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1.
Arch Esp Urol ; 73(1): 19-25, 2020 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-31950919

RESUMO

OBJECTIVE: To determine if the presence of moderate to severe lower urinary tract symptoms in medical resident are associated with workplace bullying. MATERIAL AND METHODS: Cross-sectional study conducted in medical residents. Moderate to severe lower urinary tract symptoms were defined as greater than 8 points on the International Prostate Symptom Score. Residents were classified as bullied if their total score on the Negative Acts Questoinnarie-Revised, was above 41 points. Perceived bullying was considered as present when any positive answer was documented in a specific question to measure this variable. Bivariate analysis to determine statistical differences between presence of lower urinary tract symptoms and exposure to both types of bullying was performed using χ² . The magnitude and directions of all associations were determined by calculating the Odds Ratio with 95% level of confidence. RESULTS: 209 residents were included, 63% men; 68% reported at least one lower urinary tract symptom, of which, 56% were mild, 10% moderate and 2% severe. The prevalence of bullying was 42% while perceived bullying was present in 39%. Residents with ≥8 points on the International Prostate Symptom Score had higher risk of being exposed to bullying (OR: 2.8, 95% CI: 1.1-6.7, p=0.01) and/or perceived bullying (OR: 3.1 95% CI: 1.3-7.5, p=0.00). Female gender had greater risk than man for presenting lower urinary tract symptoms at basal state (OR: 2.8, 95% CI: 1.1-6.6, p=0.01). CONCLUSIONS: Medical residents with moderate or severe urinary tract symptoms may be related to bullying. Being a woman is associated with an increased risk of developing LUTS.


Assuntos
Bullying , Internato e Residência , Sintomas do Trato Urinário Inferior , Médicos , Estudos Transversais , Feminino , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/psicologia , Masculino , Médicos/psicologia , Prevalência
2.
Int Braz J Urol ; 45(6): 1167-1179, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808405

RESUMO

INTRODUCTION: Lower urinary tract dysfunction (LUTD) is a common clinical condition. Emotional and behavioral issues are increasing among children and adolescents, with stress indicating difficulties in personal and social functioning. This study evaluated whether urinary tract symptoms (LUTS) is associated with stress. MATERIALS AND METHODS: A cross-sectional, analytical study with 6-14-year-old patients with LUTS and no anatomical/neurogenic urinary tract abnormalities was conducted using the Dysfunctional Voiding Scoring System, a psychological assessment and the Child Stress Scale. The overall stress score was analyzed in relation to the psychological assessment data. Answers to the seven specific DVSS urinary questions were compared with those for the four Child Stress Scale domains. Univariate and multivariate analyses were performed. The chi-square test and Pearson's correlation were used to determine associations. Significance was defined as p <0.05. RESULTS: Most children were male (56%). Mean age was 9.0±2.25 years. Stress was detected in 20 out of 98 patients (20.4%; 95% CI: 13-30%).Of these, 90% were born from unplanned pregnancies and 67% were upset about their disorder. All the Child Stress Scale domains were significantly associated with urinary dysfunction, with dysuria being significantly associated with all four domains. In the multivariate analysis, dysuria was the only symptom that remained associated with stress. Associations with stress strengthened as the frequency of dysuria increased: physical reactions (p <0.01), emotional reactions (p <0.05), psychological reactions with a depressive component (p<0.01) and psychophysiological reactions (p <0.05). CONCLUSION: Stress levels are higher in children and adolescents with LUTS who have more severe symptoms. Dysuria was the symptom most associated with stress, both in the physical reactions domain, in the psychological reactions domains with or without a depressive component and in the psychophysiological reactions domain.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/psicologia , Estresse Psicológico/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Distribuição por Idade , Brasil/epidemiologia , Criança , Comportamento Infantil/psicologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Prevalência , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Distribuição por Sexo , Estresse Psicológico/fisiopatologia , Inquéritos e Questionários
3.
Medicine (Baltimore) ; 98(42): e17635, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626149

RESUMO

This study aimed to investigate the metabolic syndrome-related risk factors for the development of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) in healthy men.A total of 4880 healthy men who underwent transrectal ultrasonography at our hospital during routine health examinations were included in this study. Those who had undergone a prior biopsy or surgery for prostate disease, were suspected of having urinary tract infection, or were taking BPH/LUTS or metabolic syndrome medications were excluded. BPH/LUTS was defined as an International Prostate Symptom Score (IPSS) of ≥8 and a prostate volume (PV) of ≥30 cm.The subjects had a mean age of 54.1 years, PV of 29.2 cm, prostate-specific antigen (PSA) level of 1.20 ng/mL, and IPSS of 9.2. The annual PV growth rate was 0.48 cm/year. Age, body mass index (BMI), PSA, basal metabolic rate, apolipoprotein A-1, fasting blood glucose, high-density lipoprotein (HDL) cholesterol levels were significant predictive factors for PV. Age, PSA, apolipoprotein B, fasting blood glucose, cholesterol, HDL, and low-density lipoprotein (LDL) levels were predictors of BPH/LUTS at the initial health examination. A decreased fat mass and LDL level were a significant risk factor for the development of BPH/LUTS within 5 years in men without a BPH/LUTS diagnosis at the initial examination.Metabolic syndrome-related variables were strongly associated with BPH/LUTS and by decreasing fat mass and LDL levels, development of BPH/LUTS could be prevented within 5 years in healthy Korean men.


