PURPOSE: To assess the urodynamic findings in patients with Parkinson disease (PD) with overactive bladder symptoms. METHODS: We performed a retrospective chart review of all PD patients who were seen in an outpatient clinic for lower urinary tract symptoms (LUTS) between 2010 and 2017 in a single-institution. Only patients who complained of overactive bladder (OAB) symptoms and underwent a video-urodynamic study for these symptoms were included. We excluded patients with neurological disorders other than PD and patients with voiding LUTS but without OAB symptoms. RESULTS: We included 42 patients (29 men, 13 women, 74.5±8.1 years old). Seven patients (16.7%) had a postvoid residual (PVR) bladder volume >100 mL and only one reported incomplete bladder emptying. Detrusor overactivity (DO) was found in all 42 patients (100%) and was terminal in 19 (45.2%) and phasic in 22 patients (52.4%). Eighteen patients had detrusor underactivity (DU) (42.3%). Later age of PD diagnosis was the only parameter associated with DU (P=0.02). Patients with bladder outlet obstruction (BOO) were younger than patients without BOO (70.1 years vs. 76.5 years, P=0.004), had later first sensation of bladder filling (173.5 mL vs. 120.3 mL, P=0.02) and first involuntary detrusor contraction (226.4 mL vs. 130.4 mL, P=0.009). CONCLUSIONS: DO is almost universal in all patients with PD complaining of OAB symptoms (97.1%). However, a significant percentage of patients also had BOO (36.8%), DU (47%), and increased PVR (16.7%) indicating that neurogenic DO may not be the only cause of OAB symptoms in PD patients.
Ambulatory Care Facilities ; Diagnosis ; Female ; Humans ; Lower Urinary Tract Symptoms ; Male ; Nervous System Diseases ; Parkinson Disease ; Parkinsonian Disorders ; Retrospective Studies ; Sensation ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Overactive ; Urinary Incontinence ; Urodynamics

BACKGROUND/AIMS: Although symptoms related to the pelvic floor, such as pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), are common in patients with chronic constipation (CC), its impact is not clear. Our aims were to investigate the following (1) compare pelvic floor symptom related dysfunction in irritable bowel syndrome with constipation (IBS-C) and functional constipation (FC), and (2) symptom correlation with findings on anorectal manometry (ARM) and balloon expulsion test. METHODS: This was a retrospective analysis of patients with CC undergoing ARM. IBS-C and FC were diagnosed by Rome III criteria. Pelvic Floor Distress Inventory (PFDI-20) was used to measure pelvic floor symptom distress. Constipation Severity Scale was used to assess constipation severity. RESULTS: A total of 107 patients underwent ARM (64 FC, 43 IBS-C). The overall PFDI-20 score in IBS-C was higher compared with FC patients (118.0 vs 79.2, P = 0.001). In those with IBS-C, POP, LUTS, and colorectal symptoms subscales were all higher compared with FC patients (P < 0.05 for each). On multivariable regression, IBS-C (P = 0.001) and higher constipation severity (P = 0.001) were both independently associated with higher PFDI scores. ARM parameters and abnormal balloon expulsion test did not correlate with PFDI scores. CONCLUSIONS: Compared with FC patients, those with IBS-C have significantly higher distress from pelvic floor specific symptoms including POP and LUTS. Higher abdominal pain among IBS-C patients did not entirely explain these findings. A diagnosis of IBS-C and higher constipation severity correlated with PFDI-20 scores, but dyssynergia did not.
Abdominal Pain ; Arm ; Ataxia ; Constipation ; Defecation ; Diagnosis ; Humans ; Irritable Bowel Syndrome ; Lower Urinary Tract Symptoms ; Manometry ; Pelvic Floor ; Pelvic Organ Prolapse ; Retrospective Studies

OBJECTIVE: To investigate the correlation between bladder wall thickness (BWT) measured by ultrasonography and lower urinary tract dysfunction (LUTD) in patients with lower urinary tract symptoms (LUTS). METHODS: Forty-eight women with LUTS who underwent urodynamic study and BWT by ultrasonography as outpatients were studied. We assessed LUTS during a medical examination by interview. The thinnest part of the bladder wall was measured by a transabdominal ultrasonography. We excluded patients who had visited another hospital previously because we did not know what treatment they had received, including medications, behavioral therapy, or other treatments. We constructed receiver operating characteristic (ROC) curves for diagnosis of LUTD and also determined reliable BWT criteria by calculating the area under the curve. Statistical analyses were performed using the Kolmogorov-Smirnov method and Student's t-test. RESULTS: The mean age, body mass index, and duration of symptoms were 59.9±9.7 years, 26.06±3.4 kg/m², and 53.4±38.2 months, respectively. Urodynamic study parameters (Valsalva leak point pressure, maximal urethral closure pressure, functional length, and postvoid residual volume) were lower in patients with BWT < 3 mm; however, these differences were not significant. Patients with BWT ≥3 mm developed a hypoactive bladder (P=0.009) and intrinsic sphincter deficiency (ISD) (P=0.001) at a significantly higher rate. According to the ROC analysis, the best BWT cut-off value was 3 mm for overactive bladder diagnosis. CONCLUSIONS: Women with LUTD showed higher BWT values (≥3 mm), especially patients with hypoactive bladder and ISD. Sonographic evaluation of BWT is an easy, fast, and noninvasive method for possible diagnostic tool for LUTD.
Body Mass Index ; Diagnosis ; Female ; Humans ; Lower Urinary Tract Symptoms ; Methods ; Outpatients ; ROC Curve ; Ultrasonography* ; Urinary Bladder* ; Urinary Bladder, Overactive ; Urinary Tract* ; Urodynamics

