RESUMO
BACKGROUND: Polish physicians and researchers lack an extensive and precise instrument in their native language for evaluating sexual dysfunction in individuals with neurogenic disorders. The aim of this study was to create a culturally adapted, validated, Polish language version of the Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-15) for persons with multiple sclerosis (MS) and spinal cord injury (SCI). METHODS: International recommendations and standardized methods for instrument validation were followed. Sexually active patients with MS and SCI completed the MSISQ-15, International Index of Erection Function (IIEF-15, men), and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-31, women). IIEF-15 and PISQ-31 were used as reference questionnaires. Responses were collected at baseline (test) and after 2 weeks (re-test). RESULTS: We recruited 299 Polish-speaking patients with MS or SCI. Interviews disclosed that the translated questionnaire had optimal content validity/cross-cultural adaptation. MSISQ-15 scores correlated significantly with the severity of sexual dysfunction as evaluated by IIEF-15 (r = - 0.487) and PISQ-31 (r = - 0.709). These correlations substantiated the high quality construct/criterion validity. An analysis of reliability presented good internal consistency (Cronbach's alpha of 0.93 for the total score of MS patients and 0.86 for the total score of SCI patients) and reproducibility (intraclass correlation coefficients of 0.91 for the total score of MS patients and 0.92 for the total score of SCI patients). There were no ceiling or floor effects. CONCLUSIONS: The Polish version of MSISQ-15 exhibited excellent measurement properties. It is a suitable and reliable instrument to assess sexual dysfunction in MS and SCI individuals. The Polish MSISQ-15 will enhance routine clinical practice and assist research for neurogenic patients in Poland.
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Esclerose Múltipla/complicações , Disfunções Sexuais Fisiológicas/diagnóstico , Traumatismos da Medula Espinal/complicações , Inquéritos e Questionários , Traduções , Adulto , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Polônia , Psicometria/instrumentação , Reprodutibilidade dos Testes , Disfunções Sexuais Fisiológicas/etiologia , TraduçãoRESUMO
STUDY DESIGN: Prospective cohort validation study. OBJECTIVES: In spinal cord injury (SCI), neurogenic lower urinary tract dysfunction is associated with a reduced quality of life. No specific questionnaire has been translated, culturally adapted, and validated into Polish language to assess urinary disorder-specific quality of life in people after SCI. In this study, we translated, adapted, and validated the Polish versions of the Qualiveen and SF-Qualiveen in individuals with SCI. SETTING: University Hospital in Krakow, Poland. METHODS: Translation and cross-cultural adaptation of the Qualiveen and SF-Qualiveen were done using international recommendations and well-established methods. Adult patients with SCI from the Department of Urology at the University Hospital in Krakow, Poland completed the Polish versions of the Qualiveen, SF-Qualiveen, and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) at baseline and 2 weeks later. The ICIQ-SF served as the reference instrument. Validity and reliability were determined. RESULTS: Polish-speaking patients with SCI (n = 178) were included. Content validity/cross-cultural adaptation of the translated questionnaires was investigated during face-to-face interviews. Construct/criterion validity was assessed, and positive correlations were found between the Qualiveen and ICIQ-SF as well as the SF-Qualiveen and ICIQ-SF. A reliability study revealed good internal consistency (Cronbach's alpha > 0.8) and reproducibility (intraclass correlation coefficients > 0.8) for both adapted questionnaires. We did not identify floor or ceiling effect. CONCLUSIONS: The Polish versions of the Qualiveen and SF-Qualiveen showed good measurement properties. Polish healthcare providers can now reliably and directly assess the urinary disorder-specific quality of life in individuals after SCI.
