Diagnosis and treatment of lower urinary tract symptoms suggestive of overactive bladder and bladder outlet obstruction among men in general practice in the UK

Morant, S. V.; Reilly, K; Bloomfield, G. A.; Chapple, Christopher R.

doi:10.1111/j.1742-1241.2008.01737.x

Cited by 34 publications

(28 citation statements)

References 14 publications

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“…Barriers to consult a physician are the conviction that the symptoms are a part of the normal ageing process and that treatment is non-existent (6). As such, OAB is an underdiagnosed and undertreated condition (7). In men, an additional reason for underdiagnosing/treating OAB is the fact that all micturition symptoms/LUTS are still too often attributed exclusively to an underlying prostatic pathology such as benign prostatic obstruction, while this is only one of the multiple mechanisms that can contribute to the pathophysiology of OAB (8,9).…”

Section: Introductionmentioning

confidence: 99%

Urgency and other lower urinary tract symptoms in men aged ≥ 40 years: a Belgian epidemiological survey using the ICIQ-MLUTS questionnaire

Ridder

Roumeguère

Kaufman³

2015

Int J Clin Pract

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Background and Aims: The aim of this study was to assess prevalence and associated bother of male lower urinary tract symptoms (LUTS), especially of urgency and other storage symptoms, since these are generally assumed to be underdiagnosed/undertreated in men. Methods: Data on bladder condition of men ≥ 40 years were prospectively collected by 124 general practitioners (GPs) during a regular visit for any reason, using the validated ICIQ-MLUTS questionnaire. For 13 symptoms, prevalence (scale 0-4) and bother (scale 0-10) were scored. General bladder-related quality of life (scale 0-3) was also assessed. Results: Data from 5890 men (mean age: 61.2 years) were analysed. A total of 7.7% had urgency most or all of the time (score ≥ 3) and 6.2% had bothersome urgency (score ≥ 3 + bother score ≥ 5). Nocturia (69.2%) and urgency (58.3%) were the most prevalent and bothersome symptoms. Both prevalence and bother of all LUTS increased with age. Additionally, 28.9% of men reported to be a little bothered by their bladder condition in everyday life, while 11.9% were bothered a lot/very much (2.5% in age group 40-49 years increasing to 29.2% in those > 80 years). Conclusions: In the general population of men ≥ 40 years who visited a GP for any reason, 41% indicated to be at least a little bothered by their bladder condition. The prevalence of LUTS, especially nocturia and urgency, is high and a significant number of men indicated to be seriously bothered. Increasing awareness of male LUTS, and storage symptoms in particular, is warranted to discuss management options that could increase quality of life. What's known LUTS in men are common and increase with age; however, prevalence rates in studies vary upon the definitions used. Male LUTS are still too often attributed to the prostate only, thereby focusing on voiding symptoms and disregarding storage symptoms. In addition, the burden of LUTS and particularly storage symptoms remains relatively unrecognised. What's new A validated questionnaire, not biased towards voiding symptoms, was used to assess presence and bother of LUTS in men. More than 4 of 10 men were at least a little bothered by their bladder condition. Nocturia and urgency were the most prevalent and bothersome symptoms. Although bother related to LUTS was mild at the population level, the ICIQ-MLUTS was able to identify a subgroup of men seriously bothered by LUTS.

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Section: Introductionmentioning

confidence: 99%

Urgency and other lower urinary tract symptoms in men aged ≥ 40 years: a Belgian epidemiological survey using the ICIQ-MLUTS questionnaire

Ridder

Roumeguère

Kaufman³

2015

Int J Clin Pract

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“…Men with LUTS/BPH who had both storage and voiding symptoms were identified using two criteria: (1) initial record of LUTS diagnosis, voiding symptoms, post-micturition symptoms (based on Read code lists 15 ) or an a 1 -blocker prescription, with storage symptoms or an antimuscarinic prescription recorded during the following 12 months; or (2) initial record of storage symptoms or antimuscarinic prescription, plus LUTS diagnosis, voiding symptoms, post-micturition symptoms or a 1 -blocker prescription recorded during the following 12 months. Exclusion criteria included a record of prior 5-ARI prescription, prostate surgery, chronic prostatitis or urological pain syndrome, and a 1 -blocker use for hypertension (see Supplementary Information).…”

Section: Patient Identificationmentioning

confidence: 99%

Drug treatment patterns for the management of men with lower urinary tract symptoms associated with benign prostatic hyperplasia who have both storage and voiding symptoms: a study using the health improvement network UK primary care data