PURPOSE: This study aimed to investigate the severity of lower urinary tract symptoms (LUTS) and to identify factors that influenced LUTS in advanced cancer patients with chemotherapy-induced peripheral neuropathy (CIPN). METHODS: This cross-sectional study included a total of 158 advanced cancer patients with CIPN. A structured questionnaire including the International Prostate Symptom Score and the Functional Assessment of Cancer Therapy/Gynecology Oncology Group/Neurotoxicity scale was used. Data were analyzed using the Pearson correlation coefficient and multiple regression analysis. RESULTS: Nocturia was the most prevalent LUTS. A positive relationship was found between CIPN symptoms and LUTS. The duration of cancer diagnosis and the severity of CIPN were key factors that influenced LUTS. CONCLUSIONS: The severity of CIPN symptoms was the most important predictor of LUTS. Nurses’ care for advanced cancer patients should incorporate a comprehensive health assessment, which includes a history of treatment and physical neuropathic symptoms, for any patient complaining of CIPN symptoms.
Cross-Sectional Studies ; Diagnosis ; Humans ; Lower Urinary Tract Symptoms* ; Neoplasm Metastasis ; Nocturia ; Peripheral Nervous System Diseases* ; Prostate

Voiding dysfunction is a common disease that contributes to a lower quality of life and has an increased prevalence in the elderly population. Noninvasive and objective methods such as uroflowmetry (UFM) and voiding diaries (VDs) are essential for exact diagnosis and effective treatment of this condition because patients with different causes of voiding dysfunction can complain of the same lower urinary tract symptoms. Further, different treatment options can be determined based on the diagnosis made from these symptoms. In order to improve the quality of UFM and VDs and to provide a convenient testing environment, several advances have been made by previous investigators. In this study, we investigate the history and technological mechanisms of UFM and VDs. We also aim to review UFM from the viewpoint of clinical and at-home uses, including the recently proposed toilet-shaped UFM and electronic VDs.
Aged ; Diagnosis ; Humans ; Lower Urinary Tract Symptoms ; Mobile Health Units ; Monitoring, Ambulatory ; Prevalence ; Quality of Life ; Research Personnel

PURPOSE: This study was to identify the quality of life and its related factors in patients with benign prostatic hyperplasia. METHODS: A cross-sectional survey design was utilized. Data were collected using questionnaires from 128 patients with benign prostatic hyperplasia who visited an outpatient department at one general hospital in 2016. Data were analyzed using Mann-Whitney U test, Kruskal Wallis test, Pearson's correlation coefficient and hierarchical multiple regression analysis. RESULTS: Mean age of the participant was 67.81±6.94. Mean years since diagnosis was 6.41±5.20. The mean score of quality of life was 0.82±0.09, indicating that QOL was relatively low. Lower urinary tract symptoms (p=.029), anxiety, depression, Activities of daily living were significantly correlated to with quality of life (p<.001). Activities of daily living accounted for 54% (p<.001) of the variance in quality of life as a result of hierarchical multiple regression analysis. CONCLUSION: The results of the study showed that nursing intervention may improve the quality of life of patients with benign prostatic hyperplasia by increasing their Activities of daily living.
Activities of Daily Living ; Anxiety ; Cross-Sectional Studies ; Depression ; Diagnosis ; Hospitals, General ; Humans ; Lower Urinary Tract Symptoms ; Nursing ; Outpatients ; Prostatic Hyperplasia ; Quality of Life

PURPOSE: The aims of this study were to assess the prevalence of nocturia and nocturnal polyuria (NP) and to define new cutoff values according to age and sex for both conditions. METHODS: Data from a population-based prevalence survey conducted among a random sample of 2,128 adults were analyzed in this study. Participants were requested to fill out a questionnaire including the International Continence Society (ICS) definitions of lower urinary tract symptoms and the International Consultation on Incontinence Questionnaire - Short Form. Additionally, a 1-day bladder diary was given to each individual. The participants were divided into 5 age groups. The prevalence of nocturia was calculated based on definitions of nocturia as ≥1 voiding episodes, ≥2 episodes, and ≥3 episodes. NP was evaluated according to the ICS definition. The mean±standard errors and 95th percentile values were calculated in each group as new cutoff values for NP. RESULTS: The prevalence of nocturia was estimated as 28.4%, 17.6%, and 8.9% for ≥1, ≥2, and ≥3 voiding episodes each night, respectively. When nocturia was defined as 2 or more voiding episodes at night, the prevalence decreased significantly. The mean NP index was 29.4%±15.0% in men and 23.1%±11.8% in women. For the age groups of <50 years, 50–59 years, and ≥60 years, the new cutoff values for the diagnosis of NP were calculated as 48%, 69%, and 59% for men and 41%, 50%, and 42% for women, respectively. CONCLUSIONS: We found that the definition of nocturia was still controversial and that waking up once for voiding might be within the normal spectrum of behavior. The definition of NP should be modified, and new cutoff values should be defined using the data presented in our study and in other forthcoming studies.
Adult ; Diagnosis ; Female ; Humans ; Lower Urinary Tract Symptoms ; Male ; Nocturia* ; Polyuria* ; Prevalence* ; Urinary Bladder

