowel function has implications for treating pelvic disorders. In this systematic review, we discuss the relationship between bladder and bowel function and its implications for managing coexisting constipation and overactive bladder (OAB) symptoms. Multiple PubMed searches of articles published in English from January 1990 through March 2011 were conducted using combinations of terms including bladder, bowel, crosstalk, lower urinary tract symptoms, OAB, incontinence, constipation, hypermotility, pathophysiology, prevalence, management and quality of life. Articles were selected for inclusion in the review based on their relevance to the topic. Animal studies and clinical data support bladder-bowel cross-sensitization, or crosstalk. In the rat, convergent neurons in the bladder and bowel as well as some superficial and deeper lumbosacral spinal neurons receive afferent signals from both bladder and bowel. On a functional level, in animals and humans, bowel distention affects bladder activity and vice versa. Clinically, the bladder-bowel relationship is evident through the presence of urinary symptoms in patients with irritable bowel syndrome and bowel symptoms in patients with acute cystitis. Functional gastrointestinal disorders, such as constipation, can contribute to the development of lower urinary tract symptoms, including OAB symptoms, and treatment of OAB with antimuscarinics can worsen constipation, a common antimuscarinic adverse effect. The initial approach to treating coexisting constipation and OAB should be to relieve constipation, which may resolve urinary symptoms. The relationship between bladder and bowel function should be considered when treating patients with urinary symptoms, bowel symptoms, or both.

What is evaluation of hematuria by primary care physicians? Use of electronic medical records to assess practice patterns with intermediate follow-up

BackgroundTo determine whether patients found to have hematuria by their primary care physicians are evaluated according to best practice policy. Materials and methodsThe University of Texas Southwestern Medical Center maintains institutional outpatient electronic medical records (EMR) that are used by all providers in all specialties. We conducted an Institutional Review Board approved observational study of patients found to have more than 5 red blood cells/high power field between March 2009 and February 2010. ResultsThere were 449 patients of whom the majority were female (82%), Caucasian (39%), with microscopic hematuria (MH) (85%). Almost 58% of patients were initially symptomatic with urinary symptoms or pain. Evaluation for the source of hematuria was limited and included imaging (35.6%), cystoscopy (9%, and cytology (7.3%). Only 36% of men and 8% of women were referred to a urologist. No abnormality was found in 32% and 51% of patients with gross hematuria and MH, respectively (P = 0.004). There were 4 bladder tumors and 1 renal mass detected. Male gender, ethnicity and gross (vs. microscopic) hematuria were associated with higher rate of urological referral. Advanced age, smoking, provider practice type, and the presence of urinary symptoms were not associated with an increase rate of urological referral. No additional cancers were diagnosed with 29-month follow-up. ConclusionsWhile urinalysis remains a common diagnostic tool, most cases of both microscopic and gross hematuria are not fully evaluated according to guidelines. Use of cystoscopy, cytology, and upper tract imaging is limited. Further studies will be needed to determine the extent of the problem and impact on morbidity and survival.

Association between the Geriatric Giants of urinary incontinence and falls in older people using data from the Leicestershire MRC Incontinence Study

To determine whether urinary incontinence per se and different types of urinary incontinence individually are associated with an increased risk of falls in those aged 70 years and over. To investigate whether the presence of urinary symptoms, poor quality of life and physical limitations in this population with urinary incontinence is associated with falls. Study using data from the cross-sectional postal questionnaire undertaken in the Leicestershire Medical Research Council Incontinence Study. Leicestershire. A total of 5,474 people aged 70 years or more living in the community randomly selected from general practitioners' lists. Urinary incontinence and both urge and stress incontinence were positively related to falls (P < 0.0001, P < 0.001 and P = 0.007, respectively). The larger the volume of urine lost, the greater the risk of falls (P < 0.0001). Falls were associated with the presence of urinary symptoms (P = 0.01 or less), physical limitations (P = 0.001 or less) and having a poorer quality of life (P = 0.004 or less) in respondents with urinary incontinence. An association has been shown between falling and urinary leakage including the previously unreported association with stress leakage. Falling and urinary incontinence were found to be associated with physical limitations and had an impact on quality of life.

