Tract Symptoms In Women Research Articles

Lower urinary tract symptoms in women and quality of life

Lower urinary tract symptoms (LUTSs) are the most common symptoms in women at all age groups worldwide, and their prevalence is increasing with age. LUTSs have a multifactorial status. The risk factors are age, race, pregnancy, birth, menopause, hysterectomy, obesity, chronic cough, depression, profession and family history. LUTSs have negative effects on women's quality of life, especially on the medical, physical, social, psychological, economical and sexual aspects. Studies report a relationship between the sexual dysfunction and urogynaecological diseases. Although the pathophysiology of high prevalence of sexual dysfunction in women with LUTS is not well known, it is estimated that the LUTS and sexual dysfunction occur due to the effects of low oestrogen levels on vagina, urethra, trigone epithelium and the atrophy of pelvic floor muscles. Especially women, who experience urinary incontinence (UI) and subgroup problems, report more common sexual dysfunctions (hypoactive sexual desire disorder, very urgent need for urination during the sexual intercourse and leakage, lack of sexual arousal, orgasm problems, sexual pain disorders). Despite the high prevalence of LUTS and its negative effects on the quality of life, the help‐seeking behaviours of women for overcoming LUTS differ according to the level of disturbance. Nurses should cooperate with other health care personnel in LUTS prevention, diagnosis, treatment/follow‐up, in the diagnosis of sexual dysfunction due to LUTS and its management. This article discusses the prevalence of LUTS, the risk factors of LUTS, the quality of life of women with LUTS, the negative effects of LUTS on sexual life and its nursing care.

UP-1.26: The role of alpha 1(A) Adrenoceptor antagonist tamsulosin for the treatment of patients with lower urinary tract symptoms in women: the effect of nocturia and sleep quality

UP-1.26: The role of alpha 1(A) Adrenoceptor antagonist tamsulosin for the treatment of patients with lower urinary tract symptoms in women: the effect of nocturia and sleep quality

UP-1.10: Urinary incontinence in obese people: urodynamics studies

The purpose of this study was to describe urodynamic characteristics of obese women with urinary incontinence. We investigated whether BMI is associated with lower urinary tract symptoms in women.

Lower urinary tract symptoms in women with irritable bowel syndrome

To investigate lower urinary tract symptoms (LUTS) in women with irritable bowel syndrome (IBS) and to evaluate risk factors associated with the psychiatric morbidity of these patients. The study group included 52 female patients with a diagnosis of IBS. Fifty-five women without gastrointestinal symptoms were used as controls. LUTS were evaluated using the American Urological Association Symptom Index questionnaire. Psychiatric morbidity was evaluated using a 12-item version of the Chinese Health Questionnaire. Multiple logistic regression analysis was performed to identify the risk factors associated with psychiatric morbidity in IBS patients. There were no significant differences between the two groups in any of the demographic variables. The most common LUTS in patients with IBS were storage symptoms. These patients had significantly higher scores of frequency, nocturia, urge incontinence, lower maximal flow rate and lower voiding volume (P < 0.05). In addition, significantly higher storage and total American Urological Association Symptom Index questionnaire scores were also noted in IBS patients (P < 0.05). The prevalence of psychiatric morbidity in IBS patients was 28.8%, which was significantly higher than in the control group (20%). The urinary storage symptom score (odds ratio: 1.518; 95% confidence interval: 1.17-1.96; P = 0.002) was significantly correlated with psychiatric morbidity. LUTS are common in IBS patients and have a negative impact on their psychiatric status. Healthcare providers should be aware of the psychological consequences of LUTS in these patients.

