PURPOSE: The aim of this study was to evaluate the effects of the single administration of the anticholonergics, trospium chloride, in the nocturic patients without bladder outlet obstruction for mid-term. MATERIALS AND METHODS: We included the 22 male and 102 female patients with nocturia over 3 times and without bladder outlet obstruction. Exclusion criteria was under 15 ml/sec in maximal flow rate, over 30 ml in post-void residual urine, nocturnal polyuria and medication affecting lower urinary tract symptoms including alpha-blockers, sedatives, muscle relaxants. Based on voiding diary for 3 days, frequency of the nocturia, daytime frequency and frequency of the urgency and urge incontinence were measured at pretreatment, post-treatment 1st month, 3rd month and 6th month. Additionally maximal flow rate and post-void residual urine were also recorded at the same periods. Anticholinergics was administered in flexible dose. RESULTS: In frequency of nocturia, single administration of the anticholonergics improved significantly at post-treatment 1st, 3rd and 6th month compared to pre-treatment level. The more severe the frequency of the nocturia was, the more it was improved by medication but there is no significant difference. Daytime frequency is significantly improved 3 month and 6 month after medication. In urgency and urge incontinence, the significant improvement was also observed at post-treatment 3rd month and 6th month. The significant differences between pre-treatment and post-treatment were not demonstrated in maximal flow rate and post-void residual urine. Dry mouth was the most common side effect but mild and tolerable. CONCLUSION: The single administration of the trospium chloride demonstrated a clinically significant improvement in nocturia as well as symptoms of the overactive bladder and did not affect negatively on bladder contractility.
Cholinergic Antagonists ; Female ; Humans ; Hypnotics and Sedatives ; Lower Urinary Tract Symptoms ; Male ; Mouth ; Nocturia* ; Polyuria ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge

PURPOSE: The aim of this study was to describe lower urinary tract symptoms in neuromyelitis optica (NMO), and to compare these data with urinary disorders observed in multiple sclerosis (MS) patients. METHODS: Retrospective study of data collected from January 1997 to July 2017 using the database from a Neuro-Urology Department of a university hospital. NMO and MS patients were matched for sex, age, and Expanded Disability Status Scale (EDSS) RESULTS: Twenty-six patients with NMO were included and compared with 33 MS patients. Mean age was 41.6 years (standard deviation [SD], 14,8), mostly female patients (24 vs. 2 males). Mean EDSS was 4.6 (SD, 1.8) in the 2 groups. In NMO group, 57% of the patients (n=15) had overactive bladder with urgency and urge incontinence and 38.5% (n=10) of them had nocturia. Voiding symptoms was observed in 69.2% of the patients (n=18); 42.3% of NMO patients performed self-intermittent catheterization versus 12.1% in MS patients (P=0.012). Low bladder compliance and severe urinary tract infections (pyelonephritis) were more frequent in NMO than in MS patients (respectively 15% vs. 0%, P=0.016 and 42% vs. 12%, P=0.024). CONCLUSIONS: Lower urinary tract symptoms, especially overactive bladder and urinary retention, are frequent in NMO. Low bladder compliance, serious urinary infections, and high prevalence of urinary retention requiring self-intermittent catheterization are the main symptoms significantly more frequent than in MS.
Catheterization ; Catheters ; Compliance ; Female ; Humans ; Lower Urinary Tract Symptoms* ; Multiple Sclerosis* ; Neuromyelitis Optica* ; Nocturia ; Prevalence ; Retrospective Studies ; Sensitivity and Specificity* ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge ; Urinary Retention ; Urinary Tract Infections

PURPOSE: The aim of this study was to evaluate the efficacy of functional magnetic stimulation (FMS) therapy on the lower urinary tract symptoms (LUTSs) and sexual function in female patients with stress urinary incontinence (SUI). MATERIALS AND METHODS: 39 sexually active women, with SUI treated by FMS therapy, were studied. Before treatment, female bladder questionnaires and a visual analog scale test (VAT) were used to acquire information relating to LUTS. Questions were asked about sexual function using the female sexual function index (FSFI). Treatments were performed for 20 minutes, twice a week, for 6 weeks. After treatment, the same questionnaires were repeated at 3, 6 and 12 months. The patients were divided into two groups: those with cured or improved SUI symptoms were defined as the success group, with the remainder defined as the failure group. The VAT scores of LUTSs, the domain scores and full scale scores of FSFI were analyzed. RESULTS: The success and failure groups comprised of 25 (64%) and 14 (36%) patients, respectively. In both groups, the frequency, urge incontinence and dysuria were improved. The VAT score for the overall satisfaction was significantly decreased in the success group only (p<0.05). In the success group, the domain score for 'satisfaction' in the FSFI was significantly increased (p<0.05). The full scale scores of the FSFI were significantly increased in the success group only (p<0.05). CONCLUSIONS: These results show that FMS therapy improves some LUTSs and sexual functions, with the correction of SUI symptom. Therefore, FMS therapy could be considered as a primary therapy in SUI women with LUTSs and sexual impairment.
Dysuria ; Female* ; Humans ; Lower Urinary Tract Symptoms* ; Magnetic Field Therapy* ; Surveys and Questionnaires ; Sexual Dysfunctions, Psychological ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge ; Urination Disorders ; Visual Analog Scale