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Esclerose Múltipla , Traumatismos da Medula Espinal , Sistema Urinário , Adulto , Humanos , Idioma , Polônia , Estudos Prospectivos , Qualidade de Vida , Reprodutibilidade dos Testes , Traumatismos da Medula Espinal/complicações , Inquéritos e QuestionáriosRESUMO
AIMS: No specific questionnaire to date has been available in Polish for evaluating health-related quality of life for urinary dysfunctions associated with multiple sclerosis (MS). The aim of this study was to translate, culturally adapt, and validate Polish versions of the Qualiveen and SF-Qualiveen for use in patients with MS. METHODS: Cross-cultural adaptation of the original English Qualiveen and SF-Qualiveen into Polish was performed according to international recommended and standard procedures. Adult patients with MS of the Department of Urology at the Jagiellonian University, Krakow, Poland, completed the Qualiveen, SF-Qualiveen, and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) twice: at baseline and 2 weeks later. RESULTS: One hundred eighty-nine Polish-speaking patients with MS completed the questionnaires. An intercorrelation study revealed that internal consistency was good for the total Qualiveen and SF-Qualiveen (Cronbach's α >0.8). Test-retest reliability (reproducibility) demonstrated strong stability (intraclass correlation coefficient >0.8). Content validities were optimal. Significant relationships between the Qualiveen and the ICIQ-SF, as well as the SF-Qualiveen and the ICIQ-SF, confirmed good construct/criterion validity. CONCLUSION: The Polish Qualiveen and SF-Qualiveen are reliable, valid, and consistent measures of urinary disorder-specific quality of life in patients with MS. After years of no appropriate Polish instrument being available for healthcare professionals to evaluate patients with MS, we provide these versions and recommend their use in research and clinical practice in Poland.
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Esclerose Múltipla/complicações , Qualidade de Vida , Incontinência Urinária/diagnóstico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções , Incontinência Urinária/etiologiaRESUMO
INTRODUCTION: There is no comprehensive and specific questionnaire translated, adapted and validated in the Polish language for evaluating symptoms, quality of life and complications associated with the neurogenic lower urinary tract dysfunction (NLUTD). The aim of this study was to translate, culturally adapt and validate a Polish version of the Neurogenic Bladder Symptom Score (NBSS) for patients who experience NLUTD. MATERIAL AND METHODS: Standardised guidelines and well-established methods were used for translation and cross-cultural adaptation of the NBSS. Adult patients with multiple sclerosis and spinal cord injury completed the NBSS, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the International Prostate Symptom Score (IPSS) and the SF-Qualiveen. Responses were recorded twice within a 14-day period. RESULTS: Two hundred seventy-four Polish-speaking patients with NLUTD were included in the study. Content validity was optimal. Significant relationships between NBSS (Incontinence) and ICIQ-SF, NBSS (Storage and Voiding) and IPSS, and NBSS (Quality of Life) and SF-Qualiveen confirmed good construct/criterion validity. An intercorrelation study revealed that internal consistency was good for the total NBSS and specific domains (Cronbach's alpha >0.7). Test-retest reliability (reproducibility) demonstrated strong stability (intra-class correlation coefficients >0.7 for the total NBSS). No ceiling or floor effects were present. CONCLUSIONS: The Polish NBSS demonstrated good measurement properties for a large cohort of patients with NLUTD. It is a suitable tool to assess NLUTD symptoms, consequences and quality of life. The Polish NBSS will support routine clinical practice of all types of physicians in Poland who care for patients with NLUTD.
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Sintomas do Trato Urinário Inferior/diagnóstico , Qualidade de Vida , Inquéritos e Questionários/normas , Bexiga Urinaria Neurogênica/diagnóstico , Adulto , Estudos de Coortes , Feminino , Humanos , Sintomas do Trato Urinário Inferior/complicações , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Polônia , Reprodutibilidade dos Testes , Avaliação de Sintomas , Tradução , Bexiga Urinaria Neurogênica/complicações , Incontinência Urinária/diagnósticoRESUMO
Prostatic carcinoma is the most frequent cancer in males in the Western world. A significant proportion of these cancers have a recurrent translocation involving ETS family genes, which leads to the overexpression of ERG transcription factor. Prostate cancers, which bear this mutation, differ in a number of features, including tumor microenvironment. One of the components of the tumor microenvironment is FOXP3 positive lymphocytes, which may participate in breaking immunosurveillance and promoting tumor growth. The aim of the study was to analyze the relationships between ERG expression, number of FOXP3 positive cells and other features of the tumor. The study group consisted of 65 cases. Tissue microarrays composed of 2 mm tissue cores were used for immunohistological evaluation. Immunohistochemistry for ERG and FOXP3 was performed according to the routinely applied protocol. The FOXP3 positive cells were counted and the results were expressed as the number of cells per mm2. The average number of FOXP3 positive cells was 33.30/mm2 for all cases, 21.43/mm2 for the ERG negative and 42.28/mm2 for the ERG positive group (p < 0.02). There were no significant relationships between FOXP3 positive cell count and any other parameters studied. Our results suggest that the immune response may differ between ERG negative and ERG positive prostatic carcinomas.