Cranberry Juice Fails to Prevent Recurrent Urinary Tract Infection: Results From a Randomized Placebo-Controlled Trial

A number of observational studies and a few small or open randomized clinical trials suggest that the American cranberry may decrease incidence of recurring urinary tract infection (UTI). We conducted a double-blind, placebo-controlled trial of the effects of cranberry on risk of recurring UTI among 319 college women presenting with an acute UTI. Participants were followed up until a second UTI or for 6 months, whichever came first. A UTI was defined on the basis of the combination of symptoms and a urine culture positive for a known uropathogen. The study was designed to detect a 2-fold difference between treated and placebo groups, as was detected in unblinded trials. We assumed 30% of participants would experience a UTI during the follow-up period. Overall, the recurrence rate was 16.9% (95% confidence interval, 12.8%-21.0%), and the distribution of the recurrences was similar between study groups, with the active cranberry group presenting a slightly higher recurrence rate (20.0% vs 14.0%). The presence of urinary symptoms at 3 days, 1-2 weeks, and at ≥ 1 month was similar between study groups, with overall no marked differences. CONCLUSIONS.: Among otherwise healthy college women with an acute UTI, those drinking 8 oz of 27% cranberry juice twice daily did not experience a decrease in the 6-month incidence of a second UTI, compared with those drinking a placebo.

1219 THE USE OF UROFLOWOMETRY TO EVALUATE FOR STRICTURE RECURRENCE AFTER URETHRAL RECONSTRUCTION

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery IV1 Apr 20101219 THE USE OF UROFLOWOMETRY TO EVALUATE FOR STRICTURE RECURRENCE AFTER URETHRAL RECONSTRUCTION Bradley Erickson, Benjamin Breyer, and Jack McAninch Bradley EricksonBradley Erickson More articles by this author , Benjamin BreyerBenjamin Breyer More articles by this author , and Jack McAninchJack McAninch More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.742AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The gold-standard for diagnosing urethral stricture disease is a combined retrograde urethogram and voiding cystourethrogram (RUG/VCUG). Uroflowometry (UF) is a common adjunct to these studies, though its ability to diagnose recurrence of stricture by itself after urethral reconstruction has not been fully investigated before. METHODS Our routine post-operative monitoring of urethroplasty patients includes RUG/VCUG at 3 and 12 months, and UF at 3 month intervals for a year. Patients then follow-up annually with UF, and additional RUG/VCUG testing is performed if the UF is abnormal or if the patient has new voiding symptoms. All UF, RUG/VCUG, and symptom data is stored in a prospectively maintained urethroplasty database. For this study, data from the last 10 years was analyzed and any patient that obtained a post-operative RUG/VCUG and a satisfactory UF (recorded max flow rate, voided volume > 150 cc, analysis of voiding curve (obstructed or normal) and record of current voiding symptoms) on the same day were included. UF data points, including max flow rates, obstructed/flat flow curve and presence of urinary symptoms, as well as combinations of these tests, were compared to the findings reported on the RUG/VCUG to determine their ability to predict for recurrence. RESULTS A total of 407 patients with UF data underwent urethroplasty, of which 285 (70%) met inclusion criteria. Of included men, 64 (22%) had stricture recurrence (median 7.5 (1-79) months). Table 1 shows the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each parameter as well as combinations of them. The highest specificity (98%) and PPV (90%) was achieved with a flow rate of < 10 mL/sec, an obstructive voiding curve and urinary symptoms, but this resulted in a low sensitivity (51%). The highest sensitivity (99%) and NPV (99%) was achieved when all men with symptoms and/or obstructed uroflow were evaluated. Symptoms alone had a high specificity (87%), sensitivity (88%) and NPV (95%) for predicting stricture recurrence. Table 1. Uroflowetry and diagnosis of recurrent stricture disease as compared to RUG/VCUG findings Sensitivity Specificity Positive Predictive Value Negative Predictive Value Flow Rate < 10mL/sec 54 93 73 86 Flow Rate < 15mL/sec 76 84 61 91 Flow Rate < 20mL/sec 92 67 48 96 Obstructive voiding curve 93 84 71 97 Symptoms only 87 88 71 95 Flow Rate < 10mL/sec + obstruction 54 94 76 86 Flow Rate < 10mL/sec + obstructive curve + symptoms 51 98 90 86 Symptoms and Obstructive curve 76 96 87 92 Symptoms and/or Obstructive curve 99 80 61 99 CONCLUSIONS UF is an adequate test to screen for post-operative stricture recurrence, but only when the voiding curve and urinary symptoms are also evaluated. Flow rates alone do not appear to be very helpful when used to evaluate stricture disease. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e472 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bradley Erickson More articles by this author Benjamin Breyer More articles by this author Jack McAninch More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

