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1.
Urol Int ; 104(11-12): 853-858, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32894859

RESUMO

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


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Sintomas do Trato Urinário Inferior/epidemiologia , Pneumonia Viral/epidemiologia , Hiperplasia Prostática/epidemiologia , Qualidade de Vida , Adulto , Comorbidade , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Prognóstico , Estudos Prospectivos
2.
J Urol ; 204(6): 1305-1311, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32924780

RESUMO

PURPOSE: Most international practice guidelines recommend screening for chronic kidney disease among older men with lower urinary tract symptoms. However, prior studies supporting these guidelines are insufficient due to incomplete assessments of kidney function and inadequate adjustment for confounding factors. MATERIALS AND METHODS: We conducted a cross-sectional study among 5,530 American men older than 65 years in the multicenter Osteoporotic Fractures in Men Study. Chronic kidney disease was defined per international guidelines as estimated glomerular filtration rate less than 60 ml/minute/1.73 m2 based on serum creatinine or cystatin C, or urinary albumin-to-creatinine ratio 30 mg/gm or greater. Lower urinary tract symptoms were assessed with the American Urological Association Symptom Index. Associations were estimated using multivariable linear and modified Poisson regression models. RESULTS: Chronic kidney disease prevalence was 16% among 5,530 men with serum creatinine, 24% among 1,504 men with serum cystatin C and 14% among 1,487 men with urinary albumin-to-creatinine measurements. Lower urinary tract symptoms were not associated with lower estimated glomerular filtration rate based on serum creatinine or cystatin C. Although symptom severity was modestly associated with a higher prevalence of chronic kidney disease in age/site adjusted analyses, confidence intervals were wide and associations using all 3 definitions were not statistically significant after adjustment for important confounders, including cardiovascular disease and analgesic use. CONCLUSIONS: Lower urinary tract symptoms are not independently associated with multiple measures of kidney dysfunction or prevalence of chronic kidney disease among older community dwelling men. Our results do not support recommendations for kidney function testing among older men with lower urinary tract symptoms.


Assuntos
Vida Independente/estatística & dados numéricos , Sintomas do Trato Urinário Inferior/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Albuminúria/diagnóstico , Fatores de Confusão Epidemiológicos , Creatinina/sangue , Creatinina/urina , Estudos Transversais , Cistatina C/sangue , Taxa de Filtração Glomerular/fisiologia , Humanos , Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Prevalência , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/etiologia , Índice de Gravidade de Doença , Micção/fisiologia
3.
Urologe A ; 59(10): 1195-1203, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32880664

RESUMO

Multimorbid older men are increasingly more common in daily practice and present a challenge because they are often affected by lower urinary tract symptoms (LUTS) and age-associated benign prostatic hyperplasia (BPH). In order to identify possible risks in diagnostics, therapy and counselling at an early stage, screening for functional deficits or risk factors with standardized procedures is helpful. An initial screening with subsequent assessment of everyday skills using the Barthel Index, Timed up & Go Test, and a cognitive test are recommended. If frailty syndrome is detected, it should be taken into account during the pre-, peri-, and postoperative management, as it may indicate increased morbidity and mortality. Noninvasive methods for reducing the prostate volume without anesthesia can be a therapy option in older multimorbid patients, and with individual planning and consideration of risk factors, up to 70% of individuals become symptom-free. However, there is currently no gold standard for this vulnerable patient group. Number of medications and concomitant diseases and higher need for help are per se risk factors for unsatisfactory results after transurethral resection of the prostate (TURP) or laser vaporization. With drug therapy, concomitant medications and their interactions, especially in the cytochrome system, an existing multimorbidity and adherence to therapy must be taken into account. Combination therapies may complement each other and may bridge the time until surgery. Minimally invasive methods that can be performed without general anesthesia are suitable for geriatric patients, especially those with recurrent retention. Studies with the Rezüm® system (NxThera Inc., Maple Grove, MN, USA) and UroLift® (NeoTract Inc., Pleasanton, CA, USA) show that about 70% of patients can be relieved from the permanent catheter.