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Adenocarcinoma/imunologia , Fatores de Transcrição Forkhead/imunologia , Linfócitos do Interstício Tumoral/imunologia , Neoplasias da Próstata/imunologia , Linfócitos T Reguladores/imunologia , Adenocarcinoma/genética , Adenocarcinoma/patologia , Adulto , Idoso , Contagem de Células , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/genética , Neoplasias da Próstata/patologia , Análise Serial de Tecidos , Regulador Transcricional ERG/genéticaRESUMO
A significant proportion of prostatic adenocarcinomas show recurrent translocation leading to ERG expression. Previously we found that ERG+ cases have higher microvessel density than negative ones. One factor influencing angiogenesis in cancer is mast cells. The aim of the present study was to evaluate the relationship between microvessels, mast cells and ERG status. Tissue microarrays prepared from 113 radical prostatectomy specimens were analyzed with immunohistochemistry for CD31, tryptase and chymase. Vascular profiles and tryptase-positive and chymase-positive cells were counted. The average number of tryptase-positive cells was 28.93/mm2 and chymase-positive cells 9.91/mm2. The average number of CD31+ vascular profiles was 352.66/mm2. The average number of tryptase-positive cells was 26.35/mm2 for ERG- cases and 32.12/mm2 for ERG+ cases. The average number of chymase-positive cells was 8.14/mm2 for ERG- cases and 12.06/mm2 for ERG+ cases. The average number of CD31+ vascular profiles was 321.34/mm2 for ERG- cases and 390.74/mm2 for ERG+ cases. The number of CD31+ vascular profiles was positively correlated with the number of tryptase-positive and chymase-positive cells (R = 0.26 and R = 0.20). In summary, we demonstrated an interrelationship between mast cells, microvascular density and ERG status in prostatic carcinoma.
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Adenocarcinoma/patologia , Mastócitos/patologia , Neovascularização Patológica/patologia , Neoplasias da Próstata/patologia , Adulto , Idoso , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Análise Serial de Tecidos , Regulador Transcricional ERG/biossínteseRESUMO
The aim of the work is to present regenerative medicine achievement as an alternative SUI treatment and the variety of injected cells type as well as injection techniques itself with the analysis of their quality and possible the mechanism in which they reduce urinary incontinence symptoms. For over a decade numerous authors declare use of different type of autologous mesenchymal-derived stem cells (AMDC) in male and female SUI. The leakage improvement reached 80%, despite the number of injected cells as well as the injection technique. Important subject in the AMDC treatment is the precise cell material injection into the selected spot which might be possible with the use of the endoscopic assisting robot. The robotic supported system for cells procedure might bring the missing percentage in reaching the goal in SUI treatment.
Assuntos
Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais , Incontinência Urinária/terapia , Feminino , Humanos , Injeções , Masculino , Medicina Regenerativa , Transplante AutólogoRESUMO
AIM: To investigate the safety, surgical efficiency and patients' ability to recover from urinary continence as a result of a single absorbable running suture versus single-knot running suture for vesicourethral anastomosis (VUA) during laparoscopic radical prostatectomy (LRP). MATERIAL AND METHODS: In a prospective randomised study, we evaluated 162 consecutive patients who underwent LRP with VUA using the single running suture technique or the single-knot running suture technique. Perioperative patients' characteristics, morbidity and urinary continence were analysed. RESULTS: The baseline characteristics were similar between the 2 groups. The single running suture technique was related to decreased anastomotic and total operative times compared with the Van Velthoven technique (13.17 ± 5.74 min vs. 28.49 ± 6.45 min, p = 0.0001, and 174.41 ± 62.97 min and 184.94 ± 46.16 min, p = 0.04, respectively). Overall, urinary continence rates at 3, 6 and 12 months in groups 1 and 2 were 49.4 and 69.1%, 81.5 and 86.4%, and 91.4 and 93.8%, respectively (all with p > 0.05 except the follow-up assessment at 3 months following surgery, p = 0.011). CONCLUSIONS: Both methods ensure satisfactory rates of urinary leakage and bladder neck stricture, as well as continence after LRP. However, since the single running suture VUA technique is easier to perform, and the mean anastomosis time of the single running suture VUA technique is shorter than that of the Van Velthoven technique, it appears, therefore, preferable.