PURPOSE: The goal of this study was to compare the International Prostate Symptom Storage Subscore (IPSS-s) and the overactive bladder symptom score (OABSS) as tools for assessing the symptoms of overactive bladder (OAB). METHODS: A cross-sectional study was conducted of a sample of 1,341 patients aged 50 years and older with lower urinary tract complaints who had undergone a medical examination at one of several centers. For each patient, we reviewed the International Prostate Symptom Score and the OABSS. The patients were divided into 2 groups according to their IPSS-s result (group 1, score ≥6; group 2, score<6) and into another 2 groups according to their OABSS diagnosis (group 3, OAB patients; group 4, non-OAB patients). We determined whether the OABSS varied to a statistically significant extent between groups 1 and 2. Furthermore, we evaluated the correlation of IPSS-s severity with the OABSS results in group 3, and the OAB diagnosis rate was compared between groups 1 and 2. RESULTS: In groups 1 and 2, the OABSS results were not found to vary to a statistically significant extent (P=0.326). In group 3, no significant correlation was found between IPSS-s severity and the OABSS results (P=0.385). In the prevalence analysis, no statistically significant difference was found among the groups, and the receiver operating characteristic curve showed an area under the curve of 0.474. CONCLUSIONS: The results of this cross-sectional analysis suggest that the IPSS-s and the OABSS are not significantly correlated. Although both scores are used to measure OAB symptoms, the simultaneous use of IPSS-s and OABSS is not warranted.
Cross-Sectional Studies ; Diagnosis ; Humans ; Lower Urinary Tract Symptoms ; Prevalence ; Prostate* ; ROC Curve ; Surveys and Questionnaires ; Urinary Bladder, Overactive* ; Urinary Tract

PURPOSE: To determine the proportion of patients with undetected symptoms of overactive bladder by using the overactive bladder-validated 8 (OAB-V8) screening questionnaire and investigate these symptoms were undetected in female patients who were hospitalized. METHODS: We invited 2,250 female patients hospitalized in the Aegean region of Turkey to answer a self-administered questionnaire. The questionnaire included questions on evidence of lower urinary tract symptoms (OAB-V8), relevant medical history, and demographic data. Patients with a total OAB-V8 score≥8 were defined as having OAB symptoms. RESULTS: The proportion of patients with OAB symptoms in this study was 40.6%. Nearly 57% of the patients with OAB symptoms had not been previously admitted to any hospital for lower urinary tract symptoms (LUTS). The two most common reasons why women with OAB symptoms did not admit themselves to a hospital because of LUTS were as follows: "I did not think I had a disease" and "The symptoms did not bother me," with a response rate of 74.7%. The mean OAB-V8 scores of the patients with these two responses were significantly lower than those of the other patients (P<0.001). CONCLUSIONS: This is the first study to demonstrate a significant proportion of women with undetected OAB symptoms. The main reasons the women did not admit themselves to a hospital were their unawareness of the disease and because the LUTS were not bothersome. Public awareness programs on this disease may resolve this problem.
Diagnosis ; Female* ; Humans ; Lower Urinary Tract Symptoms ; Mass Screening ; Outpatients* ; Turkey ; Urinary Bladder, Overactive*

Prostate cancer is increasing in frequency in Korea. Among them, ductal adenocarcinoma (DCP) has a more aggressive and poor prognosis than acinar adenocarcinoma (ACP), despite its low incidence. Patients usually present with symptoms of lower urinary tract symptoms and hematuria due to increasing tumor mass within the lumen of the prostatic urethra, making diagnosis of DCP by the transrectal prostate biopsy difficult. DCP is often metastasized at the time of diagnosis. DCP is transferable to most other organs but the metastasis to the anterior urethra is rare. There is no doubt that localized DCP requires radical prostatectomy (RP) but the guidelines for adjuvant therapy after RP have not yet been established. Methods of the treatment are confounded by individual differences, and arriving at a consensus is challenging due to insufficient data. We report a case of DCP and urethral metastasis after RP, thus aiding in the determination of treatment guidelines.
Adenocarcinoma* ; Biopsy ; Consensus ; Diagnosis ; Hematuria ; Humans ; Incidence ; Individuality ; Korea ; Lower Urinary Tract Symptoms ; Neoplasm Metastasis* ; Prognosis ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Urethra