Assuntos
Sintomas do Trato Urinário Inferior , Hiperplasia Prostática , Ressecção Transuretral da Próstata , Idoso , Idoso Fragilizado , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/epidemiologia , Hiperplasia Prostática/terapia , Resultado do Tratamento
4.
Maturitas ; 140: 8-13, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32972638

RESUMO

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


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Infecções Urinárias/epidemiologia , Doenças Vaginais/epidemiologia , Adulto , Atrofia , Estudos Transversais , Feminino , Humanos , Menopausa , Pessoa de Meia-Idade , Vagina/patologia
5.
BMC Public Health ; 20(1): 868, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503507

RESUMO

BACKGROUND: Lower urinary tract symptoms (LUTS) are common among men worldwide and despite frequently of benign origin, the symptoms often influence quality of life. Most men experiencing LUTS manage their symptoms in private settings without consulting their general practitioner (GP). Therefore, the purpose of this study was to identify who in the personal and professional relations Danish men discussed their bothersome LUTS with, to analyse factors associated with discussing LUTS with personal and professional relations, and to analyse how having a social network influenced healthcare seeking. METHODS: A nationwide population-based, cross-sectional survey representative of the Danish population. A total of 46,647 randomly selected men aged 20+ were invited to participate. Data were collected in 2012. The main outcome measures were odds ratios between involvement of personal and professional relations, GP contact and different characteristics (age, number of symptoms, available social network, and involvement of personal relations) among men experiencing bothersome LUTS. We used multivariate logistic regression models. RESULTS: Overall, 22,297 men completed the questionnaire. Of those, 4885 (21.9%) had experienced at least one LUTS, 23.5% had not discussed their symptoms with either personal nor professional relations and 59.1% had not discussed their LUTS with any professional relation. The symptoms were most often discussed with personal relations, primarily the spouse/partner who was involved in more than half of the cases. Odds of consulting the GP, another doctor and other healthcare professionals were two to four-fold higher when the symptoms were discussed with a personal relation. Having an available social network was significantly associated with lower odds of consulting the GP regarding frequent urination. CONCLUSIONS: Despite the high prevalence of bothersome LUTS more than one-fifth of men did not discuss their symptoms with either personal nor professional relations, and more than half did not discuss the symptoms with any professional relations. Discussing the symptoms with personal relations was generally associated with higher odds of seeking professional help, and for frequent urination, having an available social network was associated with lower odds of consulting the GP. The results may be useful for detecting and treating men bothered by LUTS.


Assuntos
Revelação , Sintomas do Trato Urinário Inferior/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Relações Profissional-Paciente , Adulto , Idoso , Estudos Transversais , Dinamarca/epidemiologia , Clínicos Gerais/psicologia , Humanos , Modelos Logísticos , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Qualidade de Vida , Projetos de Pesquisa , Inquéritos e Questionários , Adulto Jovem
7.
Neurourol Urodyn ; 39(5): 1472-1481, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32368829

RESUMO

AIMS: To determine whether childhood adversity is associated with self-reported lower urinary tract symptoms (LUTS) among older adult women. METHODS: A convenience sample of women (≥55 years old) who presented to an academic urology practice or who had participated in a previous bladder health prevention study completed questionnaires including the LUTS Tool (on frequency and bother of LUTS), the Adverse Childhood Experiences (ACEs) Questionnaire, the Spielberger State-Trait Anxiety Inventory, and the Center for Epidemiologic Studies Depression Scale. RESULTS: The average age (SD) of participants (N = 151) was 64.7 (6.9) years. The total number of ACEs predicted the total number of LUTS, ß = .39 (95% confidence interval [CI] = 0.14, 0.64), P = .003, as well as LUTS frequency, ß = .09 (95% CI = 0.04, 0.13), P < .001. ACEs predicted bother for nocturia, ß = 0.12 (95% CI = 0.03, 0.22), P = .008. Negative affect symptoms did not mediate the relationship between the total number of ACEs and the total number of LUTS. Rather, ACEs predicted LUTS and negative affect symptoms through (at least partially) independent pathways. Analyses controlled for tobacco use, number of vaginal deliveries, hypertension, overactive bladder medication use, body mass index, income, and race because these variables were significantly associated with the total number of ACEs or total number of LUTS. CONCLUSIONS: Childhood adversity has an enduring impact on risk for LUTS in adulthood even when controlling for potential confounds and this relationship cannot be explained by negative affect symptoms.


