Do sensation-related bladder diaries differ between patients with urodynamically confirmed and non-objectivised urinary incontinence?

Naoemova, Irina; Wachter, Stefan De; Wuyts, Floris L.; Wyndaele, Jean‐Jacques

doi:10.1007/s00192-007-0420-y

Cited by 14 publications

(9 citation statements)

References 14 publications

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“…Phenotypic studies confirm the differences between the two subgroups. Subjects in the DO group had less tolerance to bladder filling on regular urodynamics as they reported strong desire to void and urgency at smaller bladder volumes, consistent with previous studies on the elicitability of DO 7, 8, 23, 24. The DO group also had greater scores in clinical correlates of urgency and UUI, such as age and structural damage in the brain's white matter (both globally and in right ATR).…”

Section: Discussionsupporting

confidence: 85%

“…Failure to elicit DO during urodynamics in some patients with OAB may suggest that the underlying functional disorder of continence control is different or less severe than in those with more easily elicitable DO. Recent urodynamic studies support this idea by demonstrating physiological differences at LUT level between OAB patients who exhibit DO on urodynamic study and those who do not 7, 8. In a group of 144 such women,7 those with urodynamically elicitable DO reported strong desire to void and urgency at smaller volumes.…”

Section: Introductionmentioning

confidence: 96%

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Brain activity underlying impaired continence control in older women with overactive bladder

Tadić

Griffiths

Schaefer

et al. 2012

Neurourology and Urodynamics

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AimsTo identify, in subjects with overactive bladder (OAB), differences in brain activity between those who maintained and those who lost bladder control during functional magnetic resonance imaging (fMRI) of the brain with simultaneous urodynamics.MethodsSecondary analysis of a cohort of older women (aged >60) with proven urgency urinary incontinence, who, in the scanner, either developed detrusor overactivity and incontinence (the “DO group”) or did not (the “no DO” group). A priori hypothesis: during urgency provoked by bladder filling, without DO, activity in regions related to continence control is diminished in the DO group; specifically (1a) less activation in supplementary motor area (SMA) and (1b) less deactivation in prefrontal cortex (PFC) and parahippocampal complex (PH). We also explored phenotypic (clinical and urodynamic) differences between the groups.ResultsDuring urgency preceding DO, the DO group showed stronger activation in SMA and adjacent regions (hypothesis 1a rejected), and less deactivation in PH but no significant difference in PFC (hypothesis 1b partially accepted). These subjects were older, with more changes in brain's white matter, decreased tolerance of bladder filling and greater burden of incontinence.Conclusions(1) In older women with OAB, brain activity in the SMA is greater among those with more easily elicitable DO, suggesting a compensatory response to failure of control elsewhere. (2) OAB is heterogeneous; one possible phenotype shows severe functional impairment attributable partly to age‐related white matter changes. (3) Functional brain imaging coupled with urodynamics may provide CNS markers of impaired continence control in subjects with OAB. Neurourol. Urodynam. 31:652–658, 2012. © 2012 Wiley Periodicals, Inc.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 96%

Brain activity underlying impaired continence control in older women with overactive bladder

Tadić

Griffiths

Schaefer

et al. 2012

Neurourology and Urodynamics

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“…The observation that the baseline MVV per micturition was greater in men than in women is consistent with previous findings showing that women void more frequently and at lower volumes than men . Evidence for a relationship between the severity of urgency sensation and MVV among individuals with OAB has been shown . It is notable that ∼15% fewer women than men reported being ‘not able to hold urine’ on the UPS.…”

Section: Discussionsupporting

confidence: 90%

Efficacy of fesoterodine compared with extended‐release tolterodine in men and women with overactive bladder