Hakimi

Johnson

Nazir

et al. 2014

Current Medical Research and Opinion

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“…3), y un 93% opinaba que sus síntomas urinarios habían mejorado durante el tratamiento actual ( fig. 4) 10 (0,5%) Normalidad (18,(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)9) 694 (34,1%) Sobrepeso (25)(26)(27)(28)(29)9) 1061 (52,1%) Obesidad grado 1 (30)(31)(32)(33)(34)9) 228 ( actual, siendo el porcentaje total de pacientes que prefieren el tratamiento actual del 91%. Se realizó un análisis de regresión logística para ver los factores que podrían influir sobre la satisfacción con el tratamiento.…”

Section: Resultsunclassified

“…Los antimuscarínicos actúan sobre los receptores muscarínicos de la vejiga y son eficaces en el tratamiento de la VH 10 . En varones de edad avanzada la VH se acompaña frecuentemente de hiperplasia benigna de próstata (HBP) 11 , siendo los tratamientos utilizados los bloqueadores alfa-adrenérgicos e inhibidores de la 5 alfareductasa para tratar los síntomas de vaciado derivados de la obstrucción 12,13 . No todos los pacientes buscan ayuda profesional para este problema, y en España sólo alrededor del 17% recibe tratamiento 5 .…”

Section: Introductionunclassified

Evaluación de los motivos del cambio de tratamiento para la vejiga hiperactiva

et al. 2011

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PALABRAS CLAVEVejiga hiperactiva; Tratamiento farmacológico; Cumplimiento de la medicación; Satisfacción del paciente ResumenObjetivos: aunque el tratamiento de la vejiga hiperactiva (VH) es eficaz, muchos pacientes no responden, por lo que interesa estudiar los motivos de cambio de tratamiento y la satisfacción del paciente con el nuevo tratamiento. Material y métodos: estudio epidemiológico, transversal, no intervencionista para determinar los motivos del cambio de tratamiento en VH y la satisfacción con dicho cambio. Se reclutaron pacientes con VH (OAB-V8 ≥ 8), de ambos sexos, mayores de 18 años, que habían modificado su tratamiento en los 3-4 meses previos. Se recogieron datos demográficos, síntomas, tratamiento previo, actual y concomitante, motivo del cambio, impresión clínica global (ICG) de gravedad y de mejoría, cuestionario Morinsky Green, satisfacción con el tratamiento, preferencia del mismo y la escala del beneficio del tratamiento (TBS). Resultados: de 3.365 pacientes reclutados, 2.038 (61%) fueron evaluables (61,1 ± 11,2 años; 77% mujeres). El médico solicitó el cambio de tratamiento en un 69% y el paciente en un 31% por motivos de falta de beneficio clínico (60%), efectos secundarios (24%), petición del paciente (8%), incumplimiento terapéutico (6%) y otros (2%). El 52% de los pacientes cumplió con el nuevo tratamiento. Según ICG, el 65,4% presentó mejoría respecto al tratamiento anterior. Un 60% de los pacientes se mostró bastante/muy satisfecho con el tratamiento actual, un 91% lo prefirió al previo y un 93% opinó que sus síntomas habían mejorado. Conclusiones: la falta de beneficio clínico es el principal motivo del cambio de tratamiento de la VH. La mayoría de los pacientes prefieren el nuevo tratamiento.

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Diagnosis and treatment of lower urinary tract symptoms suggestive of overactive bladder and bladder outlet obstruction among men in general practice in the UK

Abstract: Diagnosis of both storage and voiding LUTS occurs at much lower rates than indicated by prevalence estimates. Despite the availability of effective prescription therapies, many men with storage and/or voiding LUTS may not be receiving appropriate treatment in UK general practice.

Cited by 34 publications

References 14 publications

Urgency and other lower urinary tract symptoms in men aged ≥ 40 years: a Belgian epidemiological survey using the ICIQ-MLUTS questionnaire

Urgency and other lower urinary tract symptoms in men aged ≥ 40 years: a Belgian epidemiological survey using the ICIQ-MLUTS questionnaire

Drug treatment patterns for the management of men with lower urinary tract symptoms associated with benign prostatic hyperplasia who have both storage and voiding symptoms: a study using the health improvement network UK primary care data

Evaluación de los motivos del cambio de tratamiento para la vejiga hiperactiva

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