Assuntos
Maus-Tratos Infantis/psicologia , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/psicologia , Idoso , Ansiedade/complicações , Ansiedade/psicologia , Criança , Depressão/complicações , Depressão/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos do Humor/complicações , Transtornos do Humor/psicologia , Noctúria/complicações , Noctúria/psicologia , Prevalência , Autorrelato , Inquéritos e Questionários
8.
Geriatr Gerontol Int ; 20(7): 670-673, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32400935

RESUMO

AIM: In this study, we investigated self-measured voiding time in the Japanese population. METHODS: A survey questionnaire was used to determine self-measured voiding time in Japanese participants aged ≥20 years. In addition to demographic data such as age and sex, relevant medical conditions, including hypertension, diabetes mellitus, renal impairment and other disorders, were also recorded. Voiding time was measured whenever the participant had the urge to void. RESULTS: In total, 2493 healthy individuals (1347 men, mean ± SD, age 60.50 ± 12.16 years, and 1146 women, 51.16 ± 12.97 years) participated in the survey. Self-measured voiding time was 27.71 ± 20.25 s for men, and 17.49 ± 11.87 s for women. Additionally, 1227 participants with certain diseases were included (1026 men, aged 67.12 ± 9.93 years, and 201 women, 60.26 ± 11.02 years). In this group, self-measured voiding time was significantly longer at P < 0.01 (30.71 ± 20.98 s in men, 21.28 ± 15.56 s in women). In men whose international prostate symptom score (IPSS) was >7, voiding time was significantly longer (healthy men: IPSS ≤7 n = 868, 23.9 ± 14.88 s, IPSS ≥8 n = 479, 34.6 ± 26.05 s, P < 0.05, men with comorbidities: IPSS ≤7: n = 504, 25.64 ± 15.63 s, IPSS ≥8: n = 522, 35.6 ± 24.11 s, P < 0.05). CONCLUSIONS: This self-reported internet survey revealed that self-measured voiding time was longer in men than women regardless of age, and was significantly prolonged with age regardless of sex. Furthermore, self-measured voiding time could be a good screening tool to predict urinary function and health status. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2020; ••: ••-••.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Micção/fisiologia , Adulto , Idoso , Comorbidade , Feminino , Nível de Saúde , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Sistema Urinário/fisiopatologia
9.
Neurourol Urodyn ; 39(4): 1098-1107, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32249998

RESUMO

AIMS: We determined the prevalence, severity, and correlates of nocturia in a large clinical cohort of patients. METHODS: Patients presenting with lower urinary tract symptoms (LUTS) completed 3-day bladder diaries. Nocturia was quantified based on the mean number of nighttime voids documented over the 3 days. Nocturia subtypes (global polyuria, nocturnal polyuria [NP], reduced global bladder capacity, and reduced nocturnal bladder capacity) were assessed. Bother due to nocturia was measured by the LUTS Tool. Sleep quality was assessed with the Patient-Reported Outcomes Measurement Information System Sleep Scale. Multivariable multinomial regression was used to explore patient characteristics associated with nocturia. RESULTS: In 502 participants with analyzable diaries (285 men and 217 women), the mean number of nocturia episodes over 3 days was 0 in 103 (20.5%), >0 to <1 in 151 (20.1%), 1 to <2 in 165 (32.9%), and ≥2 in 83 (16.5%). Sixty-seven percent of the participants with nocturia ≥1 reported significant bother from their nocturia. NP was the most common nocturia subtype and was present in 17% of those with nocturia = 0, 40% of those with nocturia >0 to <1, 65% of those with nocturia 1 to <2%, and 77% with nocturia 2+. Higher degrees of nocturia were associated with male sex, greater sleep disturbance, and a higher likelihood of exhibiting multiple nocturia subtypes. CONCLUSIONS: Nocturia ≥1 occurred in 49% of LUTS patients and caused significant bother in the majority of them. The most common subtype was NP, but a substantial proportion of patients exhibited additional characteristics.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Noctúria/epidemiologia , Poliúria/epidemiologia , Bexiga Urinária/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Noctúria/diagnóstico , Noctúria/fisiopatologia , Poliúria/diagnóstico , Poliúria/fisiopatologia , Prevalência
10.
Neurourol Urodyn ; 39(5): 1430-1436, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32324941

