Terminology for bladder health research in women and girls: Prevention of Lower Urinary Tract Symptoms transdisciplinary consortium definitions

Abstract

Aim To report research terminology and definitions for describing healthy bladder function among women and girls. Methods The Prevention of Lower Urinary tract Symptoms (PLUS) Consortium developed research terminology and definitions for elements of healthy bladder function based on existing understanding of storage and emptying functions of the bladder and accepted definitions of lower urinary tract symptoms (LUTS). The novel concept of a bladder “bioregulatory” function was also proposed. Elements of bladder function corresponding to bladder health (BH) and LUTS were developed and refined using an iterative process. A comprehensive reference table structured by bladder function (Storage, Emptying, and Bioregulatory) and elements of each function was created to document proposed research terminology and definitions. Results The BH research definitions for each bladder function are: (1) Storage: the ability to hold urine for a reasonable duration of time and sense bladder fullness without fear of or concern about urgency, discomfort or leakage; (2) Emptying: the ability to empty the bladder completely in a timely, efficient, effortless, comfortable manner; and (3) Bioregulatory: the bladder barrier protects the individual/host from pathogens, chemicals, and malignancy. Research definitions for seven Storage, seven Emptying, and three Bioregulatory elements of function are presented. Novel LUTS research definitions were developed when gaps in existing definitions were identified or nonclinical language was desired. Conclusions PLUS BH definitions reflect a transdisciplinary approach to standardizing research definitions for elements of bladder function from a perspective of health rather than dysfunction and provide a framework for studying BH in clinical practice, public health promotion, and LUTS prevention.

The Influence of Vaginal Native Tissues Pelvic Floor Reconstructive Surgery in Patients with Symptomatic Pelvic Organ Prolapse on Preexisting Storage Lower Urinary Tract Symptoms (LUTS)

“…That means that the definition of success and the methodology of final outcomes assessment have evolved and definitely are not based only on anatomic results, but also on functional outcome measures and patient-centered results as well. This is in line with the recently proposed evaluation of bladder health being defined as "a complete state of physical, mental, and social well-being related to bladder function, and not merely the absence of LUTS" [21]. Therefore, pelvic health should be defined not only as the lack of prolapse, but also proper functions-including urine and stool continence and sexual functions as well.…”

Normative noninvasive bladder function measurements in healthy women: A systematic review and meta‐analysis

“…Early work of the PLUS Research Consortium has focused on developing the concept of bladder health in the context of established LUTS (unhealthy bladder) terminology and proposing novel definitions by bladder function (storage, emptying, and bioregulatory). 2,3 In addition to recognizing the need for healthy bladder terminology, the Consortium also recognized the importance of corresponding reference values for bladder function in asymptomatic or healthy women. Although extensive studies have been conducted on objective measures of bladder function in women with LUTS, limited normative data exist in women without LUTS, either by noninvasive or invasive testing.…”

Is the juice worth the squeeze? Transdisciplinary team science in bladder health

“…PLUS investigators recognized the need for upfront time to develop a positive transdisciplinary culture, and that this would likely delay short‐term productivity when judged by traditional metrics (eg, publications, presentations, and abstracts at national meetings). These short‐term delays have already been offset by progress with conceptual work and research that promises a significant health impact, including 11 peer‐reviewed papers, 1,9,10,15‐22 26 peer‐reviewed abstracts, 23‐47 and 15 invited presentations to date. PLUS has formalized key strategic initiatives informed by the shared language, critical awareness, and transdisciplinary orientation developed over the past 4 years.…”