Assuntos
LDL-Colesterol/sangue , Sintomas do Trato Urinário Inferior/etiologia , Síndrome Metabólica/complicações , Hiperplasia Prostática/etiologia , Medição de Risco/métodos , Idoso , Biomarcadores/sangue , Biópsia , Glicemia/metabolismo , Índice de Massa Corporal , Progressão da Doença , Endossonografia , Seguimentos , Humanos , Incidência , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prognóstico , Próstata/diagnóstico por imagem , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/epidemiologia , Reto , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
4.
Transplant Proc ; 51(9): 2921-2926, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31627917

RESUMO

BACKGROUND: With the aging of recipients of renal transplantation (RT) one of the emerging issues is the incidence of low urinary tract symptoms (LUTS), which may have negative consequences on the graft survival and function. The aim of our study was to assess the influence of LUTS and the treatment with transurethral resection of the prostate (TURP) on the outcome of RT. MATERIALS AND METHODS: We collected data from men over 55 who underwent RT at our center from January 2007 to December 2016. We analyzed the incidence of LUTS; the rate of treatment with TURP; the eGFR (estimated glomerular filtration rate) at 6 months and 1, 3, and 5 years from transplantation; and graft survival. RESULTS: Fifty-five patients out of 268 experienced LUTS, and 19 of them had a bladder outlet obstruction (BOO). Patients experiencing BOO had a significantly higher hazard ratio (HR) of graft failure (HR 5.7, CI 1.56-21.4) compared to the other recipients. Of the 18 patients treated with TURP, 10 received the procedure within 6 months from the LUTS onset. They had a significantly absolute eGFR improvement at 6 months from the intervention (+14.25 mL/min ± 8.10) compared to the patients treated later (-8.4 mL/min ± 14.43). DISCUSSION: We showed the negative effects of LUTS on kidney graft function and survival. Although TURP is the standard therapy for such an issue, the best timing for it still has to be defined. Our experience supports the need for an early treatment of the LUTS for promoting the outcome of the RT.


Assuntos
Transplante de Rim , Hiperplasia Prostática/complicações , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata , Idoso , Sobrevivência de Enxerto , Humanos , Transplante de Rim/efeitos adversos , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/epidemiologia , Obstrução do Colo da Bexiga Urinária/epidemiologia , Obstrução do Colo da Bexiga Urinária/etiologia , Obstrução do Colo da Bexiga Urinária/cirurgia
5.
Medicine (Baltimore) ; 98(40): e17409, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577752

RESUMO

Lower urinary tract symptoms (LUTS) have detrimental impact on health-related quality of life. This study has 2 aims: first to identify the optimum model for LUTS study and then to explore the potential associated factors of LUTS and bother LUTS with the optimum model among adult women in China.The survey was conducted in 6 regions of China between February and July 2006. A modified Chinese Bristol Female LUTS questionnaire was administered. The number of LUTS was the main outcome measure. The fitting goodness was compared to identify the optimum model with likelihood ratio test statistics. Zero-inflated negative binomial (ZINB) model was used to explore the potential associated factors of LUTS and bother LUTS.Of all 18,992 respondents, 55.5% of respondents reported one (any LUTS) or more LUTS (mixed LUTS) and 36.5% of respondents reported one or more bother LUTS. With the largest log likelihood and smallest AIC and BIC, ZINB model showed the best goodness of fit. In the ZINB model, we identified multiple associated factors for any LUTS and mixed LUTS; older age (ß≥0.2), overweight [ß = 0.059, 95%CI (0.016∼0.102)], obese [ß = 0.143, 95%CI (0.087∼0.198)], postmenopausal status [ß = 0.099, 95%CI (0.023∼0.175)], prolonged labor [ß = 0.188, 95%CI (0.104∼0.272)], constipation [ß = 0.309, 95%CI (0.262∼0.357)], coexisting pelvic organ prolapse (POP) [ß = 0.348, 95%CI (0.224∼0.473)], diabetes (ß = 0.178, 95%CI (0.100∼0.257), hypertension [ß = 0.092, 95%CI (0.041∼0.143)], smoking (ß = 0.192, 95%CI (0.127∼0.258) and alcohol consumption [ß = 0.063, 95%CI (0.001∼0.126)] increased the odds of mixed LUTS. We identified multiple associated factors for bother LUTS and mixed LUTS; older age (ß ≥ 0.1), prolonged labor [ß = 0.153, 95%CI (0.031∼0.275)], constipation [ß = 0.359, 95%CI (0.292∼0.426)] coexisting POP (ß = 0.212, [95%CI (0.031∼0.393)], diabetes [ß = 0.154, 95%CI (0.030∼0.278)], and smoking [ß = 0.169, 95%CI (0.076∼0.262)] increased the odds of bother mixed LUTS.ZINB model was the optimum model to explore the potential associated factors of LUTS. Older age, coexisting POP and constipation were both closely related to any and bother LUTS, also the severity of LUTS. Compared to nulliparity, single or multiple deliveries and women who had perineal laceration had nothing to do with the severity of LUTS.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Comorbidade , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Pessoa de Meia-Idade , Modelos Estatísticos , Prevalência , Qualidade de Vida , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
6.
Pan Afr Med J ; 32: 190, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31312302