RESUMO

AIMS: The aim of this study is to identify factors associated with urinary incontinence (UI) in a community sample of young nulligravid women. METHODS: This was a secondary analysis from a cross-sectional survey-based study of cisgender women aged 18 to 25 years recruited through a national registry of research volunteers. Participants completed validated questionnaires assessing toileting behaviors, lower urinary tract symptoms (LUTS), and bowel symptoms. Women were excluded from analysis if currently pregnant, any prior pregnancy, cystectomy, or any neurologic disease including spinal cord injury, stroke, or multiple sclerosis. Analyses determined the prevalence of symptoms and evaluated candidate risk factors for UI. RESULTS: Final analyses included 964 women (mean age, 22.6 ± 2.0). Monthly UI was identified in 295 (30.6%) subjects, with mixed UI being the most common (56.9%; n = 168). Seventy-two women (7.4%) reported fecal incontinence (FI) and 24 (3.5%) women reported both UI and FI. After multivariable regression modeling, UI was associated with an intermittent urine stream and the delayed voiding toileting behavior subscale. CONCLUSIONS: UI in this cohort of young nulliparous women was highly prevalent and warrants further study as to the cause. Therapeutic guidelines to prevent UI and LUTS may need to be adjusted by targeting populations earlier than traditionally considered.


Assuntos
Incontinência Urinária/epidemiologia , Adolescente , Adulto , Estudos Transversais , Incontinência Fecal/complicações , Incontinência Fecal/epidemiologia , Feminino , Número de Gestações , Humanos , Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/epidemiologia , Intestino Neurogênico/complicações , Intestino Neurogênico/epidemiologia , Prevalência , Sistema de Registros , Fatores de Risco , Inquéritos e Questionários , Micção , Adulto Jovem
11.
Neurourol Urodyn ; 39(4): 1185-1202, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32119156

RESUMO

AIMS: Although lower urinary tract symptoms (LUTS) may occur at different periods during the life course of women, a little research on LUTS has adopted a life course perspective. The purpose of this conceptual paper is to demonstrate how life course theory and life course epidemiology can be applied to study bladder health and LUTS trajectories. We highlight conceptual work from the Prevention of Lower Urinary Tract Symptoms Research Consortium to enhance the understanding of life course concepts. METHODS: Consortium members worked in transdisciplinary teams to generate examples of how life course concepts may be applied to research on bladder health and LUTS in eight prioritized areas: (a) biopsychosocial ecology of stress and brain health; (b) toileting environment, access, habits, and techniques; (c) pregnancy and childbirth; (d) physical health and medical conditions; (e) musculoskeletal health; (f) lifestyle behaviors; (g) infections and microbiome; and (h) hormonal status across the life span. RESULTS: Life course concepts guided consortium members' conceptualization of how potential risk and protective factors may influence women's health. For example, intrapartum interventions across multiple pregnancies may influence trajectories of bladder health and LUTS, illustrating the principle of life span development. Consortium members also identified and summarized methodologic and practical considerations in designing life course research. CONCLUSIONS: This paper may assist researchers from a variety of disciplines to design and implement research identifying key risk and protective factors for LUTS and bladder health across the life course of women. Results from life course research may inform health promotion programs, policies, and practices.


