Moving towards a comprehensive assessment of lower urinary tract symptoms (LUTS)

Coyne, Karin S.; Barsdorf, Alexandra I.; Thompson, Christine; Ireland, Andrea M.; Milsom, Ian; Chapple, Christopher R.; Kopp, Zoë; Bavendam, Tamara

doi:10.1002/nau.21202

Cited by 63 publications

(66 citation statements)

References 20 publications

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“…Our data suggest, however, that pain and depression are closely linked in patients with UCPPS. It should also be noted that although one dimension of urinary severity was sufficient in our sample, there are questionnaires, such as the LUTS Tool, 30 that assess a large number of symptoms individually that could be used to study individual symptoms from specific pathophysiologies (e.g., strictures causing split urine steam).…”

Section: Discussionmentioning

confidence: 99%

Pain and Urinary Symptoms Should Not be Combined into a Single Score: Psychometric Findings from the MAPP Research Network

Griffith¹,

Stephens‐Shields²,

Hou

et al. 2016

Journal of Urology

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Purpose The purpose of this study was to create symptom indices – that is, scores derived from questionnaires – to accurately and efficiently measure symptoms of interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome, collectively referred to as urologic chronic pelvic pain syndromes (UCPPS). We created these indices empirically, by investigating the structure of symptoms using exploratory factor analysis. Materials and Methods As part of the Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network, participants (N = 424) completed questionnaires including the Genitourinary Pain Index (GUPI), the Interstitial Cystitis Symptom Index (ICSI), and the Interstitial Cystitis Problem Index (ICPI). Individual items from questionnaires about bladder and pain symptoms were evaluated by principal components and exploratory factor analysis to identify indices with fewer questions to comprehensively quantify symptom severity. Additional analyses included correlating symptom indices with symptoms of depression, a known comorbidity of patients with pelvic pain. Results and Conclusions Exploratory factor analyses suggested that two factors, pain severity and urinary severity, provided the best psychometric description of items contained in the GUPI, the ICSI, and the ICPI. These factors were used to create two symptom indices for pain and urinary symptoms. Pain, but not urinary symptoms, was associated with symptoms of depression in a multiple regression analysis, suggesting that these symptoms may impact patients with UCCPS differently; for pain severity, B (SE) = 0.24 (0.04), 95% CI of B = 0.16–0.32, β = 0.32, p < .001. Our results suggest that pain and urinary symptoms should be assessed separately, rather than combined into one total score. Total scores that combine the separate factors of pain and urinary symptoms into one score may be limited for clinical and research purposes.

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Section: Discussionmentioning

confidence: 99%

Pain and Urinary Symptoms Should Not be Combined into a Single Score: Psychometric Findings from the MAPP Research Network

Griffith¹,

Stephens‐Shields²,

Hou

et al. 2016

Journal of Urology

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“…Patients were invited to participate if they reported at least one urinary symptom based on a 1-month recall period on the LUTS Tool. 8 Table 1 lists the study inclusion and exclusion criteria, and all participants were provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…The primary measures of LUTS for this report are the validated LUTS Tool, with a 1-week recall, 8 and the American Urological Association Symptom Index (AUA-SI). The AUA-SI was initially developed to assess the severity of LUTS associated with benign prostatic hyperplasia (BPH), 10 but it has been utilized in women.…”

Section: Methodsmentioning

confidence: 99%

Baseline Lower Urinary Tract Symptoms in Patients Enrolled in LURN: A Prospective, Observational Cohort Study

et al. 2018

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Purpose To describe and compare the frequency and type of lower urinary tract symptoms (LUTS) reported by men and women at the time they were recruited from urology and urogynecology clinics into the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) multi-center, prospective, observational cohort study. Materials and Methods Six research sites enrolled treatment-seeking men and women who reported any LUTS at a frequency more than “rarely” during the past month on the LUTS tool. At baseline, study participants underwent a standardized clinical evaluation and completed validated questionnaires; urological tests were performed, including pelvic/rectal examination, post-void residual, and urinalysis. Results A total of 545 women and 519 men were enrolled. The mean age was 58.8 ± 14.1 years. At baseline, nocturia, frequency, and a sensation of incomplete emptying were similar between men and women, whereas men experienced more voiding symptoms (90% vs. 85%, p=0.007), and women reported more urgency (85% vs. 66%, p<0.001). Women also reported more urinary incontinence (any type) than men (82% vs. 51% p<0.001), which was predominantly mixed incontinence (57%). Men rarely reported stress incontinence (1%), but did have other urinary incontinence (44% post-void dribbling) or urgency incontinence (46%). Older participants had higher odds of reporting symptoms of nocturia and urgency. Conclusion In this large treatment-seeking cohort of men and women, LUTS varied widely by sex and age. Men reported more voiding symptoms and non-stress or urgency urinary incontinence, whereas women reported more incontinence overall and urgency. Older participants had greater odds of urgency and nocturia.

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“…is a validated measure including 22 questions that assess severity and bother for a range of urinary symptoms. 10 This tool was used to categorize women with LUTS into subgroups based on presence of UI and type of UI (SUI, UUI, MUI, and other UI). Question #16 of the LUTS Tool states, “Below are several situations in which people can leak urine.…”

Section: Methodsmentioning

confidence: 99%

Mental Health, Sleep and Physical Function in Treatment Seeking Women with Urinary Incontinence

et al. 2018

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Purpose To examine how mental health measures, sleep, and physical function are associated with presence and type of urinary incontinence (UI) and severity in women seeking treatment for lower urinary tract symptoms (LUTS). Methods This is a baseline cross-sectional analysis in treatment-seeking women with LUTS. All participants completed the LUTS Tool, which was used to classify women based on UI symptoms and measure severity. Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires for depression, anxiety, sleep disturbance, and physical function; the Perceived Stress Scale (PSS); and the International Physical Activity Questionnaire Short Form (IPAQ-SF) were administered. Multivariable regression modeling was used to assess associations with the presence, type, and severity of urinary symptoms. Results We studied 510 women; mean age was 56±14 years, 82% were Caucasian, 47% were obese, and 14% reported diabetes. Most women (n=420, 82.4%) reported UI (70 stress UI, 85 urgency UI, 240 mixed UI, 25 other UI). In adjusted analyses, there were no differences in any of the mental health, sleep, or physical function measures based on presence versus absence of UI. Among those with UI, PROMIS anxiety and sleep disturbance scores were higher for those with mixed UI compared to stress UI. Increasing UI severity was associated with higher PROMIS depression and anxiety, and higher PSS scores, though higher UI severity was not associated with differences in sleep or physical function. Conclusions Among treatment-seeking women with LUTS, increasing UI severity, rather than presence or type of UI, is associated with increased depression, anxiety, and stress.

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Moving towards a comprehensive assessment of lower urinary tract symptoms (LUTS)

Abstract: LUTS that are excluded from the IPSS, most notably incontinence, were prevalent even among mildly symptomatic participants. Since storage symptoms appear to drive treatment seeking, identifying, and treating these symptoms is essential when caring for patients with LUTS.

Cited by 63 publications

References 20 publications

Pain and Urinary Symptoms Should Not be Combined into a Single Score: Psychometric Findings from the MAPP Research Network

Pain and Urinary Symptoms Should Not be Combined into a Single Score: Psychometric Findings from the MAPP Research Network

Baseline Lower Urinary Tract Symptoms in Patients Enrolled in LURN: A Prospective, Observational Cohort Study

Mental Health, Sleep and Physical Function in Treatment Seeking Women with Urinary Incontinence

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