RESUMO

Introduction: Incidence of urethral stricture recurrence ranges between 2% to 36.4% with 75% occurring within the first 6 months of surgery. Hence, they need to identify the predictors of recurrence following urethroplasty. Methods: This is a retrospective study involving patients that had urethroplasty from January 2008 to December 2017. Patients' records were reviewed. Analyzed data were for patients with a minimum follow up of one year from the time of urethroplasty and included aetiology of urethral stricture, presence of suprapubic cystostomy, prior urethral dilatation, urine M/C/S, site of urethral stricture, length of urethral stricture, type of urethroplasty, level of training of the surgeon, type of urethral stent used and duration of stenting. Analysis was done using SPSS version 23. P-value of < 0.05 was considered significant. Results: Eighty seven urethroplasties were done, from January 2008 to December 2017. However, only records of 44 patients were accessible. Twenty patients completed duration of follow up ≥ one year. Urethral stricture recurrence was defined as resurgence of Lower Urinary Tract Symptoms (LUTS) within one year. Median age of the patients was 39.5 (± 19) years. Urethral stricture recurrence rate was 25% with mean time to recurrence from urethroplasty of 5.3 (±3) months. The use of preoperative suprapubic catheter (SPC) for urinary diversion as well as urethroplasties performed by the consultants had a lower incidence of recurrence. Conclusion: This study found urethral stricture recurrence of 25%. The level of training of surgeon vis-à-vis the expertise and experience seems to be an important factor, though not statistically significant in determining the outcome of urethroplasty.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Stents , Estreitamento Uretral/epidemiologia , Procedimentos Cirúrgicos Urológicos/métodos , Adolescente , Adulto , Idoso , Seguimentos , Hospitais Universitários , Humanos , Incidência , Sintomas do Trato Urinário Inferior/etiologia , Pessoa de Meia-Idade , Nigéria , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Estreitamento Uretral/cirurgia , Cateterismo Urinário/métodos , Adulto Jovem
7.
Cir. pediátr ; 32(3): 145-149, jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183734

RESUMO

En los últimos años se ha incrementado la prevalencia de disfunciones del tracto urinario inferior (DTUI), afectando al 10-15% de escolares. Este incremento se ha relacionado con cambios en el estilo de vida y dietéticos. Pocos estudios analizan los factores de riesgo. Nuestro objetivo es conocer la prevalencia de DTUI y sus principales factores. Realizamos un estudio observacional transversal de prevalencia sobre una muestra representativa de escolares de nuestra comunidad (N=1.069). Utilizamos un cuestionario sobre hábitos de aprendizaje miccional, hábito intestinal y datos dietéticos. Asociamos el cuestionario PLUTSS (Pediatric Lower Urinary Tract Symptoms Score) de screening de DTUI, tras traducirlo y validarlo en español. Análisis de regresión logística evaluaron los principales factores de riesgo. Los varones retiran el pañal más tarde (2,41 vs. 2,25) comenzando el colegio con mayor porcentaje de incontinencia. El 31,9% retiraron el pañal para poder escolarizarse. La prevalencia de incontinencia urinaria fue 15% diurna y 12,2% nocturna, la de DTUI 8,3%, estreñimiento 20%, incontinencia fecal 2,8%, ITUs 12,4%, hábito posponedor 39,8%. El 28,7% de las DTUI referían repercusión psicológica. Los principales factores de riesgo fueron: varón (OR 1,87), menor edad (OR 0,78), retirada de pañal forzada por escolarización (OR 2,14), estreñimiento (OR 1,61) y hábito retencionista (OR 3,87). Nuestro estudio mostró una elevada prevalencia de disfunción vesical en nuestra población pediátrica. El sexo masculino, el hábito posponedor, la escolarización precoz y el estreñimiento fueron los principales factores de riesgo. Conocer su epidemiología, nos ha permitido emitir recomendaciones escolares, familiares y en atención primaria, con el fin de prevenir esta patología tan prevalente


Recently, many papers report an increase of pediatric lower urinary tract dysfunction (LUTD), which affects 10-15% of schoolchildren. Recent life style and dietary changes have been postulated as the cause of that high prevalence. There is a lack in epidemiological investigations about bowel and bladder dysfunctions and the risk factors. We aim to know the LUTD prevalence and the main risk factors. We carry out an observational and transversal investigation with a representative sample of our pediatric schoolchildren (N=1,069). We used a questionnaire about toilet training habits, social, familiar, and dietary data. We also used the PLUTSS (Pediatric Lower Urinary Tract Symptoms Score) questionnaire after validation of the Spanish version. The logistic regression analysis determined the main risk factors of DTUI. Results showed that boys get toilet trained later than girls (2.41 vs. 2.25) and the rate of incontinence is greater than girls when they start on the school. 31.9% of children remove their diapers to get into school. The prevalence was 15% for diurnal urinary incontinence and 12.2% nocturnal, DTUI 8.3%, constipation 20%, faecal incontinence 2.8%, ITUs 12.4%, retention habits 39.8%. 28.7% of children with DTUI refer psychological affectation. The main independent predictors were: male sex (OR 1.87), younger children (OR 0.78), forced toilet training (OR 2.14), constipation (OR 1.61) and holding habits (OR=3.87). This study showed a high prevalence of bladder in our pediatric population. Male gender, voiding postposition, early schooling or constipation were the main risk factors. The knowledge of the bladder and bowel dysfunction prevalence and the toilet training habits in our Community lets us to conclude school, family and primary care recommendations. This will let to prevent this so much prevalent disease