Assuntos
Promoção da Saúde , Bexiga Urinária/fisiopatologia , Saúde da Mulher , Adulto , Parto Obstétrico , Feminino , Hábitos , Humanos , Estilo de Vida , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Gravidez , Autocuidado
12.
Arch. esp. urol. (Ed. impr.) ; 73(1): 19-25, ene.-feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192890

RESUMO

OBJETIVO: Determinar si la presencia de síntomas del tracto urinario inferior moderados a severos en médicos residentes se asocian con la exposición a bullying laboral. MATERIAL Y MÉTODOS: Estudio transversal realizado en médicos residentes. Se definió síntomas del tracto urinario inferior moderados a severos como más de 8 puntos en el Índice Internacional de Síntomas Prostáticos. Los residentes se consideraron como expuestos a bullying si el puntaje total en la Escala de Conductas Negativas era mayor a 41 puntos. Se consideró como bullying percibido cualquier respuesta positiva en una pregunta específica para medir esta variable. Se realizó un análisis bivariado utilizando la Χ² para determinar diferencias estadísticas entre la presencia de síntomas del tracto urinario inferior y la exposición a ambos tipos de bullying. La magnitud y dirección de las asociaciones se establecieron calculando el Odds Ratio con un intervalo de confianza al 95%. RESULTADOS: Se incluyeron 209 residentes, 63% hombres; 68% refirieron algún síntoma del tracto urinario, de los cuales, 56% fueron leves, 10% moderados y 2% severos. La prevalencia de bullying fue de 42% y el bullying percibido se presentó en el 39%. Los residentes con ≥ 8 puntos en el Índice Internacional de Síntomas Prostáticos tuvieron mayor riesgo de estar expuestos a bullying (OR: 2,8, IC 95%: 1,1-6,7, p = 0,01) y bullying percibido (OR: 3,1 95% CI: 1,3-7,5, p 0,00). Ser mujer se asoció con mayor riesgo de presentar síntomas del tracto urinario inferior (OR: 2,8, IC 95%: 1,1-6,6, p = 0,01). CONCLUSIONES: Los médicos residentes con síntomas del tracto urinario moderados o severos pueden estar relacionados a bullying. Ser mujer se asocia a mayor riesgo de presentar STUI


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
Humanos , Masculino , Feminino , Bullying , Internato e Residência , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/psicologia , Médicos/psicologia , Estudos Transversais , Prevalência
13.
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
14.
BMC Neurol ; 20(1): 24, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31952513

RESUMO

BACKGROUND: Most patients with multiple sclerosis (MS) suffer from bladder dysfunction during the course of the disease. This study was conducted to examine the prevalence of these complications among patients with MS. METHODS: This cross-sectional study was performed on 602 patients with MS who referred to the neurology clinics of Kashani and Alzahra Hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Multistage random cluster sampling was performed and the informed consent form was signed by the subjects. Then, all the data were collected through interviews using the Lower Urinary Tract Symptom Score (LUTSS) developed in accordance with the definitions presented by the International Continence Society (ICS) and the International Prostate Symptom Score (I-PSS) and DASS-21 questionnaire. The data were analyzed using descriptive and inferential statistical tests in SPSS. RESULTS: The prevalence rate of lower urinary tract symptoms (LUTS) was 87.6% among all the subjects, with a similar rate among women (88.0%) and men (86.0%). There was a significant difference between men and women in terms of the prevalence of stress urinary incontinence (SUI), intermittent urine flow, hesitancy, straining, and dribbling (P <  0.050). There was no significant difference between women and men in terms of the prevalence of other symptoms (P > 0.050). A significant difference was observed in the degree of LUTS with age, marital status, marriage duration, education, illness duration, clinical course, disability, anxiety, depression, and stress (P<  0.05). Moreover, logistic regression analysis revealed that there was a higher probability of a urinary problems among patients with MS and a high EDSS score [0.67 (0.507-0.903), P = 0.008]. CONCLUSIONS: A high prevalence of LUTS was found among patients with MS. There was a higher probability of a urinary tract problem among patients with MS and a high EDSS score. Therefore, it is recommended that the health system take the necessary measures regarding timely detection and treatment of LUTS among these patients in order to prevent secondary outcomes and improve the quality of life (QOL) of patients with MS.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/etiologia , Esclerose Múltipla/complicações , Adulto , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Inquéritos e Questionários
15.
Qual Life Res ; 29(5): 1311-1321, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31900760

