Prevalence and Characteristics of Urinary Incontinence in a Treatment Seeking Male Prospective Cohort: Results from the LURN Study

Helfand, Brian T.; Smith, Abigail R.; Lai, H. Henry; Yang, Claire C.; Gore, John L.; Erickson, Beth; Kreder, Karl J.; Cameron, Anne P.; Weinfurt, Kevin P.; Griffith, James W.; Lentz, Aaron; Talaty, Pooja; Andreev, Victor P.; Kirkali, Ziya; Lurn,

doi:10.1016/j.juro.2018.02.075

Cited by 33 publications

(29 citation statements)

References 30 publications

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“…2 Similarly, bowel symptoms such as constipation and fecal incontinence are common in adults with urinary incontinence. 3,4 However, the mechanism for why urinary and defecatory symptoms coexist in adults with pelvic floor disorders is not well understood. Proposed mechanisms include the physical proximity of the bladder and rectum, resulting in mechanical obstruction of one organ by the distention of the other; however, this model only explains the coexistence of symptoms in conditions such as constipation.…”

mentioning

confidence: 99%

Regions of the brain activated in bladder filling vs rectal distention in healthy adults: A meta‐analysis of neuroimaging studies

Halani

Andy

Rao

et al. 2019

Neurourology and Urodynamics

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Aims: Adults with pelvic floor disorders commonly present with overlapping bladder and bowel symptoms; however, the relationship between urinary and defecatory dysfunction is not well understood. Our aim was to compare and determine if overlapping brain regions are activated during bladder filling and rectal distention in healthy adults. Methods: We conducted separate Pubmed searches for neuroimaging studies investigating the effects of rectal distention and bladder filling on brain activation in healthy subjects. Coordinates of activated regions were extracted with cluster-level threshold P < .05 and compared using the activation likelihood estimate approach. Results from the various studies were pooled and a contrast analysis was performed to identify any common areas of activation between bladder filling and rectal distension. Results:We identified 96 foci of activation from 14 neuroimaging studies on bladder filling and 182 foci from 17 studies on rectal distension in healthy adults. Regions activated during bladder filling included right insula, right and left thalamus, and right periaqueductal grey. Regions activated during rectal distention included right and left insula, right and left thalamus, left postcentral gyrus, and right inferior parietal lobule. Contrast analysis revealed common activation of the right insula with both rectal distention and bladder filling.Conclusion: Bladder filling and rectal distention activate several separate areas of the brain involved in sensory processing in healthy adults. The common activation of the insula, the region responsible for interoception, in these two conditions may offer an explanation for the coexistence of bladder and defecatory symptoms in pelvic floor disorders. K E Y W O R D S bladder filling, insula, interoception, neuroimaging, pelvic floor disorders, rectal distention

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mentioning

confidence: 99%

Regions of the brain activated in bladder filling vs rectal distention in healthy adults: A meta‐analysis of neuroimaging studies

Halani

Andy

Rao

et al. 2019

Neurourology and Urodynamics

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“…The strengths of the development process included intensive engagement with health care providers who treat LUTS, women and men with LUTS who did and did not seek care for their LUTS, plus community individuals without LUTS. We also included aspects of symptoms not covered by any single measure currently in use (e.g., different aspects of urinary incontinence, dribbling and post-void symptoms, and abnormal bladder sensations before and between urination 13 ), careful attention to the wording of items and their evaluation through cognitive interviews, which included participants with lower levels of literacy, a translatability review to facilitate later translations into other languages, and helpful reference data from over 816 patients seeking care for LUTS.…”

Section: Discussionmentioning

confidence: 99%

The Comprehensive Assessment of Self-Reported Urinary Symptoms: A New Tool for Research on Subtypes of Patients with Lower Urinary Tract Symptoms

et al. 2019

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Purpose: To improve the potential for finding clinically important subtypes of patients with lower urinary tract symptoms (LUTS), we describe the development of the Comprehensive Assessment of Self-reported Urinary Symptoms (CASUS) —and use it to present data on the experiences of LUTS in treatment-seeking women and men from a prospective observational cohort. Materials and Methods: An initial list of LUTS as confirmed in 22 qualitative interviews with providers and 88 qualitative interviews with care-seeking and non-care-seeking women and men with LUTS. Items from extant measures were adopted and revised and new items were developed, and all were evaluated for understanding in 64 cognitive interviews. Items were administered to a prospective cohort of female and male LUTS patients seeking care and analyses were conducted to describe item response distributions and correlations among item responses separately for women and men. Results: A total of 444 males and 372 females provided responses to CASUS. There were several sets of items that had different relationships for women compared to men. In particular, the associations between sensation-related items and incontinence-related items were generally positive among females, but were often negative among males. Conclusions: Using an intensive development process, the CASUS addresses a wide range of LUTS. It should help to identify clinically important subtypes of patients. Further, the collection of items can provide the foundation for shorter measures for use in the clinic and as trial endpoints.

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“…Persons with LUT dysfunction may seek care for their symptoms. Undoubtedly, there is an individual threshold for the decision to seek professional care 2 and without a doubt this threshold has wide intra-individual variation. Any person with symptoms who arrives at professional care enters a form of diagnostic process.…”

Section: Introductionmentioning

confidence: 99%

Contemporary diagnosis of lower urinary tract dysfunction.

Rosier

2019

F1000Res

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Introduction: Diagnosis of lower urinary tract (LUT) dysfunction starts with categorization in clinical syndromes, and initial management is based on the assumptions about pathophysiology that these syndromes contain. However, clinical practice guidelines are ambiguous in clinical specialists’ diagnosis of dysfunction after failure of initial management. This is a narrative and critical review of the existing evidence, and the aim is to suggest practice improvements in the process of clinical specialists’ diagnosis for patients resistant to initial management. Methods and Results: Evidence is collated on the basis of the author’s personal preference in combination with good clinical practice general principles. Statements and suggestions to improve reflect personal opinion. For two groups of patients with LUT dysfunction, the strategy of initial diagnosis is summarized and desirable principles of secondary care diagnosis are discussed. More specifically, a structure for the contemporary care of women with signs and symptoms of urinary incontinence is described and for that of the group of men older than 45 years with symptoms of LUT dysfunction. Conclusions: Urodynamic testing is the undisputed gold standard for objective assessment and is the only way to stage and grade the dysfunction. Clinical practice guidelines and clinical specialists are too modest about the use and applicability of objective or urodynamic testing for referred persons with LUT dysfunction that is resistant to initial pragmatic management. Objective assessment and diagnosis are mainstays in secondary care, and the indication to perform objective assessments in patients with LUT dysfunction should be advised much more specifically in guidelines and practice recommendations.

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Prevalence and Characteristics of Urinary Incontinence in a Treatment Seeking Male Prospective Cohort: Results from the LURN Study

Cited by 33 publications

References 30 publications

Regions of the brain activated in bladder filling vs rectal distention in healthy adults: A meta‐analysis of neuroimaging studies

Regions of the brain activated in bladder filling vs rectal distention in healthy adults: A meta‐analysis of neuroimaging studies

The Comprehensive Assessment of Self-Reported Urinary Symptoms: A New Tool for Research on Subtypes of Patients with Lower Urinary Tract Symptoms

Contemporary diagnosis of lower urinary tract dysfunction.

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