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Incontinência Urinária/epidemiologia , Tampões Absorventes para a Incontinência Urinária , Fatores de Risco , Sintomas do Trato Urinário Inferior/epidemiologia , Estudos Transversais , Inquéritos e Questionários , Modelos Logísticos , Ensino Fundamental e Médio
8.
J Prev Med Public Health ; 52(3): 147-153, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31163949

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the association between body mass index (BMI) and severe lower urinary tract symptoms (LUTS) in Korean males. METHODS: This study was conducted on males aged ≥50 years who participated in the 2011 Korean Community Health Survey. LUTS severity was assessed using the Korean version of the International Prostate Symptom Score (IPSS) questionnaire, and was dichotomized as severe (IPSS >19) and non-severe (IPSS ≤19). BMI was divided into 6 categories: <18.5, 18.5-22.9, 23.0-24.9, 25.0-27.4, 27.5-29.9, and ≥30.0 kg/m2. To evaluate the relationship between BMI and LUTS, a survey-weighted multivariate Poisson regression analysis was performed to estimate prevalence rate ratios (PRRs). Age, smoking status, alcohol intake, physical activity, educational level, household income, and comorbidities were adjusted for in the multivariate model. RESULTS: A U-shaped relationship was detected between BMI and severe LUTS. Compared with a BMI of 23.0-24.9 kg/m2, the PRR for a BMI <18.5 kg/m2 was 1.65 (95% confidence interval [CI], 1.35 to 2.02), that for a BMI of 18.5-22.9 kg/m2 was 1.25 (95% CI, 1.09 to 1.44), that for a BMI of 25.0-27.4 kg/m2 was 1.20 (95% CI, 1.00 to 1.45), that for a BMI of 27.5-29.9 kg/m2 was 1.11 (95% CI, 0.83 to 1.47), and that for a BMI ≥30.0 kg/m2 was 1.85 (95% CI, 1.18 to 2.88). CONCLUSIONS: This study showed that both high and low BMI were associated with severe LUTS.


Assuntos
Índice de Massa Corporal , Sintomas do Trato Urinário Inferior/diagnóstico , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Correlação de Dados , Estudos Transversais , Exercício/psicologia , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , República da Coreia/epidemiologia , Fumar/epidemiologia
9.
Medicine (Baltimore) ; 98(23): e15943, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169717

RESUMO

Young adults with longstanding ketamine abuse present with lower urinary tract symptoms (LUTSs), which may be accompanied by urinary tract infection (UTI). However, the morbidity and risk factors for ketamine-associated LUTS accompanied by UTI (KALAUTI) are still unknown. To ascertain these, we surveyed patients with a history of ketamine abuse and LUTS at the time of their initial presentation.One hundred untreated patients with ketamine-associated LUTS were initially surveyed at 3 medical institutions. The patients' basic demographic and clinical information, KALAUTI status, and possible risk factors were obtained via a questionnaire and analyzed.Eighty-one patients were finally enrolled. Eight patients (9.88%) had a definitive diagnosis of KALAUTI and 16 (19.75%) had suspected KALAUTI. The diagnosis of KALAUTI was ruled out in the remaining 57 patients (70.37%). Patients with upper urinary tract involvement, longer duration of drug use, or more severe LUTS (P < .05), were more prone to KALAUTI. Frequent urine culture and a higher voiding symptom score (VSS) were risk factors for KALAUTI (P < .05), increasing the risk of KALAUTI by 44.241- and 1.923-fold, respectively.The study indicates that frequent urine culture and severe VSS are risk factors for KALAUTI. The possibility of UTI should be considered in ketamine abusers with LUTS in the clinical setting.


Assuntos
Ketamina , Sintomas do Trato Urinário Inferior/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Infecções Urinárias/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Sintomas do Trato Urinário Inferior/induzido quimicamente , Masculino , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo , Infecções Urinárias/induzido quimicamente , Adulto Jovem
10.
Medicine (Baltimore) ; 98(18): e15502, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045838

RESUMO

BACKGROUND: The aim of this meta-analysis was to understand the relationship between statin with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). METHODS: A systematic literature search was conducted using PubMed, Embase, Cochrane Library, Chinese Medical and Biological Literature Database, China HowNet, Vip, and Wanfang. We calculated pooled odds ratios (OR) and 95% CI and standardized mean difference (SMD). Using Stata 12.0 and Review 5.3 for meta-analysis. RESULTS: This meta-analysis included 11 articles and 49,128 participants. Results show statins could not reduce the incidence of BPH [OR = 0.77 (0.57, 1.03, P = .08]. For patients over 60 years old, statins could reduce the incidence of BPH [OR = 0.35 (0.22, 0.55), P < .0001]. Statins can slow down the progression of LUTS in BPH [SMD = -0.32 (-0.54, -0.10), P = .004], but there is no significant correlation between them in patients taking drugs for less than 1 year. CONCLUSION: Statins have no significant effect on the incidence of BPH, but statins can reduce the risk of BPH for patients over 60 years old. For patients with hyperlipidemia, the duration of medication is more than 1 year, which can slow down the progression of LUTS. However, more high-quality and large sample size studies are needed to further improve and verify.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Hiperlipidemias/tratamento farmacológico , Sintomas do Trato Urinário Inferior/induzido quimicamente , Hiperplasia Prostática/induzido quimicamente , Idoso , China/epidemiologia , Humanos , Incidência , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/epidemiologia , Fatores de Risco , Fatores de Tempo
11.
J Urol ; 202(5): 1008-1014, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31059664