Metabolic Syndrome Components Worsen Lower Urinary Tract Symptoms in Women with Type 2 Diabetes

Diabetic women are more susceptible to develop lower urinary tract symptoms (LUTS), especially overactive bladder (OAB). However, data regarding the effect of components of metabolic syndrome (MS) on this association are conflicting. The objective of the study was to examine the potential role of MS in the development of LUTS in diabetic women. The study was a prevalence study conducted between 2005 and 2007. The study was conducted in a university hospital. A total of 518 women with type 2 diabetes aged 50-75 yr were included. They were subgrouped as MS (47.5%) and non-MS (52.5%) groups according to whether they fulfilled the criteria of MS. We used American Urological Association Symptom Index (AUA-SI) to evaluate LUTS and Indevus Urgency Severity Scale to evaluate OAB, respectively. Women in the MS group had significantly higher storage and total AUA-SI scores as well as a higher prevalence of LUTS and OAB. Most intriguingly, the number of MS components was strongly associated with the LUTS severity because the AUA-SI scores increased in parallel to the number of components were present. Similar results were found between MS and OAB. Multivariate analysis revealed that peripheral neuropathy, but not MS, significantly predicted LUTS in diabetic women after age adjustment. However, MS remained significantly predictive for LUTS and OAB after additional adjustment for neuropathy. Our results suggest that MS may especially influence LUTS and OAB in diabetic women, probably by compounding the effect of peripheral neuropathy.

Effect of Urethral Dilatation on Women With Voiding Dysfunction

Despite a lack of evidence for its efficacy in the literature, urethral dilatation (UD) has been used by urologists and urogynecologists for many years to treat a variety of lower urinary tract symptoms in women. Recent surveys of clinical practice suggest that a significant proportion of clinicians continue to perform UD, with it being more commonly used by those trained more than 10 years ago. Recent outcome data on UD in women with overactive bladder and voiding dysfunction have shown poor long-term efficacy, with a 13% risk of de novo urodynamic stress incontinence. Resolution of symptoms is associated with a postprocedure increase in maximum flow rate and a decrease in detrusor pressure at maximum flow. Further studies are needed to delineate the role, if any, of UD in the management of women with overactive bladder and voiding dysfunction.

Lower urinary tract symptoms in women with pelvic organ prolapse

The objective of this study was to describe lower urinary tract symptoms (LUTS) and urinary incontinence (UI) symptoms in women with prolapse. LUTS were measured with the urinary distress inventory (UDI) and UI symptoms with UDI and the Medical, Epidemiological and Social Aspects of Aging (MESA) in women with POPQ stage >or=I support. UI symptoms were classified as stress- or urge-only, stress-predominant or urge-predominant mixed, or mixed. Bladder function was assessed by urodynamics. Bi- and multivariable analyses were performed. Three hundred thirty-six women aged 62 +/- 13 years were characterized by UDI scores as having mixed 72% (n = 242), urge-only 24% (n = 80), and stress-only <1% (n = 1) UI symptoms. Of subjects with mixed UI symptoms, 57% (n = 137) were stress-predominant and 43% (n = 105) were urge-predominant. In multivariable regression models, advancing age and prolapse were associated with less reported distress related to stress UI symptoms. Prior hysterectomy was associated with higher total UDI scores. Similar findings were noted with MESA. Mixed UI symptoms are the predominant symptom type in women with POP.

The Effect of Asymptomatic Urethral Caruncle on Micturition in Women with Urinary Incontinence

PurposeThe aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence.Materials and MethodsA total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards.ResultsBoth groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference.ConclusionsOur results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon's decision whether to treat asymptomatic UC.

Levator ani defect status and lower urinary tract symptoms in women with pelvic organ prolapse

Among women with pelvic organ prolapse, compare rates of lower urinary tract symptoms by levator ani defect (LAD) status. Urinary incontinence and obstructive voiding are analyzed among 151 women with prolapse whose LAD status was determined with magnetic resonance imaging. Women with major LAD are less likely to experience stress incontinence when "coughing, laughing, or sneezing" (odds ratio (OR) 0.27) and when "twisting, reaching, lifting, or bending over" (OR 0.26) than women with normal muscles. They are less likely to have obstructive symptoms characterized by assuming an "unusual toileting position" or "changing positions...to start or complete urination" (OR 0.27). Women with minor LAD are more likely to experience stress incontinence with exercise (OR 3.1) and urge incontinence (OR 4.0) than those with normal muscles. Lower urinary tract symptoms are less common among women with prolapse and major levator ani defects and more common among those with minor defects.

