A Review of Aging and the Lower Urinary Tract: The Future of Urology

Nishii, Hisae

doi:10.5213/inj.2142042.021

Cited by 22 publications

(11 citation statements)

References 100 publications

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“…The relationship between LUTS and frailty remains unknown because crosssectional studies can only address association. 5,7 Frailty alters the level of physical activity, which may contribute to LUTS. On the other hand, LUTS may affect frailty via frequent voiding, especially at night.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, they are components of heterogeneous syndromes. The relationship between LUTS and frailty remains unknown because cross‐sectional studies can only address association 5,7 . Frailty alters the level of physical activity, which may contribute to LUTS.…”

Section: Discussionmentioning

confidence: 99%

“…Lower urinary tract symptoms (LUTS) and frailty are common among older adults and remarkably affect their daily lives. [1][2][3][4][5][6][7][8][9] Both LUTS and frailty are related to multiple comorbidities and unfavorable outcomes, such as reduced physical activity, hospitalizations, falls, impaired cognition, and poor quality of life. [10][11][12][13][14][15][16][17][18][19] Furthermore, several studies have revealed close associations between LUTS and frailty.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between lower urinary tract symptoms and frailty

et al. 2023

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Objective To elucidate the relationship between frailty and lower urinary tract symptoms (LUTS). Methods We longitudinally evaluated the temporal changes and the relationships between frailty and LUTS in 247 community‐dwelling adults (45 years or older) at baseline and at a 5‐year follow‐up. We used the Fried phenotype (phenotype‐based frailty), 5‐item modified frailty index (5i‐mFI; comorbidity‐based frailty), and frailty discriminant score (comprehensive frailty assessment) to evaluate frailty. LUTS were evaluated using the international prostate symptom score (IPSS) and overactive bladder symptom score (OABSS). Results We analyzed 247 participants with a median age of 60 years. The median IPSS and OABSS were significantly increased over the 5 years. The proportion of frail individuals did not increase significantly over the 5 years. Of the three frailty assessment tools, the 5i‐mFI score significantly increased between 2014 and 2019. Multiple linear regression analyses showed that the 5i‐mFI score was significantly associated with the severity of LUTS in 2014 to 5i‐mFI in 2019 but not with 5i‐mFI in 2014 to the severity of LUTS in 2019. Conclusion The effect of LUTS on frailty might be greater than the effect of frailty on LUTS. Further large‐scale studies are needed to elucidate the relationship between LUTS and frailty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship between lower urinary tract symptoms and frailty

et al. 2023

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“…The main drug therapies for OAB include anti‐cholinergic agents, β3‐adrenoceptor agonist, and combination therapies of those drugs 19 . However, an association between anti‐cholinergic agents and an increased risk of falls and cognitive, physical, and functional impairment has been reported 20 ; thus, anti‐cholinergic burden has to be considered in OAB treatment among the older adult population. A network meta‐analysis regarding the safety and efficacy of treatments for OAB among elderly showed that the β3‐adrenoceptor agonist was similarly effective to anti‐cholinergic agents and did not cause adverse events that were typically associated with anti‐cholinergic agents 21 .…”

Section: Discussionmentioning

confidence: 99%

The current state of family caregiver burden and support of toilet problems for elderly with mild cognitive impairment and Alzheimer's disease

et al. 2023

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Objective To conduct an exploratory examination of caregiver burden involving toilet problems in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) and related characteristics. Methods We included 50 outpatients with amnestic MCI and AD and their caregivers. Patients were subclassified into three groups: MCI, mild AD, and moderate/severe AD. We used the Japanese version of the Zarit Burden Interview (J‐ZBI) to evaluate caregiver burden and conducted a questionnaire on the frequency of lower urinary tract symptoms and related caregiver burden. We compared the frequency of questionnaire items with the level of burden in each group and subsequently determined the J‐ZBI correlation coefficient. Results Among the questionnaire items, the caregiver's burden of “increased daytime urinary frequency,” “nocturia,” “urinary incontinence,” and “they cannot clean the toilet” statistically significantly correlated with J‐ZBI scores (ρ = 0.52, 0.65, 0.79, and 0.83, respectively). Items including “they cannot clean the toilet,” “the smell of excrement is bothersome,” “assistance for transfer is necessary,” “they soil the clothes and bed,” and “they cannot clean the genital region” were significantly more common in the patient group with moderate/severe AD. Conclusions Lower urinary tract symptoms and toilet problems were significantly correlated with caregiver burden. Toilet problems differ depending on the severity of dementia. Therefore, a support system based on dementia severity is required to address toilet problems.

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“…Lower urinary tract symptoms (LUTS) such as incontinence and bladder storage or voiding issues are more likely to occur in females than males. It has been estimated that up to 80% of women experience LUTS 15 . However, the frequency of symptoms and their impact on women's wellbeing varies from mild to more severe.…”

Section: Discussionmentioning

confidence: 99%

Conditions Diagnosed on Bladder Biopsy in Adult Female Patients with Lower Urinary Tract Symptoms (LUTS) Refractory to Medical Treatment

Rehman¹,

Ahmad²,

Sahi³

et al. 2022

PJMHS

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Introduction: The incidence of lower urinary tract symptoms (LUTS) as the sole presenting symptom for bladder cancer has traditionally been reported to be low. Refractory LUTS are a well-recognized initial presenting symptom in a small percentage of patients with newly diagnosed bladder cancer. Traditionally, patients who present with refractory LUTS are thought to have carcinoma in-situ (CIS) at diagnosis. Objectives: The objective of this study was to evaluate the evaluate the Conditions diagnosed on bladder biopsy in adult female patients with lower urinary tract symptoms (LUTS) refractory to medical treatment. Materials and Methods: We queried our database of bladder cancer patients in the hospital to identify patients who presented solely with LUTS and were subsequently diagnosed with bladder cancer. Demographic, clinical, and pathologic variables were examined. Results: 4.1% (14/340) of bladder cancer patients in our series presented solely with LUTS. Mean age and Charlson Co-morbidity Index of these patients was 66.4 years. Of the 14 patients in our data presenting with LUTS, 9 (64.3%), 4 (28.6%), and 1 (7.1%) patients presented with clinical stage Ta, carcinoma in Situ (CIS), and T2 disease. At a follow up of 6 months, recurrence occurred in 7 (50.0%) patients with progression occurring in 1 (7.1%) patient. 11 (78.6%) patients were alive and currently disease free, and 3 (21.4%) patients had died, with only one (7.1%) death attributable to bladder cancer. Practical implication: This study suggests that urologists should have a low threshold for evaluating patients with unexplained LUTS for underlying bladder cancer. Conclusions: It is concluded that incidence of LUTS as the sole presenting symptom in patients with newly diagnosed bladder cancer. Keywords: UTI, Bladder, Patients, Hyperplasia, LUTS, Cancer

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A Review of Aging and the Lower Urinary Tract: The Future of Urology

Cited by 22 publications

References 100 publications

Relationship between lower urinary tract symptoms and frailty

Relationship between lower urinary tract symptoms and frailty

The current state of family caregiver burden and support of toilet problems for elderly with mild cognitive impairment and Alzheimer's disease

Conditions Diagnosed on Bladder Biopsy in Adult Female Patients with Lower Urinary Tract Symptoms (LUTS) Refractory to Medical Treatment

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