RESUMO

PURPOSE: While lower urinary tract symptoms and bladder behaviors are known to be associated with certain occupations, little is known about restroom access or environmental factors which may contribute to this relationship. We aimed to characterize reasons that women limit restroom use at work. We also sought to determine whether women who limit use at work report more unhealthy bladder habits and lower urinary tract symptoms. MATERIALS AND METHODS: We performed a cross-sectional study of full-time working women in the United States. Women completed validated questionnaires recording toileting behaviors, lower urinary tract symptoms and perceptions of the occupational toilet environment. We compared women who limited restroom use at work most or all of the time to those who did not limit or did so occasionally or sometimes. RESULTS: Of the 3,062 women in the final analytical sample 11% reported limiting restroom use at work most or all of the time. This group reported lower satisfaction with restroom cleanliness and privacy in particular. They more frequently identified toilet factors of poor quality, limited accessibility and restricted use by employer. The prevalence of unhealthy bladder habits was significantly higher among women who limited restroom use, as was the prevalence of urgency, monthly urinary incontinence and infrequent voiding. CONCLUSIONS: In this cross-sectional study of women working full time those who limited restroom use at work reported a higher prevalence of unhealthy bladder habits and certain urinary disorders. Future studies should determine whether limited restroom use at work is a modifiable risk factor for unhealthy bladder habits and bladder health outcomes.


Assuntos
Hábitos , Sintomas do Trato Urinário Inferior/psicologia , Toaletes/estatística & dados numéricos , Micção/fisiologia , Estudos Transversais , Feminino , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/fisiopatologia , Prevalência , Estudos Retrospectivos , Inquéritos e Questionários , Estados Unidos/epidemiologia
12.
Pan Afr Med J ; 32: 15, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31143320

RESUMO

There are growing concerns on the varying pattern of advanced prostate cancer (PCa) presentation across the world. We report some of the unusual presentations of PCa at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, South-Western Nigeria. A review of all patients with histologically confirmed PCa who had unusual presentations between January 2014 and December 2015 was done. Unusual presentation was defined as an atypical feature in the absence of lower urinary tract symptoms (LUTS), with the diagnosis of PCa only suspected after abnormal digital rectal examination (DRE) and/or elevated prostate specific antigen (PSA) assay. Thirteen patients had an unusual presentation in OAUTHC during the study period. Five (38.5%) had left supraclavicular swellings while four (30.8%) had haematochyzia and tenesmus. Other unusual presentations include large bowel obstruction requiring emergency colostomy (2;15.4%) and a scalp mass (1;7.7%). All patients had appropriate treatment for stage of PCa and are being followed up in the out-patient clinic. The change in presentations of PCa may suggest the need for DRE and serum PSA assay among all middle-aged and elderly men presenting at health facilities. Large scale studies on PCa across different population groups may also help at identifying related clinical, demographic and epidemiological factors as well as possible validation of some of these unusual presentations.


Assuntos
Exame Retal Digital/métodos , Sintomas do Trato Urinário Inferior/epidemiologia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Neoplasias da Próstata/patologia
13.
Scand J Urol ; 53(2-3): 166-170, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31006310

RESUMO

Objective: To analyze which factors in the history of a posterior urethral valve (PUV) patient relate to lower urinary tract symptoms (LUTS) in adulthood. This study also aimed to evaluate whether the patients have developed signs of a myogenic failure of detrusor. Materials and methods: LUTS were evaluated with a DAN-PSS questionnaire in 78 adult patients treated for PUV in childhood. Symptom scores (SS) were compared with patient characteristics and types of treatment. The results of uroflowmetry and post-voiding residual (PVR) measurements were collected from their latest visit to Helsinki University Children's Hospital. Results: The median total symptom score (TSS) was 1 (IQR = 0-5, range = 0-18). The patient age during the investigation and SS were associated (R = 0.220, p = 0.032), but the primary creatinine level and SS were not (R = 0.260, p = 0.081). The median age for achieving continence was 6.3 years. The SS and the age when becoming continent were not associated (p = 0.365 and p = 0.679, respectively). In the age group of 39 years or more, 19 patients with a previous bladder neck incision (BNI) had a higher storage-SS than 15 patients without any previous bladder neck incision (1 (IQR = 0-5) vs 0 (IQR = 0-0), p = 0.030). According to symptoms and post-voiding residual measurements, myogenic failure in adults seems to be rare. Conclusions: LUTS are common, but severe symptoms referring to myogenic failure are rare in men treated for PUV in childhood. The specific reasons for LUTS are difficult to indicate and even the sickest children do not necessarily have LUTS in adulthood.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Obstrução Uretral/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Cistostomia , Finlândia/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Noctúria/epidemiologia , Fatores de Risco , Estomas Cirúrgicos , Inquéritos e Questionários , Uretra/cirurgia , Bexiga Urinária/cirurgia , Bexiga Urinária Hiperativa/epidemiologia , Bexiga Inativa/epidemiologia , Derivação Urinária , Incontinência Urinária de Urgência/epidemiologia , Adulto Jovem
14.
Clin Orthop Relat Res ; 477(4): 872-878, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30844824