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Laparoscopia/métodos , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Técnicas de Sutura/instrumentação , Suturas , Uretra/cirurgia , Bexiga Urinária/cirurgia , Idoso , Anastomose Cirúrgica/métodos , Desenho de Equipamento , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos ProspectivosRESUMO
BACKGROUND: There has been a large body of research on obesity and the risk of prostate cancer (PCa) that has been published recently. However, the epidemiological evidence for such an association has not been consistent. This may be attributed to the nature of case-control and retrospective studies, which generally are more prone to biases. Therefore, we conducted a systematic review of prospective cohort studies to assess the association between obesity and the risk of PCa incidence and death. METHODS: A search of the PubMed database and references of published studies (from inception until March 2013) was conducted. Twenty-three eligible studies were identified and included in the systematic review. RESULTS: The evidence from the prospective cohort studies linking obesity with PCa incidence has not been consistent. However, cumulative data is compelling for a strong positive association between obesity and fatal PCa. CONCLUSIONS: Obesity is a significant diet-related risk factor for fatal PCa. Further well-constructed, large cohort studies on the potential association between obesity and PCa, as well as on underlying mechanisms, are needed.
Assuntos
Obesidade/epidemiologia , Neoplasias da Próstata/epidemiologia , Humanos , Incidência , Masculino , Obesidade/diagnóstico , Obesidade/mortalidade , Prognóstico , Estudos Prospectivos , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/mortalidade , Medição de Risco , Fatores de RiscoRESUMO
The aim of this study was to examine the relationship between cadmium (Cd) and bladder cancer (urothelial carcinoma of the bladder). Cadmium concentrations in two 36-sample series of bladder cancer tissue and blood, from patients with the neoplasm, were matched with those of the control group. The amount of heavy metal in every tissue sample was determined using atomic absorption spectrometry. This was correlated with tumour stage. While the median cadmium concentration levels reached statistically lower values in the bladder cancer tissue, as compared with the non-cancer one (11.695 ng/g and 56.32 ng/g respectively, p < 0.001), the median Cd levels in the blood of the patients with this carcinoma showed no statistical difference when compared to those of the control group (8.237 µg/l and 7.556 µg/l respectively, p = 0.121). The median levels of cadmium in the bladder tissue, depending on the stage of the tumour, compared with the tissue without the neoplasm, observed the same relationship for both non-muscle invasive and muscle-invasive tumours (p < 0.002 and p < 0.02 respectively). This study has shown that patients with urothelial carcinoma of the bladder had lower tissue cadmium levels than people without tumour while no difference in the Cd blood levels between the two groups of patients under investigation was found.
Assuntos
Cádmio/metabolismo , Carcinoma de Células de Transição/metabolismo , Carcinoma de Células de Transição/patologia , Neoplasias da Bexiga Urinária/metabolismo , Neoplasias da Bexiga Urinária/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Urotélio/metabolismo , Urotélio/patologiaRESUMO
Open radical cystectomy with orthotopic neobladder reconstruction is a complex procedure not only carrying a significant risk of peri- and postoperative complications but also a high, 3% risk of mortality to the patient. The advantages of performing cystectomy with various urinary diversion methods by the use of minimal invasive techniques include minimal surgical trauma, lower requirement for blood transfusion, swift recovery and shorter hospital stay. The aim of this paper is to describe an operative technique for neobladder urinary diversion formation via minilaparotomy, and classic laparoscopic technique with our own modification in patients who underwent laparoscopic radical cystectomy.