«Correlaciones urodinámicas del residuo posmiccional»

Objectives To study the possible correlation between the existence of postmicturition residual (PR), both in men as in women, with other urodynamic parameters. Material and methods A retrospective study in a series of 121 patients (33 male, 88 female), age X=68.22 and SD=12.904 (16–90 years), with a significative PR had been underwent a videourodynamic study. All cases of neurogenic vesicourethral dysfunctions and post pelvic radiotherapy were excluded. Statistical study was performed between the PR and the presence of urinary symptoms, urodynamic data, and findings of physical examination. The study was conducted, both descriptive and with statistical correlations. We used the Spearman Rho and compared with the median chi-square. Results We found a positive correlation (men and women), between the PR and bladder capacity (p=0.001) and between the PR free flowmetry and PR test pdet/flow (r=0.450 p=0.001). In women, a positive correlation was found between the PR and the urethral resistance (URA) (p=0.001), and between PR and voiding by abdominal pressure (p<0,05). We found a negative correlation in men between the PR and the parameters of detrusor contraction (W80–W20) (p<0.05). Not found statistically significant correlation between the PR and cystometry, nor with the urodynamic diagnosis of obstruction, associated radiological semiology, hyperactive bladder and emptying symptoms in men. Conclusions The PR behaved more as a parameter measurement of detrusor contractility, than a parameter of the lower urinary tract obstruction. The PR was not associated with any clinic or associated radiologic semiology.

Dyspareunia, Urinary Sensory Symptoms, and Incontinence Among Young Chinese Women

This study examined the prevalence of dyspareunia, urinary sensory symptoms, and urinary incontinence and explored their associations among sexually active Chinese women aged 15-34 years. Data from 3,150 women were analyzed from a survey undertaken during 2003 in 30 counties in China as part of the United Nations Population Fund Country Program. The overall prevalence of dyspareunia was 4.7%. Urinary pain, burning or frequency was reported by 8.5%, 6.2% reported urinary incontinence, and 2.3% reported both sets of urinary symptoms. The prevalence of urinary incontinence, both alone and in combination with sensory symptoms, increased in a linear manner with age. Dyspareunia was associated with early sexual debut, primary level of education, and membership of minority ethnic communities. Urinary sensory symptoms and incontinence were more common among those reporting early sexual debut, those with less schooling, and women engaged in agricultural and manual unskilled occupations. Urinary incontinence was more common among women who had had a previous vaginal delivery compared to nulliparous women. Dyspareunia was strongly associated with the presence of urinary symptoms, particularly among those with both sensory symptoms and incontinence (26.8%). Nearly a quarter of women who had dyspareunia had sought treatment but fewer had done so for urinary incontinence. Dyspareunia and urinary symptoms show distinct but overlapping patterns of association with demographic variables. The findings indicate unmet need for assessment and advice about these symptoms in women's reproductive health programs.

What is the pain of interstitial cystitis like?

To describe the characteristics of pain experienced by patients with interstitial cystitis (IC) in terms of pain site, severity, and character, we performed a secondary analysis of data from the IC database (ICDB), which was a prospective, longitudinal, cohort study of IC patients. We analyzed the cross-sectional baseline data from 629 patients who had a completed baseline symptom questionnaire. Patients answered questions about whether they had pain or discomfort associated with urinary symptoms over the past 4 weeks and if so, about the location, characteristics, intensity, and frequency of their pain. Logistic regression examined associations between pain location and the presence of urinary symptoms. Analyses were performed using SAS version 8.2 (SAS Institute, Cary, NC, USA) and considered significant at the 5% level. Five hundred and eighty-nine (94%) patients with a mean age of 45 years (SD 14 years) reported baseline pain or discomfort associated with their urinary symptoms. The most common baseline pain site was lower abdominal (80%), with urethral (74%) and low back pain (65%) also commonly reported. The majority of patients described their pain as intermittent, regardless of the pain site. Most patients reported moderate pain intensity, across all pain sites. There was a statistically significant link between pain in the urethra, lower back, and lower abdomen, and urinary symptoms. Patients with IC report pain at several sites other than the bladder, possibly arising from the previously well-described myofascial abnormalities of pelvic floor and abdominal wall present in patients with IC and other chronic pelvic pain syndromes.