RESUMO

BACKGROUND: Lower urinary tract symptoms (LUTS) and urinary bother have been reported in adults undergoing surgery and have been associated with urinary tract infections, longer hospital stays, increased surgical costs, and decreased patient satisfaction. Previous reports indicate that up to one in two patients with lumbar spine pathology have moderate-to-severe LUTS, but little is known about LUTS in patients with cervical spine conditions. QUESTIONS/PURPOSES: (1) What is the prevalence of moderate-to-severe LUTS and clinically relevant urinary bother among patients undergoing elective cervical spine surgery? (2) Does the presence of myelopathy affect frequency of moderate-to-severe LUTS or clinically relevant urinary bother among patients undergoing elective cervical spine surgery? (3) Do MRI findings of spinal cord injury or compression correlate with presence and severity of LUTS? METHODS: We performed a cross-sectional study using clinical data collected from adult patients undergoing elective cervical spine surgery. Over an approximately 30-month period, we approached all patients who were evaluated in the preoperative clinic before undergoing elective cervical spine surgery. Of the 257 approached, 242 participated (94%). Study participants ranged in age from 34 to 83 years with a mean age of 58 years (SD 12). There were 108 males (45%) and 134 females (55%). A validated questionnaire, the International Prostate Symptom Score (IPSS), was used to identify LUTS. The IPSS score ranges from 0 to 35 points with LUTS presence defined as a score of ≥ 8 and LUTS severity categorized as mild (IPSS 0-7), moderate (IPSS 8-19), or severe (IPSS 20-35). Quality of life resulting from urinary bother is scored 0 to 6 with scores ≥ 4 considered clinically relevant urinary bother. Patients were grouped into a myelopathy group and a nonmyelopathy group based on diagnosis as assigned by the operating surgeon. MRIs were analyzed by one spine surgeon to identify the presence of cord signal, number of levels with cord compression (mm), and a calculated compression ratio score with cord compression and with compression ratio among patients with myelopathy. RESULTS: The prevalence of moderate LUTS in our patient sample was 40% (97 of 242; 95% confidence interval [CI], 34%-47%). The prevalence of severe LUTS in our patient sample was 8% (19 of 242; 95% CI, 5%-12%). Clinically relevant urinary bother was reported in 18% of patients (41 of 228; 95% CI, 13%-24%). After adjustment for age and sex, the odds of moderate-to-severe LUTS among patients with myelopathy was greater than that observed in patients without myelopathy (adjusted odds ratio, 2.0; p = 0.015). The prevalence of clinically relevant urinary bother was higher in patients with myelopathy (30% [26 of 88]) compared with those with no myelopathy (11% [15 of 140]; p < 0.001). With the numbers available, among patients with myelopathy, there was no difference in distribution of LUTS symptom severity or IPSS score according to cord signal presence (50% [23 of 46]) and absence (65% [31 of 48]; p = 0.153), number of levels with compression (70% [seven of 10 with four levels]; 59% [13 of 22 with three levels]; 51% [19 of 37] with two levels; and 60% [15 of 25] with one level; p = 0.730), millimeters of cord compression (r = 0.02; p = 0.854), or compression ratio (r = 0.09; p = 0.413). CONCLUSIONS: Nearly half of all patients undergoing elective cervical spine surgery had moderate-to-severe LUTS. This is more than double the prevalence that has been reported in a community-dwelling adult population. These symptoms can impair quality of life, lead to surgical complications (urinary retention or incontinence), and may be mistaken for cauda equina, prompting potentially unnecessary imaging and studies. Given that urinary bother is reported less frequently than LUTS, patients may be less likely to seek care for urinary symptoms before undergoing surgery. Therefore, it is important to increase provider awareness of the high prevalence of LUTS. LEVEL OF EVIDENCE: Level III, prognostic study.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Procedimentos Ortopédicos , Doenças da Medula Espinal/cirurgia , Medula Espinal/cirurgia , Transtornos Urinários/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais , Efeitos Psicossociais da Doença , Estudos Transversais , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/fisiopatologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Oregon/epidemiologia , Procedimentos Ortopédicos/efeitos adversos , Prevalência , Qualidade de Vida , Medula Espinal/diagnóstico por imagem , Medula Espinal/fisiopatologia , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/epidemiologia , Doenças da Medula Espinal/fisiopatologia , Transtornos Urinários/diagnóstico , Transtornos Urinários/fisiopatologia
15.
Urology ; 128: 66-70, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30817957