Assuntos
Cistectomia/métodos , Íleo/cirurgia , Laparoscopia/métodos , Derivação Urinária/métodos , Humanos , Laparotomia/métodos , Tempo de Internação , Resultado do TratamentoRESUMO
AIM: The biological behaviour of prostate cancer (PCa) varies significantly and cannot be, therefore, predicted. Better understanding of the mechanisms underpinning PCa oncogenesis and progression with its yet-to-be discovered poor prognostic factors is essential in order to optimise and tailor treatment to an individual patient. The aim of this paper was to investigate the association between the rate of focal PCa neuroendocrine activity, tumour cell proliferation index score, and the rate of PCa positive core needle biopsy results. MATERIAL AND METHODS: 92 men, with histologically confirmed PCa, which was clinically confined to the prostate and was graded with Gleason score > or =7, had their core needle biopsies under transrectal ultrasonography guidance performed. The PCa neuroendocrine activity was immunohistochemically confirmed using antibodies against Chromogranin-A and neuron specific enolase. RESULTS: The neuroendocrine activity was detected in 14 (13%) out of 92 PCa patients participating in the study. The proliferative index was not increased in non-cancerous prostate cells. There was no relationship between PCa neuroendocrine activity, the number and percentage of PCa positive biopsies, prostate volume, serum PSA concentration, and Gleason score found. CONCLUSIONS: No association between selected PCa prognostic factors and neuroendocrine activity could be found in patients with organ confined prostate cancer.
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Transformação Celular Neoplásica/patologia , Células Neuroendócrinas/patologia , Neoplasias da Próstata/patologia , Idoso , Biópsia com Agulha de Grande Calibre , Diferenciação Celular , Cromogranina A/análise , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Fosfopiruvato Hidratase/análise , Prognóstico , Neoplasias da Próstata/químicaRESUMO
AIM: Routine placement of JJ ure teric stents, following uncomplicated endoscopic removal of a ureteral stone, still remains debatable. Indwelling JJ stents are not without any risks. They often can cause marked discomfort, or even pain. The aim of this study was to prospectively evaluate patient's perceived pain due to renal colic and indwelling JJ stent left following ure terorenoscopic lithotripsy (URSL). MATERIAL AND METHODS: 54 patients with colicky pain due to distal ureteric stone, and who underwent uncompli cated ureterorenoscopic lithotripsy, were included in the study. Follow ing URSL, patients were randomly selected to have either JJ stent left in situ (Group I), or remain without a stent (Group II). Among all study par ticipants levels of pain prior, as well as 14 days after the procedure were evalu ated with the use of a visual analogue pain scale. RESULTS: Pain perception at the time of colic did not vary between men and women (6.30 +/- 1.33 and 6.38 +/- 1.11, respectively, p=0.293). Similarly, no differences in perceived pain were noted 14 days following URSL. Mean pain score in patients with indwelling JJ stent was 2.12 +/- 1.23 as compared to 2.15 +/- 0.67 in those without it (p=0.148). CONCLUSIONS: No increase in pain levels due to indwelling JJ stent could be observed. Further research to allow for better assessment of discomfort and pain caused by an indwelling JJ stent on a larger cohort, and which could also discriminate patients' psy chosomatic symptoms, is needed.
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Litotripsia/efeitos adversos , Cólica Renal/etiologia , Stents/efeitos adversos , Cálculos Ureterais/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/classificação , Dor/etiologia , Medição da Dor , Estudos Prospectivos , Cólica Renal/diagnóstico , Adulto JovemRESUMO
INTRODUCTION: Many epidemiological and experimental studies report a strong role of chemical carcinogens in the etiology of bladder cancer. However, involvement of trace elements in the tumorigenesis of transitional cell carcinoma of the bladder has been poorly investigated. The aim of this study was to examine the relationship between zinc, copper and bladder cancer. MATERIALS AND METHODS: Zinc and copper concentration and Cu/Zn ratio in two 36-sample series of bladder cancer tissue and sera from patients with this neoplasm were matched with those of the control group. The amount of trace elements in every tissue sample was determined using atomic absorption spectrometry. This was correlated with tumor stage. RESULTS: While the copper concentrations reached statistically higher values in the bladder cancer tissue, the zinc levels in the sera and bladder tissue of the patients with this carcinoma were substantially lower as compared to those of the control group. The serum Cu/Zn ratio was significantly higher in the bladder cancer group and this increase was greater in the patients with muscle-invasive neoplasm. CONCLUSIONS: The results obtained suggest a relationship between trace elements and the bladder cancer.