Lower urinary tract symptoms (LUTS) are classified into three groups: storage, voiding, and post-micturition symptoms. The most popular causes of LUTS are benign prostatic hyperplasia (BPH) and overactive bladder (OAB). Although BPH is a pathologic term, clinically, we use this when patients have LUTS due to benign prostatic enlargement and obstruction. OAB is defined as urgency, with or without urge incontinence, usually with frequency and nocturia. Currently alpha1-adrenoceptor antagonists are the most common drug treatment for BPH, and are thought to act by relaxing the prostatic smooth muscle. They are all effective for the treatment of LUTS/BPH. 5alpha-reductase inhibitors, such as fiansteride and dutasteride, are another treatment option for BPH symptoms, which reduce the prostatic volume by inducing epithelial atrophy. Long-term combination therapy with alpha-1-blockers and 5alpha-reductase inhibitors reduces the risk of the overall clinical progression of BPH significantly more than does treatment with either drug alone. Antimuscarinics are the mainstay for the treatment of OAB. Antimuscarinics competitively block muscarinic receptors of all subtypes but with variations in selectivity for the different subtypes. When they are used for the treatment of OAB, they are active during the storage phase of the bladder, with little or no effect on voiding contractions. Desmopressin acetate is a synthetic analogue of Arginin vasopressin, which has been proven effective for the treatment of nocturnal polyuria in LUTS.
Atrophy ; Azasteroids ; Contracts ; Deamino Arginine Vasopressin ; Dutasteride ; Humans ; Lower Urinary Tract Symptoms ; Muscarinic Antagonists ; Muscle, Smooth ; Nocturia ; Polyuria ; Prostatic Hyperplasia ; Receptors, Muscarinic ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge ; Vasopressins

The availability of new urologic medications has made it possible to manage a variety of urologic disorders successfully in a primary care setting. As a result, primary care physicians(PCPs) need to be familiar with the terminology and screening instruments used by urologists to decipher and categorize urologic symptoms. PCPs are often responsible for the treatment of lower urinary tract symptoms and benign prostatic hyperplasia(BPH). Evolving strategies of management include utilization of both symptom-modifying treatment and disease-modifying treatment. Alphablockers excellently provide symptomatic treatment, but do not alter long-term disease progression. 5-alpha reductase inhibitors can reduce the need for surgical intervention and the incidence of acute urinary retention. The combination of alphablockers and 5-alpha reductase inhibitors would be the choice of therapy in some patients, typically those with large prostate glands indicative of disease progression. Overactive bladder(OAB) is defined as urinary urgency with or without urge incontinence, usually with frequency and nocturia, in the absence of a pathologic or metabolic condition that can explain these symptoms. The diagnosis of OAB should be made after a careful history taking, physical examination, laboratory evaluation, and use of tools such as voiding diaries. Anticholinergic agents are the first choice for drug therapy. Treatment that couples drug therapy with behavioral techniques aimed at modifying abnormal voiding patterns may provide the best outcomes in many patients with OAB. There are situations for referring patients to urologists for more detailed evaluation and management, including when the PCP has a lack of interest in or sufficient knowledge about lower urinary tract symptoms and if the patient shows a poor response to prior noninvasive therapy, requiring in-depth investigation.
5-alpha Reductase Inhibitors ; Cholinergic Antagonists ; Diagnosis ; Disease Progression ; Drug Therapy ; Family Characteristics ; Humans ; Incidence ; Lower Urinary Tract Symptoms ; Mass Screening ; Nocturia ; Physical Examination ; Primary Health Care* ; Prostate ; Prostatic Hyperplasia ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge ; Urinary Retention