UP-2.008: Is There an Association Between Obesity and Lower Urinary Tract Symptoms in Women? A Cross-Sectional Study of Korean Elderly Women

UP-2.008: Is There an Association Between Obesity and Lower Urinary Tract Symptoms in Women? A Cross-Sectional Study of Korean Elderly Women

Lower urinary tract symptoms in women with multiple sclerosis: 2

Bladder dysfunction in women with multiple sclerosis (MS) is a common and distressing problem affecting up to 75% of patients (Das Gupta and Fowler, 2003). It can seriously affect their quality of life and in some cases cause deterioration of MS symptoms. The first part of this article (Rantell, 2009) set out how to perform a full assessment of these patients and how to diagnose their lower urinary tract symptoms (LUTS). This second article aims to provide an overview of the conservative, pharmacological and surgical management of lower urinary tract symptoms. Often women will need a combination of therapies to achieve optimum benefit from treatment. Management and interventions should be regularly re-assessed as women's symptoms and their severity may change over time as the disease progresses.

Prevalence and risk factors for bothersome lower urinary tract symptoms in women with diabetes mellitus from hospital-based diabetes clinic

There is limited data on prevalence and risk factors for bothersome lower urinary tract symptoms (LUTS) in women with diabetes mellitus (DM). This study assesses prevalence and risk factors for bothersome LUTS and voiding dysfunction in women with DM. Two hundred twenty women participated in this study. Participants completed the King's health questionnaire and the international consultation on incontinence-female lower urinary tract symptom questionnaire. Symptoms prevalence and urinary flow rate were assessed. Logistic regression models for risk factors of bothersome LUTS and voiding dysfunction were constructed. One hundred forty-eight women completed the study. Sixty-one women (41%) had bothersome LUTS. Urgency incontinence, urgency, and nocturia were the most bothersome. Fifty-six (38%) had voiding dysfunction. Neuropathy and glycosylated haemoglobin were independent risk factors for voiding dysfunction. Voiding dysfunction did not affect quality of life in women with DM. Overactive bladder symptoms are the most bothersome in diabetic women. Neuropathy and glycosylated haemoglobin are risk factors for voiding dysfunction.

Lower urinary tract symptoms in women

To summarize recent population-based literature on the prevalence and consequences of urinary incontinence and overactive bladder (OAB) symptoms in women and describe our present knowledge regarding known risk factors. The prevalence of urinary incontinence in women ranged from 5 to 69%, with most studies reporting a prevalence of any urinary incontinence in the range of 25-45%. In a longitudinal population study in which women were followed for 16 years, the overall prevalence of urinary incontinence increased from 15 to 28%, and the incidence rate of urinary incontinence was 21%, whereas the corresponding remission rate was 34%. Increasing evidence is now available regarding a genetic component in the cause of stress urinary incontinence. The reported prevalence of OAB in women varied between 7.7 and 31.3%, and in general, prevalence rates increased with age. In a longitudinal study, the prevalence of OAB, nocturia and daytime micturition frequency of eight or more times per day increased by 9, 20 and 3%, respectively, in a cohort of women followed from 1991 to 2007. The incidence of OAB was 20%, and the corresponding remission rate was 43%. Urinary incontinence and OAB are highly prevalent conditions. The cost of illness for urinary incontinence and OAB is a substantial economic and human burden and is likely to increase further in the future, highlighting the need for effective forms of management.

