Fundamentals of terminology in lower urinary tract function

Abstract

Aims To summarize basic definitions in the International Continence Society (ICS) Standardization of Terminology in lower urinary tract (LUT) function and their application. Methods Fundamental terminology in the ICS Standardization of Terminology LUT Function was identified and summarized. Results Evaluation of LUT requires appreciation of symptoms, signs and urodynamic observations. Symptoms are categorized according to their occurrence during the micturition cycle into storage symptoms (eg, increased daytime frequency [IDF], urgency, nocturia, or incontinence) or voiding and post‐voiding symptoms (eg, slow stream or post micturition dribbling). Several problems may be present, giving rise to symptom syndromes, notably overactive bladder (during the storage phase) or underactive bladder (during the voiding phase). Signs may be derived from a bladder diary or may be elicited on physical examination. Urodynamic observations may be made by assessing flow rate, and this is combined with pressure measurement when undertaking filling cystometry and pressure flow studies. Key elements of flow and pressure measurement are described. Conclusions The review provides a succinct summary of symptoms, signs, and urodynamic observations as set out in the ICS Standard on LUT Function.

Neurological lower urinary tract dysfunction essential terminology

“…People with NLUTD may describe storage, voiding, and post voiding symptoms consistent with the definitions used for the general population. 2,3 Sometimes, a patient may not express that a symptom is present, so it is appropriate to discuss with the caregiver as well when establishing the presenting complaint. Storage symptoms may converge in Neurogenic Overactive Bladder, which is a symptom syndrome characterized by urgency, with or without urgency urinary incontinence, usually with increased daytime frequency and nocturia in the setting of a clinically relevant neurologic disorder with at least partially preserved sensation.…”

“…In describing the features of an individual patient's dysfunction, clinicians should appreciate the distinction between symptoms, signs, and urodynamic observations as set out in the ICS Standardisation of Terminology of Lower Urinary Tract Function (for summary see). A summary of the classification of neurological lesions, including the potential clinical and urodynamic features, is given in Figure .…”

“…People with NLUTD may describe storage, voiding, and post voiding symptoms consistent with the definitions used for the general population . Sometimes, a patient may not express that a symptom is present, so it is appropriate to discuss with the caregiver as well when establishing the presenting complaint.…”

Re: Drake M.J.: Fundamentals of terminology in lower urinary tract function. Neurourol Urodyn. 2018; 37:S13‐9. doi: 10.1002/nau.23768

“…The sounding board article “Fundamentals of terminology in lower urinary tract function” is timely and indispensable to educate assessment of lower urinary tract function and dysfunction. It contains the essential terms and has also included a paragraph “urodynamic observations.”…”

“…In the example shown it is unclear when FSF occurs, or SDV. But I would also teach that specific evidence for the relevance of these landmarks is regrettably not yet fully understood, apart from judging normality, maybe as a consequence of the lack of precision.…”