RESUMO

PURPOSE: To estimate the prevalence of lower urinary tract symptoms (LUTS) in primary care using the International Continence Society symptom definition; to evaluate the association between LUTS and health-related quality of life (HRQOL); and to evaluate the treatment gaps. METHODS: Patients aged 40 and above were randomly recruited in a Hong Kong public primary care. Patients were asked (i) how often they experienced 18 individual LUTS during the past 4 weeks and (ii) whether they had sought treatments for their LUTS. The 12-Item Short Form Health Survey version 2 (SF-12 v2) and the modified Incontinence Impact Questionnaire-Short Form (IIQ-7) were used to measure HRQOL. RESULTS: 500 patients completed the survey. 75.8% of the patients had at least one LUTS "at least sometimes", with patients with a combination of storage, voiding, and post-micturition symptoms being the most prevalent (22.2%), followed by a combination of voiding and storage symptoms (14%). Only 14% of LUTS patients had sought treatments for their LUTS. LUTS was associated with a negative effect in all domains of the SF-12 v2 and IIQ-7 and patients with a combination of storage, voiding, and post-micturition symptoms had the worst HRQOL. Finally, having a combination of storage, voiding, and post-micturition symptoms and poorer HRQOL were factors associated with having sought treatments for LUTS. CONCLUSION: A high prevalence of LUTS but low treatment-seeking rates implied possible unmet needs of LUTS patients in primary care, suggesting the potential for more active interventions to alleviate the negative impact of LUTS on patients' HRQOL.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Qualidade de Vida/psicologia , Incontinência Urinária/psicologia , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Hong Kong/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde , Inquéritos e Questionários , Micção/fisiologia
16.
Rheumatology (Oxford) ; 59(6): 1315-1324, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31586421

RESUMO

OBJECTIVES: Urinary tract involvement is a seldom-reported manifestation of SSc that could compromise patients' quality of life. This study compares lower urinary tract symptoms (LUTS) in SSc patients and in healthy subjects and their association with clinical and diagnostic parameters. METHODS: LUTS were assessed through self-reported questionnaires in 42 SSc patients and 50 matched healthy subjects. Statistical analyses were performed to explore LUTS in the two populations and their association with SSc variables, including nailfold videocapillaroscopy patterns, SSc-related antibodies and DXA parameters. RESULTS: SSc patients showed significantly higher prevalence and severity of urinary incontinence (UI) and overactive bladder (OAB) than healthy controls (P < 0.005, P < 0.01). SSc was a strong predictor of LUTS, independent of demographic data, comorbidities and treatments (odds ratio 5.57, 95% CI 1.64-18.88). In SSc patients OAB positively correlated with sarcopenia (P < 0.001), and both OAB and UI significantly correlated with reduced BMD (P < 0.05, P = 0.001). UI positively correlated with Scl70 antibodies (P < 0.05) and ciclosporin treatment (P = 0.001) and negatively with RNA polymerase III antibodies (P < 0.05); OAB positively correlated with calcinosis (P < 0.005) and negatively with methotrexate treatment (P < 0.05). Nailfold videocapillaroscopy 'active' and 'late' patterns were predominant among SSc patients presenting urinary symptoms, although no statistical correlation was found. CONCLUSION: For the first time urinary tract involvement was found to be significantly higher in SSc patients than in healthy matched controls. In addition, sarcopenia, bone damage and calcinosis appeared significantly correlated with LUTS, suggesting a possible interplay.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Escleroderma Sistêmico/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Angioscopia Microscópica , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
17.
J Pediatr Adolesc Gynecol ; 33(2): 160-166, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31655179