et al. 2013

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Objective• To assess the efficacy of fesoterodine 8 mg vs extended-release (ER) tolterodine 4 mg for overactive bladder (OAB) symptoms in terms of patient-reported outcomes in women and in men. Subjects and Methods• Pooled data from two 12-week, randomized, double-blind, double-dummy studies were analysed. • Participants eligible for the studies were Ն18 years old, had self-reported OAB symptoms for Ն3 months in 3-day baseline diaries and had Ն8 micturitions and Ն1 urgency urinary incontinence (UUI) episode per 24 h. • Individuals were randomized to fesoterodine (4 mg for 1 week then 8 mg for 11 weeks), ER tolterodine (4 mg), or placebo.• Changes from baseline in 3-day bladder diary variables and scores from the Patient Perception of Bladder Condition (PPBC), Urgency Perception Scale (UPS), and Overactive Bladder Questionnaire (OAB-q), were assessed, as was the 'diary-dry' rate (the proportion of subjects with >0 UUI episodes according to baseline diary and no UUI episodes according to post-baseline diary).• The primary endpoint was the change from baseline to week 12 in UUI episodes. Results• At week 12, women showed significantly greater improvement with fesoterodine 8 mg (n = 1374) than with ER tolterodine 4 mg (n = 1382) and placebo (n = 679) in UUI episodes (primary endpoint), micturition frequency, urgency episodes, and all other diary endpoints (except nocturnal micturitions versus ER tolterodine), and also in scores on the PPBC, UPS, and all OAB-q scales and domains (all P < 0.005).• Diary-dry rates in women were significantly greater with fesoterodine (63%) than with tolterodine (57%; P = 0.002) or placebo (48%; P < 0.0001).• In men, there were no significant differences in improvement in UUI episodes between any treatment groups at week 12. Improvements in men were significantly greater with fesoterodine 8 mg (n = 265) than with ER tolterodine (n = 275) for severe urgency and the OAB-q Symptom Bother domain and were also significantly greater with fesoterodine than with placebo (n = 133) for micturition frequency, urgency episodes, severe urgency episodes, PPBC responses and scores on all OAB-q scales and domains at week 12 (all P < 0.04).• The most frequently reported treatment-emergent adverse events in both genders were dry mouth (women: fesoterodine, 29%; ER tolterodine, 15%; placebo, 6%; men: fesoterodine, 21%; ER tolterodine, 13%; placebo, 5%) and constipation (women: fesoterodine, 5%; ER tolterodine, 4%; placebo, 2%; men: fesoterodine, 5%; ER tolterodine, 3%; placebo, 1%). • Urinary retention rates were low in women (fesoterodine, <1%; ER tolterodine, <1%; placebo, 0%) and men (fesoterodine, 2%; ER tolterodine <1%; placebo, 2%). Conclusion• This analysis supports the superiority of fesoterodine 8 mg over ER tolterodine 4 mg on diary endpoints, including UUI, symptom bother and health-related quality of life in women.• In men, fesoterodine 8 mg was superior to ER tolterodine 4 mg for improving severe urgency and symptom bother.

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“…However, as currently described it does not include simultaneous assessment of urgency severity, which would distinguish UUI from stress UI episodes. Both scales have established test‐retest reliability [2,3], but as yet have not been fully validated [2,3,22,23].…”

Section: Introductionmentioning

confidence: 99%

Reliability and normal ranges for the Patient’s Perception of Intensity of Urgency Scale in asymptomatic women

et al. 2010

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Female Lower Urinary Tract Symptoms Long Form, to exclude those with bothersome lower urinary tract symptoms. Participants completed two separate 7-day bladder diaries with a 1-week interval between. Reliability was assessed using intraclass correlation, Spearman's correlation, and Student's t -test. RESULTSForty volunteers were recruited. Most (67.5%) reported no urgency episodes. Convenience voids accounted for 26.8% of all voids. There was a significant positive effect of age ( r = 0.34, P = 0.034) on urgency episodes, but no effect on mean urge scores ( r = − 0.03, P = 0.843). The reliability of assessment of frequency (0.86), nocturia (0.84), and the mean urge scores (0.85), were better than the reliability of assessment of urgency episodes (0.56), which occurred infrequently. The 95th centile for daily urinary frequency was 7.27 and for weekly urgency episodes was 2.00. CONCLUSIONThe PPIUS is a reliable tool for assessing urinary urge sensation in women. Inclusion of this measure in bladder diaries does not compromise the recording of other variables. KEYWORDSlower urinary tract symptoms, frequency volume charts, urinary urgency, incontinence, overactive bladder Study Type -Symptom prevalence (prospective cohort) Level of Evidence 1b

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Do sensation-related bladder diaries differ between patients with urodynamically confirmed and non-objectivised urinary incontinence?

Cited by 14 publications

References 14 publications

Brain activity underlying impaired continence control in older women with overactive bladder

Brain activity underlying impaired continence control in older women with overactive bladder

Efficacy of fesoterodine compared with extended‐release tolterodine in men and women with overactive bladder

Reliability and normal ranges for the Patient’s Perception of Intensity of Urgency Scale in asymptomatic women

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