RESUMO

OBJECTIVE: To examine the association between shift work or shift work disorder (SWD) and lower urinary tract symptoms (LUTS). Nonstandard shift workers are defined as those working shifts outside of a normal 7 AM-6 PM work day. METHODS: Men presenting to a single andrology clinic between July 2014 and June 2017 completed questionnaires that included questions about work schedules, shift work status, SWD[1][1], personal well-being via the Patient Health Questionnaire-9, and LUTS (International Prostate Symptom Score [IPSS]). Men who had previously undergone prostate surgery were excluded. Shift work and SWD on IPSS was assessed via multivariate linear regression. RESULTS: Of the 2571 men who completed all questionnaires, 619 (24.1%) reported working nonstandard shifts in the past month. Of these, 196 (31.7%) had high risk of SWD as determined by a questionnaire. When controlling for age, medications, surgical intervention for benign prostatic hyperplasia, comorbidities, and testosterone (T) levels, nonstandard shift work overall was not associated with worse LUTS (P = .82). However, nonstandard shift workers at high risk for SWD had IPSS scores that were clinically significantly higher (3.74 points ± 0.57 standard error) than nonstandard shift workers without SWD (P <.0001). CONCLUSION: Nonstandard shift workers at high risk for SWD have worse LUTS than those without SWD. However, no association between nonstandard shift work and LUTS was found.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Doenças Profissionais/epidemiologia , Qualidade de Vida , Jornada de Trabalho em Turnos/efeitos adversos , Tolerância ao Trabalho Programado/fisiologia , Adulto , Seguimentos , Humanos , Incidência , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Inquéritos e Questionários , Estados Unidos/epidemiologia
16.
Clinics (Sao Paulo) ; 74: e713, 2019 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-30892415

RESUMO

OBJECTIVES: To assess the prevalence and interrelationship between lower urinary tract symptoms and sexual dysfunction in men with multiple sclerosis (MS). METHODS: In a cross-sectional study, we evaluated 41 men (mean age 41.1±9.9 years) with MS from February 2011 to March 2013, who were invited to participate irrespective of the presence of lower urinary tract symptoms or sexual dysfunction. Neurological impairment was assessed with the Expanded Disability Status Scale; lower urinary tract symptoms were evaluated with the International Continence Society male short-form questionnaire, and sexual dysfunction was evaluated with the International Index of Erectile Function. All patients underwent transabdominal urinary tract sonography and urine culture. RESULTS: The mean disease duration was 10.5±7.3 years. Neurological evaluation showed a median Expanded Disability Status Scale score of 3 [2-6]. The median International Continence Society male short-form questionnaire score was 17 [10-25]. The median International Index of Erectile Function score was 29 [15-46]. Twenty-nine patients (74.4%) had sexual dysfunction as defined by an International Index of Erectile Function score <45. Voiding dysfunction and sexual dysfunction increased with the degree of neurological impairment (r=0.02 [0.02 to 0.36] p=0.03 and r=-0.41 [-0.65 to -0.11] p=0.008, respectively). Lower urinary tract symptoms and sexual dysfunction also displayed a significant correlation (r=-0.31 [-0.56 to -0.01] p=0.04). CONCLUSIONS: Most male patients with MS have lower urinary tract symptoms and sexual dysfunction. The severity of the neurological disease is a predictive factor for the occurrence of voiding and sexual dysfunctions.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Esclerose Múltipla/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Disfunção Erétil/complicações , Humanos , Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/diagnóstico , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Prevalência , Qualidade de Vida , Índice de Gravidade de Doença , Disfunções Sexuais Fisiológicas/complicações , Disfunções Sexuais Fisiológicas/diagnóstico , Inquéritos e Questionários , Bexiga Urinária Hiperativa/complicações , Adulto Jovem
17.
Urology ; 127: 91-96, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30822484

RESUMO

OBJECTIVE: To assess the impact of systemic comorbidities on a validated health phenotype score (ACTIONS: Anxiety, Cardiovascular, Testosterone, Insulin/diabetes, Obesity, Neurologic, Sleep apnea) on outcomes of transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH) for symptoms and medication discontinuation. MATERIALS AND METHODS: Comorbidities of men undergoing TURP for BPH from 2004 to 2015 were assessed with the validated ACTIONS phenotype totaling a score from 0 to 2 for each domain (Anxiety, Cardiovascular, Testosterone, Insulin/diabetes, Obesity, Neurologic, Sleep apnea). BPH medication discontinuation, change in International Prostate Symptom Score, postvoid residual, and patient satisfaction were assessed. Descriptive and comparative statistics were calculated with significance set at P <.05. RESULTS: The 319 men had a median age of 74.0 (interquartile range 67-78). Mean ACTIONS score was significantly lower in men who discontinued alpha-blockers or 5-alpha reductase inhibitors compared to those who did not (3.37 ± 2.14vs 4.79 ± 2.75, P <.0001). ACTIONS score <4 was significantly associated with medication discontinuation (P = .0014). Lower scores in Testosterone (P = .04), Neurologic (P = .003), and Sleep apnea (P = .04) domains were significantly associated with medication discontinuation. Total ACTIONS score was not independently associated with changes in International Prostate Symptom Score or postvoid residual. CONCLUSION: Lower ACTIONS score was associated with BPH medication discontinuation after TURP, suggesting men with lower comorbidity burdens do better after the procedure. The ACTIONS phenotype score is easily calculated and may aid the preoperative counseling of men undergoing TURP for BPH.