RESUMO

STUDY OBJECTIVE: To determine the prevalence of lower urinary tract symptoms (LUTS) and associated risk factors in pregnant adolescents. DESIGN: Descriptive study. SETTING: The obstetrics and gynecology outpatient departments of a training and research hospital in Turkey. PARTICIPANTS: Two hundred six pregnant adolescents younger than the age of 19 years. INTERVENTIONS: None. Questionnaire-based data and the Bristol Female Lower Urinary Tract Symptoms-Short Form (BFLUTS-SF) were collected from pregnant adolescents. MAIN OUTCOME MEASURES: Comparisons were made with independent samples t test, one-way analysis of variance, Mann-Whitney U, and Kruskal-Wallis tests, and linear regression for the analysis of the potential risk factors. RESULTS: The prevalence of at least 1 of the LUTS in pregnant adolescents was 78.6% (162/206). The prevalence of storage symptoms was more than those of urinary incontinence and voiding symptoms. Among LUTS, the prevalence of nocturia, urgency, frequency, bladder pain, and urinary incontinence was 59.3% (122/206), 54.4% (112/206), 39.3% (81/206), 37.4% (77/206), and 27.2% (56/206), respectively. Of pregnant adolescents with LUTS, 30.2% (49/162) of pregnant adolescents with LUTS reported seeking treatment for LUTS in this study. The total median scores from the BFLUTS-SF increased with gestational week, but no statistical significant difference was identified (P > .05). According to the results of the linear regression analysis, daily coffee consumption, smoking, chronic coughing, constipation, and urinary tract infection history were found to be associated with the total mean score on the BFLUTS-SF in pregnant adolescents. CONCLUSION: LUTS were found to be common among pregnant adolescents, with storage symptoms being the most frequently reported. Prenatal education could increase the number of adolescents who seek treatment, thereby improving the clinical course of LUTS.


Assuntos
Sintomas do Trato Urinário Inferior/epidemiologia , Complicações na Gravidez/epidemiologia , Gravidez na Adolescência , Adolescente , Feminino , Humanos , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , Turquia/epidemiologia
18.
Int J Impot Res ; 32(2): 207-212, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31024115

RESUMO

We aimed to assess the correlation between premature ejaculation (PE), lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and depression in the cohort of the last 329 patients seeking medical help for distressing early ejaculation at a single tertiary-referral center. All patients completed the premature ejaculation diagnostic tool (PEDT), the International Index of Erectile Function (IIEF), the Beck's Inventory for Depression (BDI), and the International Prostate Symptom Score (IPSS) at their first assessment. Overall, 133 (0.4) patients had PEDT ≥ 11, suggestive for PE. The characteristics of patients with and without PE according to PEDT findings were compared with the Mann-Whitney and Fisher's exact tests. Linear regression analysis tested the association between LUTS and PEDT score. Patients with PE depicted lower median scores for IIEF-overall satisfaction, intercourse satisfaction and erectile function than non-PE individuals (all p < 0.004). Similarly, patients with PE showed higher median BDI scores (7 versus 4; p < 0.0002), median IPSS total score (7 versus 5), storage (4 versus 2), and voiding (3 versus 2) subscores (all p < 0.01) compared to those without PE. At linear regression analysis, IPSS storage subscore (Coeff: 0.28; 95%CI: 0.05-0.51, p = 0.01) and BDI score (Coeff: 0.10; 95%CI: 0.01-0.19, p = 0.02) were associated with higher PEDT values, after accounting for IIEF-EF score, patients' age, body mass index and Charlson Comorbidity Index. Our findings suggest that storage symptoms and depression should be carefully investigated when assessing patients complaining of PE in the real-life setting.