Lower urinary tract symptoms in women with multiple sclerosis: part 1

Multiple sclerosis (MS) affects about 85,000 people in the UK, and is the commonest progressive neurological disease affecting young people (Compston and Coles, 2002). Bladder dysfunction can be found in up to 75% of patients with MS (DasGupta and Fowler, 2003). In a study by Hemmett et al (2004), 87% of people with MS reported bladder symptoms and 70% felt that they had a moderate to high adverse effect on their quality of life. This article, the first in a two-part series, examines how MS can affect normal bladder function, looking at what symptoms patients may present with. It also provides an overview of how nurses can assess and diagnose these bladder problems. The conservative, pharmacological and surgical interventions for the management of lower urinary tract symptoms will be discussed in the second part of this series.

A Longitudinal Population-based Survey of Urinary Incontinence, Overactive Bladder, and Other Lower Urinary Tract Symptoms in Women

BackgroundFemale urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) are highly prevalent conditions with a profound influence on well-being and quality of life. There are a few studies describing progression as well as remission, in the short term, of UI in the general population as well as in selected groups; at present, there are very few population-based studies describing the natural course of other LUTS in the same women, and there are no long-term longitudinal studies. ObjectiveTo describe the prevalence of UI, OAB, and other LUTS in the same women studied prospectively over time and, thus, to assess possible progression or regression. Design, setting, and participantsA longitudinal population-based study was performed in one primary health care district in the city of Gothenburg, Sweden. The participants were a sample of women aged ≥20 yr who were randomly selected from the Swedish National Population Register, assessed in 1991 (n=2911), and available for reassessment in 2007 (n=1408). MethodsA self-administered postal questionnaire regarding UI, OAB, and other LUTS was returned by 77% of the contacted women in 1991. The same women who responded in 1991 and who were still alive and available in the Swedish National Population Register 16 yr later were reassessed using a similar self-administered postal questionnaire. Results and limitationsIn 2007, 1081 of the available 1408 women responded to the questionnaire (77%). The overall prevalence of UI, OAB, nocturia, and daytime micturition frequency of eight or more times per day increased by 13%, 9%, 20% (p<0.001), and 3% (p<0.05), respectively, from 1991 to 2007. The incidence of UI and OAB were 21% and 20%, respectively, and the corresponding remission rates were 34% and 43%, respectively. Women with OAB symptoms were classified as OAB dry or OAB wet, depending on the presence or absence of concomitant UI. The prevalence of OAB dry did not differ between the two assessment occasions (11% and 10%, respectively), but the prevalence of OAB wet increased from 6% to 16% (p<0.001). ConclusionsUI and other LUTS constitute dynamic conditions. In this study, there was a marked overall increase in the prevalence of UI, OAB, and nocturia in the same women from 1991 to 2007. Both incidence and remission of most symptoms were considerable.

Evaluation of cleaning activities on respiratory symptoms in asthmatic female homemakers

Asthma among professional cleaners is recognized as a common cause of new-onset and aggravated occupational asthma. Women are usually the primary persons responsible for cleaning their homes, but little information is available regarding the health impact of cleaning in the nonoccupational setting. To compare health effects of cleaning among asthmatic and nonasthmatic women who are the primary cleaners in their homes. A 12-week, prospective, parallel-group study assessing the effects of cleaning on peak expiratory flow rates and upper and lower respiratory tract symptoms in women with and without asthma. Twenty-five women with asthma and 19 without asthma, ages 18 to 65 years, completed the study. No effect was observed on peak expiratory flow rates after cleaning between groups. Upper respiratory tract symptoms increased after cleaning for both groups, adjusted for chemical severity exposure index and duration of cleaning. However, the change in the number of lower respiratory tract symptoms (after cleaning minus before cleaning) was statistically significant for asthmatic patients compared with nonasthmatic patients (P = .01). The study suggests that cleaning activities are associated with increased lower respiratory tract symptoms in asthmatic patients independent of chemical severity exposure index and cleaning duration. Women with asthma should be routinely interviewed as to whether they clean their home and cautioned about the potential respiratory health effects of these activities.