Assuntos
Antagonistas Adrenérgicos alfa/administração & dosagem , Sintomas do Trato Urinário Inferior/epidemiologia , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/métodos , Agentes Urológicos/administração & dosagem , Idoso , Estudos de Coortes , Comorbidade , Seguimentos , Humanos , Incidência , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Fenótipo , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/fisiopatologia , Valor Preditivo dos Testes , Cuidados Pré-Operatórios/métodos , Hiperplasia Prostática/diagnóstico , Estudos Retrospectivos , Medição de Risco , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento , Agentes Urológicos/efeitos adversos , Suspensão de Tratamento
19.
Biomed Res Int ; 2019: 7826085, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30809546

RESUMO

Background: Excision and primary anastomotic (EPA) urethroplasty remains the gold standard definitive treatment for short urethral stricture disease. For patients, postoperative erectile function and quality of life are the main goals of the surgery. Patient-reported outcome measures (PROMs) are therefore of major importance. Objective: The objective of this study was to prospectively analyse functional outcomes and patient satisfaction. Design Settings and Participants: We prospectively evaluated 47 patients before and after EPA from August 2009 until February 2017. The first follow-up visit occurred after a median of 2.2 months (n = 47/47), with the second and third follow-ups occurring at a median of 8.5 months (n = 38/47) and 20.2 months (n = 31/47). Before surgery and at each follow-up visit, the patients received five questionnaires: the International Prostate Symptom Score (IPSS), the International Prostate Symptom Score with the Quality of Life (IPSS-QOL) score, the Urogenital Distress Inventory Short Form (UDI-6) score, the International Index of Erectile Function-5 (IIEF-5) score, and the ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTS-QOL) score. Surgical Procedure: Surgery was performed in all cases using the same standardized EPA technique. Outcome Measurements and Statistical Analysis: Voiding symptoms, erectile dysfunction, and quality of life were analysed using paired sample t-tests, with a multiple-testing Bonferroni correction. Any requirement for instrumentation after surgery was considered treatment failure. Results and Limitations: Patients with mild or no baseline erectile dysfunction showed significant decline in erectile function at first follow-up (mean IIEF-5 of 23.27 [standard deviation; SD: 2.60] vs. 13.91 [SD: 7.50]; p=0.002), but this had recovered completely at the third follow-up (IIEF-5: 23.25 [SD: 1.91]; p=0.659). Clinically significant improvements were noted in IPSS, IPSS-QOL-score, UDI-6-score, and ICIQ-LUTS-QOL-score at the first follow-up (p<0.0001). These improvements remained significant at the second and third follow-ups (p<0.0001) for all PROMs. Three of the patients experienced stricture recurrence. The main limitations of this study were incomplete questionnaires, loss to follow-up, and low number of patients. Conclusions: EPA results in an initial decline in erectile function, but full recovery occurred at a median of 20 months. Voiding improved significantly, and a major improvement in quality of life was noted, which persisted for up to 20 months after surgery. Patient Summary: This study showed the importance of patient-reported outcome measures in indicating the actual outcome of urethral stricture disease surgery.


Assuntos
Disfunção Erétil/fisiopatologia , Uretra/cirurgia , Estreitamento Uretral/cirurgia , Idoso , Anastomose Cirúrgica , Disfunção Erétil/complicações , Disfunção Erétil/epidemiologia , Humanos , Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Ereção Peniana/fisiologia , Hiperplasia Prostática/complicações , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/fisiopatologia , Qualidade de Vida , Inquéritos e Questionários , Uretra/fisiopatologia , Estreitamento Uretral/epidemiologia , Estreitamento Uretral/fisiopatologia
20.
BMC Urol ; 19(1): 15, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30791899

RESUMO

BACKGROUND: There is paucity of information on the community-based prevalence and severity of lower urinary tract symptoms (LUTS) in men who are 40 years and older in the southeast region of Nigeria. This study seeks to determine the community-based prevalence of LUTS and the relationship between LUTS, and body mass index (BMI) and mid-abdominal circumference (MAC) in men. METHODS: An interviewer-administered, questionnaire-based survey. Three of nine settlement clusters were randomly selected while systematic random sampling of 1 in 3 eligible subjects was used to select participants. Analysis was done using SPSS® version 20. RESULTS: One thousand three hundred and nineteen duly completed questionnaires were analyzed. The respondents are within ages 40-92 years with mean age 54.2 ± 10.2 years, mean BMI 25.97 ± 4.18Kg/m2 and mean MAC 89.80 ± 12.43 cm. Overall prevalence of LUTS is 20.2%. Nocturia at a prevalence of 19.2% is the most prevalent lower urinary tract symptom and also the earliest to manifest. LUTS prevalence and severity increases with increasing age. About 9.6% report moderate LUTS while 2.3% report severe LUTS. Storage LUTS are reported more frequently than voiding LUTS. LUTS did not vary significantly with BMI, MAC or Wealth-Index. CONCLUSION: LUTS prevalence and severity vary with age, but not with BMI, MAC or Wealth-Index.


Assuntos
Índice de Massa Corporal , Recursos em Saúde/tendências , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/epidemiologia , Índice de Gravidade de Doença , Circunferência da Cintura , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Recursos em Saúde/economia , Humanos , Sintomas do Trato Urinário Inferior/economia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Circunferência da Cintura/fisiologia
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