Assuntos
Depressão/etiologia , Sintomas do Trato Urinário Inferior/etiologia , Ereção Peniana , Ejaculação Precoce/complicações , Adulto , Estudos Transversais , Depressão/epidemiologia , Humanos , Itália/epidemiologia , Modelos Lineares , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Ejaculação Precoce/epidemiologia , Inquéritos e Questionários
19.
BJU Int ; 125(6): 905-910, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31837098

RESUMO

OBJECTIVE: To examine the correlation between urinary and faecal microbial profiles and the different aspects of lower urinary tract symptoms (LUTS) in men, as there is accumulating evidence that variations in the human microbiota may promote different benign disease conditions. PATIENTS AND METHODS: We extracted total DNA from urine and faecal samples of a group of men, under an Institutional Review Board-approved protocol. At the same time, International Prostate Symptom Score (IPSS) data were collected. We then amplified the extracted DNA and sequenced it using bacterial 16S ribosomal RNA gene high-throughput next-generation sequencing platform, and analysed the microbial profiles for taxonomy to examine the correlation between the different operational taxonomy units (OTUs) and LUTS represented by the total IPSS, the different symptom levels of the IPSS (mild, moderate, and severe) and its subcomponents of storage, nocturia, voiding, and bother. RESULTS: We included 30 patients (60 samples; one urine and one faecal per patient). In all, 48 faecal OTUs showed a significant correlation with one or more of the IPSS components; 27 with nocturia, 19 with bother, 16 with storage symptoms, and nine with voiding symptoms. The most substantial negative (protective) correlation was between Lachnospiraceae Blautia, a bacteria that increases the availability of gut anxiolytic and antidepressant short-chain fatty acids, and bother (correlation coefficient 0.702; P = 0.001). The abundance of L. Blautia continued to have a protective correlation against LUTS when looking at the different levels of IPSS severity (moderate and severe vs mild, correlation coefficient 0.6132; P = 0.002). Ten unique urinary OTUs showed significant correlation with LUTS; eight with nocturia, one with bother, three with storage, and one with voiding, but no faecal OUT had more than a low correlation with the outcomes of interest in this study. CONCLUSIONS: Our prospective work finds a plausible correlation between L. Blautia and LUTS. Additional studies are needed to determine if the correlations found in the present research are applicable to the general population of patients affected by LUTS.


Assuntos
Bactérias , Fezes/microbiologia , Sintomas do Trato Urinário Inferior , Microbiota/genética , Urina/microbiologia , Adulto , Bactérias/classificação , Bactérias/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/microbiologia , Masculino , Estudos Prospectivos , Hiperplasia Prostática
20.
Neurourol Urodyn ; 39(2): 688-694, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31804751

RESUMO

AIMS: To investigate the prevalence of overactive bladder (OAB) and assess its risk factors in 5- to 14-year-old Chinese children. METHODS: A cross-sectional study of OAB prevalence was performed by distributing 11 800 anonymous self-administered questionnaires to parents in five provinces of mainland China from July to October 2018. The questionnaires included questions on sociodemographics, history of urinary tract infection (UTI), lower urinary tract symptoms (LUTS), family history of LUTS, bowel symptoms, and details about the elimination communication (EC) start time. OAB was defined as urgency and increased the daytime frequency with or without urinary incontinence. RESULTS: A total of 10 133 questionnaires qualified for statistical analysis. The overall prevalence of OAB was 9.01% and decreased with age, from 12.40% at 5 years to 4.55% at 14 years (χ2 trend = 88.899; P < .001). The proportion of dry OAB increased with age, whereas the proportion of wet OAB decreased. A late-onset of EC was associated with a high OAB prevalence (χ2 trend = 39.802; P < .001). Children with obesity, a history of UTI, nocturnal enuresis (NE), a family history of LUTS, constipation, and fecal incontinence had a higher prevalence of OAB than did normal children (P < .05). CONCLUSION: Obesity, a history of UTI, NE, a family history of LUTS, and bowel symptoms are risk factors associated with OAB. Starting EC before 12 months of age might help reduce the prevalence of OAB in children.


Assuntos
Bexiga Urinária Hiperativa/epidemiologia , Adolescente , Fatores Etários , Grupo com Ancestrais do Continente Asiático , Criança , Pré-Escolar , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Obesidade Pediátrica/complicações , Obesidade Pediátrica/epidemiologia , População , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
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