Discontinuation Rates of Anticholinergic Medications Used for the Treatment of Lower Urinary Tract Symptoms

To estimate the discontinuation rates of anticholinergic medications used for the treatment of lower urinary tract symptoms in women. A large administrative database was used for this study. Women aged 18 years and older who were prescribed anticholinergic medications were included. An overall and drug-specific discontinuation rate for nine different anticholinergic medications was estimated. Covariates examined included number of prior drug classes used, number of switches performed, number of prior drug episodes, year of initiation, age, and history of smoking. The Kaplan-Meier method was used to estimate an overall discontinuation rate. A Cox multivariable regression was performed for the drug-specific analysis. There were 49,419 episodes of anticholinergic therapy available for analysis from 29,369 women. The average number of treatment episodes and number of drug classes prescribed per patient were 1.65+/-1.31 and 1.54+/-0.57, respectively. The median time for overall anticholinergic drug discontinuation was 4.76 months. The 6-month unadjusted cumulative incidence of discontinuation was 58.8% (95% confidence interval [CI] 58.4-59.3). The percentage of episodes in which women switched to another medication was 15.8% (95% CI 15.4-16.1). At 6 months, the adjusted cumulative incidence of discontinuation was as follows: oxybutynin 71% (95% CI 68.4-73.5), tolterodine tartrate 61% (59.4,64.3), extended-release oxybutynin 57% (95% CI 55.1-59.4), and extended-release tolterodine tartrate 54% (95% CI 52.3-57.7). Discontinuation rates for anticholinergic medications are high regardless of the class of medication used. II.

Horseback Riding: Impact on Sexual Dysfunction and Lower Urinary Tract Symptoms in Men and Women

To determine whether subjects engaged in horseback riding are more likely to be affected by sexual dysfunction and lower urinary tract symptoms than those engaged in sports with less perineal impact. Surveys evaluating the presence of and the risk factors for sexual dysfunction and urinary symptoms were distributed among members of equestrian clubs, swimming clubs, and individual horseback riders and swimmers. About 327 surveys were distributed by hand at horse shows and swimming pools. A total of 2000 surveys were sent by direct mail to random members of 1 national equestrian organization and 1 national swimming organization. We also evaluated bicycle habits as a possible confounding factor. There was no significant association between horseback riding and lower urinary tract symptoms (P = .1759) and sexual dysfunction (P = .1793) in males. The same applies to the association of horseback riding and lower urinary tract symptoms (P = .5036) and sexual dysfunction (P > .05) in females, although there was a trend toward a protective association between horseback riding and stress incontinence (P = .0567). Years of bicycling (P = .04) and hardness of the bicycle seat (P = .02) were associated with an increased prevalence for lower urinary tract symptoms in women. Regular participation in horseback riding is not significantly associated with increased prevalence of lower urinary tract symptoms or sexual dysfunction, although it may be associated with decreased prevalence of stress urinary incontinence. Bicycle riding may be associated with higher prevalence of lower urinary tract symptoms in women.

Lower urinary tract symptoms in women—A common but neglected problem

The purpose of this review is to provide nurse practitioners (NPs) an understanding of female lower urinary tract symptoms (LUTS). Scientific literature including articles on epidemiology, assessment, impact on quality of life (QoL), treatment barriers, and management. Female LUTS are common and adversely affect QoL. Nevertheless, the social stigma prevents many women from seeking treatment, and healthcare providers often lack adequate time to inquire about bladder health. Although LUTS are not life threatening, the impact is tremendous, and there is an urgent need for healthcare providers to improve management of chronic conditions. NPs should play a role in driving this response by increasing awareness of LUTS, taking the lead in examining barriers to treatment, and providing long-term support to patients.

Botulinum Toxin for Lower Urinary Tract Symptoms in Women

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