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Carcinoma de Células de Transição/sangue , Cobre/sangue , Neoplasias da Bexiga Urinária/sangue , Zinco/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espectrofotometria Atômica/métodos , OligoelementosRESUMO
PURPOSE: To compare urodynamic characteristics in patients with idiopathic detrusor overactivity (IDO) with those of an age matched cohort with diabetes mellitus (DM) and detrusor overactivity (DO). Secondly, to determine whether urodynamic features could help distinguish these two groups of patients. MATERIALS AND METHODS: Urodynamic data was collected on 58 female patients; 29 with IDO and 29 with DM and detrusor overactivity. Eight urodynamic parameters were selected for analysis: amplitude of the first overactive contraction (AOFC), the volume at the first contraction, cystometric capacity, maximal detrusor pressure, maximal flow rate, voiding pressure at maximal flow, voided volume and postvoid residual (PVR) urine volume. Finally, sensitivity analysis for distinguishing urodynamic parameters between studied groups was performed. RESULTS: AOFC, volume at AOFC and maximal detrusor pressure were statistically greater in diabetic patients, compared with the non-diabetic group of women (16.00 cm H2O versus 9.00 cm H2O, 309.00 mL versus 167.00 mL and 76.48 cm H2O versus 55.41 cm H2O respectively). A specificity of 72.41% and positive predictive value of 71.43% were achieved for AOFC with cutoff value of 12 cm H2O. These parameters were further improved with cutoff value of 258 mL for volume at AOFC and were 75.86% and 73.08% respectively. CONCLUSIONS: Certain urodynamic parameters in diabetic female patients with DO are shown to be significantly different than those in women with IDO. Further prospective study should provide additional information about the pathogenesis and progression of DO in diabetic patients as well as the validity of diabetic screening in patients with IDO.
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Diabetes Mellitus/fisiopatologia , Bexiga Urinária Hiperativa/fisiopatologia , Urodinâmica/fisiologia , Adulto , Fatores Etários , Idoso , Métodos Epidemiológicos , Feminino , Hemoglobinas Glicadas/análise , Humanos , Pessoa de Meia-Idade , Valores de Referência , Bexiga Urinária Hiperativa/sangue , Incontinência Urinária/fisiopatologiaRESUMO
OBJECTIVES: A link between sexual functioning and depression has been reported. However, it is still unknown whether lower urinary tract symptoms (LUTS) coexist or correlate with sexual dysfunction (SD) in depressed individuals. Depressed patients represent a unique population because of a possible bidirectional relationship between SD and depression and between LUTS and depression. Thus, the aim of this study was to investigate relationships between depression severity, SD and LUTS for patients with depression. METHODS: In this cross-sectional study, we analyzed data on depression, sexual functioning and LUTS from depressed patients who were treated in our department of adult psychiatry. Data were obtained from the Hamilton Rating Scale for Depression, the International Index of Erectile Function (IIEF), the Female Sexual Function Index (FSFI), and the International Prostate Symptom Score (IPSS). RESULTS: We included one hundred two patients diagnosed with, and treated for, depression. The participants reported a high overall prevalence of SD (60.8%), and SD correlated with depression severity. LUTS were also highly prevalent with 86% of the participants reporting at least mild LUTS severity. Despite coexistence of LUTS and SD in multiple patients, we did not find a statistically significant relationship between LUTS and SD in our cohort. CONCLUSIONS: In our exclusive group of individuals diagnosed with, and treated for, depression, depression severity had a negative effect on sexual functioning. Although there was no statistically significant relationship between LUTS and SD, they coexisted in multiple patients. Therefore, LUTS and SD should still be systematically assessed in patients with depression.
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Disfunção Erétil , Sintomas do Trato Urinário Inferior , Disfunções Sexuais Fisiológicas , Adulto , Estudos Transversais , Depressão/epidemiologia , Disfunção Erétil/complicações , Disfunção Erétil/epidemiologia , Feminino , Humanos , Sintomas do Trato Urinário Inferior/complicações , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Disfunções Sexuais Fisiológicas/complicaçõesRESUMO
BACKGROUND: The aim of this study was to perform a cross-sectional study of Polish neurogenic patients to measure, at the population level, the prevalence, bother and behavior associated with treatment for lower urinary tract symptoms (LUTS) and overactive bladder (OAB). METHODS: This epidemiological study was based on data from LUTS POLAND, a computer-assisted and population-representative telephone survey. Participants were classified by age, sex and place of residence. RESULTS: LUTS POLAND includes 6005 completed interviews, of which 1166 (19.4%) were for individuals who had ever received any treatment by neurologists and/or neurosurgeons. Among these neurogenic participants, LUTS prevalence was 72.3%, statistically higher than for non-neurogenic respondents. At the population level, neurogenic patients had about a 20% higher risk for LUTS presence than non-neurogenic participants (relative risk: 1.17-1.21). LUTS prevalence did not differ between men and women. Frequency was the most common of the LUTS. Forty percent of neurogenic respondents described having more than one LUTS subtype (i.e., storage, voiding, and/or post-micturition symptom subtype), and more than 50% of respondents reported OAB symptoms. Both storage and voiding symptoms were bothersome, and many neurogenic individuals (42.3-51.0%) expressed anxiety about bladder function affecting quality of life. Only one-third (34.9-36.6%) of neurogenic participants had sought treatment for their LUTS, and the majority of such individuals received and maintained treatment. CONCLUSIONS: LUTS and OAB symptoms were highly prevalent and bothersome among Polish neurogenic patients at the population level. Because the scale of seeking treatment for LUTS was low, Polish neurogenic patients may not be adequately informed about multiple effects of LUTS and OAB.