PURPOSE: To evaluate the efficacy of acute maximal functional electrical stimulation(AMFES) for the treatment of overactive bladder(OAB). MATERIALS AND METHODS: Twenty-eight patients(male 3, female 25) with OAB symptoms were treated with AMFES(10Hz biphasic alternating pulse, 20 min per session, 10 sessions) via intravaginal or anal electrode. They were divided into OAB symptoms with and without detrusor overactivity(DO) based on urodynamic study (n=15 vs. 13, respectively). DO-present group was subdivided into idiopathic DO subgroup (IDO, n=9) and neurogenic DO subgroup(NDO, n=6). The outcomes were assessed by 3-day frequency-volume chart and the Bristol Female Lower Urinary Tract Symptoms Questionnaire Changes in OAB symptoms at 1 and 3 months after discontinuing the stimulation were evaluated. RESULTS: Cure rates for urgency and urge incontinence at 1-month after stimulation were determined as 62.5% and 50% in IDO group, 66.7% and 66.7% in NDO group, respectively, which were higher compared to DO-absent group. At 3-month after treatment most patients in IDO and DO-absent group who achieved a cure at 1 month, maintained improvement, however three(75%) of 4 patients in NDO group recurred. There were no significant changes in urodynamic parameters. The detrusor overactivity was no longer observed in 5(55.6%) patients in IDO group and none in NDO group. CONCLUSION: AMFES has a beneficial effect on women with OAB. Our data suggest electrical stimulation may have a significant carry-over effect in well-selected OAB patients although further studies with large population are needed to establish long-term results.
Electric Stimulation Therapy ; Electric Stimulation* ; Electrodes ; Female ; Humans ; Lower Urinary Tract Symptoms ; Surveys and Questionnaires ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urinary Incontinence ; Urinary Incontinence, Urge ; Urodynamics

PURPOSE: We investigated the prevalence of lower urinary tract symptoms (LUTS), and the inconvenience of each symptom, using an ICS-male Questionnaire (ICS-mQ) in Korean man. We also evaluated the relationships between symptoms, prostate volume and urodynamic parameters of a bladder outlet obstruction (BOO). MATERIALS AND METHODS: 180 male LUTS patients, from 7 urological institutions, were enrolled in this study. The ICS-mQ was used to measure the severity of the symptoms, with a bothersomeness scale. Transrectal sonography and urodynamic studies, including Schaefer linear passive urethral resistance relation (L-PURR), were performed. RESULTS: The 5 most frequent symptoms were voiding symptoms, such as reduced stream, terminal dribbling, incomplete emptying, intermittency and hesitancy, in that order. However, the 5 most bothersome symptoms included 2 voiding, and 3 storage, symptoms, such as incomplete emptying, urge incontinence, pain in bladder, nocturnal incontinence and hesitancy. 34.4% of the nocturia patients felt quite, or severely, bothered, but only 1.1% felt no problem. The mean value of estimated prostate volume, by sonography, was 29.8+/-14.1ml. There were no correlations between the severity of symptoms and the prostate size. There were also little, or no, correlations between a wide range of symptoms and the urodynamic parameters of BOO. CONCLUSIONS: The most frequent symptoms of male patients with LUTS are voiding symptoms, but they suffered more from storage, than from voiding, symptoms. The severities of the symptoms, or the bothersomeness, were not correlated with the prostate size or the urodynamic parameters of a bladder outlet obstruction. Therefore, the relief of a bladder outlet obstruction is not crucial to relieve the symptoms.
Humans ; Korea* ; Lower Urinary Tract Symptoms* ; Male ; Nocturia ; Prevalence ; Prostate ; Surveys and Questionnaires* ; Rivers ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urinary Incontinence, Urge ; Urodynamics

PURPOSE: We investigated the prevalence of lower urinary tract symptoms (LUTS), and the inconvenience of each symptom, using an ICS-male Questionnaire (ICS-mQ) in Korean man. We also evaluated the relationships between symptoms, prostate volume and urodynamic parameters of a bladder outlet obstruction (BOO). MATERIALS AND METHODS: 180 male LUTS patients, from 7 urological institutions, were enrolled in this study. The ICS-mQ was used to measure the severity of the symptoms, with a bothersomeness scale. Transrectal sonography and urodynamic studies, including Schaefer linear passive urethral resistance relation (L-PURR), were performed. RESULTS: The 5 most frequent symptoms were voiding symptoms, such as reduced stream, terminal dribbling, incomplete emptying, intermittency and hesitancy, in that order. However, the 5 most bothersome symptoms included 2 voiding, and 3 storage, symptoms, such as incomplete emptying, urge incontinence, pain in bladder, nocturnal incontinence and hesitancy. 34.4% of the nocturia patients felt quite, or severely, bothered, but only 1.1% felt no problem. The mean value of estimated prostate volume, by sonography, was 29.8+/-14.1ml. There were no correlations between the severity of symptoms and the prostate size. There were also little, or no, correlations between a wide range of symptoms and the urodynamic parameters of BOO. CONCLUSIONS: The most frequent symptoms of male patients with LUTS are voiding symptoms, but they suffered more from storage, than from voiding, symptoms. The severities of the symptoms, or the bothersomeness, were not correlated with the prostate size or the urodynamic parameters of a bladder outlet obstruction. Therefore, the relief of a bladder outlet obstruction is not crucial to relieve the symptoms.
Humans ; Korea* ; Lower Urinary Tract Symptoms* ; Male ; Nocturia ; Prevalence ; Prostate ; Surveys and Questionnaires* ; Rivers ; Urinary Bladder Neck Obstruction* ; Urinary Bladder* ; Urinary Incontinence, Urge ; Urodynamics