RESUMO
The aim of this study was to investigate the effect of lower urinary tract symptoms (LUTS) on behavior related to treatment of Polish adults aged ≥ 40 years. Methods: We conducted a computer-assisted telephone survey with a study sample stratified by age, sex, and place of residence (type, size, urban versus rural) reflecting the entire Polish population. Participants rated the frequency and symptom-specific bother of individual LUTS and their effects on seeking and receiving treatment, treatment satisfaction, and treatment continuation. We adjusted multiple logistic regression models to analyze the simultaneous effects of predictor variables on each dependent variable. Results: Overall, 6005 participants completed the interview. One third (29.6-33.5%) of participants with LUTS were seeking treatment, and 24.0-26.4% received treatment. There was no difference in treatment seeking and receiving between urban and rural areas. Whereas storage and voiding symptoms were significantly related to treatment seeking by both men and women, treatment receiving correlated only with voiding symptoms in men and only with storage symptoms in women. Most respondents who received treatment were satisfied; treatment dissatisfaction was related to the presence of storage symptoms in both men and women. Only 50% of all participants continued their treatment; discontinuation of treatment was statistically more prevalent for women than for men. Conclusion: This investigation, the first population-representative study performed in Eastern Europe, revealed a low frequency of seeking treatment for LUTS. In addition, symptoms that inclined participants to seek treatment might not have been adequately addressed by the treatment they received. We also found a relatively high rate of treatment discontinuation. Clearly, there is a need for both improved patient education about LUTS treatment and a need for increased clinician awareness of the coexistence of different symptoms in men and women plus proactive evaluation by physicians for all types of LUTS and associated bother.
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Sintomas do Trato Urinário Inferior , Adulto , Idoso , Europa (Continente)/epidemiologia , Feminino , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Sintomas do Trato Urinário Inferior/terapia , Masculino , Polônia/epidemiologia , Prevalência , Qualidade de Vida , Inquéritos e QuestionáriosRESUMO
PURPOSE: An established link exists between overactive bladder (OAB) syndrome and impaired sleep. However, earlier research on this subject only focused on the general population, and certain patient subgroups have not been examined adequately. Depressed patients constitute a unique population because of a possible bidirectional relationship between OAB and depression. Thus, we investigated the association between OAB symptoms and sleep quality in patients with depression. METHODS: In this prospective, cross-sectional study, we analyzed data on depression, sleep quality, and OAB symptoms from depressed patients treated at our department of adult psychiatry. Data were collected with the Hamilton Rating Scale for Depression, the Holland Sleep Disorders Questionnaire, the Athens Insomnia Scale, and the OAB Module of the International Consultation on Incontinence Questionnaire. RESULTS: In total, 102 patients treated for depression were enrolled. Thirteen patients (12.7%) met the diagnostic threshold of OAB with the International Consultation on Incontinence Questionnaire OAB Module. Patients with depression and concomitant OAB had significantly higher scores on the Holland Sleep Disorders Questionnaire than patients classified as nonOAB (P<0.01). OAB patients also had a higher risk of insomnia relative to non-OAB individuals (P<0.05). In addition, the relationship between OAB symptoms and sleep quality in patients with depression was independent from age and sex. CONCLUSION: In our cohort composed exclusively of individuals treated for depression, OAB symptoms were present in a significant proportion of patients, and OAB negatively affected sleep quality. Therefore, we recommend that OAB symptoms should be assessed collectively in patients with depression.