PURPOSE: A lot of patients with stress urinary incontinence(SUI) have lower urinary tract symptoms. So we evaluated the changes of voiding pattern following transobturator tape(TOT) operation, and investigated the factors for predicting persistent urinary frequency after operation. MATERIALS AND METHODS: The items of preoperative evaluations consisted of history taking, physical examination, cystometrography, 3 day frequency-volume chart and symptoms questionnaire. Patients with anticholinergics or any neurologic diseases that affect the voiding pattern were excluded. Between January to November 2006, 46 patients with TOT operation were enrolled, and were reevaluated with physical examination, 3 day frequency-volume chart and symptom questionnaires, postoperatively. RESULTS: The patients who voided 8 or more times per day had shorter symptom duration and higher body mass index(BMI) than those who voided under 8 times per day(each p<0.05). In 30 patients who void 8 or moretimes per day preoperatively, 17(56.7%) patients became void under 8 times, postoperatively. In each patient who had urgency or urge incontinence symptoms preoperatively, respective 72.7 and 82.8% resolved their symptoms, postoperatively. No one complained de novo urgency or urge incontinence, postoperatively. In a multivariate analysis, the patient with a history of previous pelvic surgery or moderate to severe urge incontinence was tightly associated with an increased likelihood of persistent urinary frequency after TOT operation (odd ratio[OR] 24.8, 95% confidence interval[CI] 2.044-301.284, p=0.012 and OR 31.9, 95% CI 1.662- 613.619, p=0.022, respectively). CONCLUSIONS: The TOT operation can improve the symptoms of urinary frequency, urgency and urge incontinence in patients with SUI. However, the patients who had previous pelvic surgeriesor moderate to severe urge incontinence should be fully advised for the risk of sustaining frequency, postoperatively
Cholinergic Antagonists ; Female ; Humans ; Lower Urinary Tract Symptoms ; Multivariate Analysis ; Physical Examination ; Suburethral Slings ; Urinary Incontinence ; Urinary Incontinence, Stress ; Urinary Incontinence, Urge

PURPOSE: Overactive bladder (OAB) is a manifestation of urgency, regardless of urge incontinence, due to involuntary bladder contraction during the storage period. There is a close association between constipation and OAB, but constipation cannot be readily diagnosed. The aims of this study were to evaluate the prevalence of constipation in OAB and the consequent therapeutic effects according to the diagnostic criteria for constipation. METHODS: We collected clinical data from 40 children (mean age, 71+/-22 months) with chief complaints of urgency, frequency, and incontinence. A voiding questionnaire and a 2-day voiding diary were collected, and urinalysis, the Bristol stool scale, and plain abdominal radiography were performed. Constipation was defined as conditions satisfying at least one of the following criteria: Rome III diagnostic criteria, Bristol stool scale types I/II, or a Leech score higher than 8 points as determined by plain radiography. Lower urinary tract symptoms, defecation symptoms, and the bladder volume of patients were examined, and the therapeutic outcomes by constipation diagnostic criteria were evaluated. RESULTS: Of the 40 OAB patients, 25 had constipation. Among them, 6 had reduced functional bladder capacity (24%; P>0.05). Regarding treatment, in patients who satisfied only one diagnostic criterion, the symptoms improved in 76.9%, 76.9%, and 69.6% of patients meeting the Rome III criteria, Bristol stool scale, and Leech score, respectively (P<0.05). Among the 8 patients satisfying all three criteria, 75% responded to treatment (P<0.05). CONCLUSIONS: The prevalence of constipation in OAB is high. Constipated patients recruited by use of the Rome III criteria, Bristol scale, and Leech score alone and together showed similar outcomes on OAB improvement after the treatment of constipation, which implies that each criterion has the same strength and can be applied comprehensively and generally.
Child ; Constipation ; Contracts ; Defecation ; Humans ; Lower Urinary Tract Symptoms ; Pediatrics ; Prevalence ; Radiography, Abdominal ; Rome ; Urinalysis ; Urinary Bladder ; Urinary Bladder, Overactive ; Urinary Incontinence, Urge