The overlooked association between lower urinary tract dysfunction and psychiatric disorders: a short screening test for clinical practice

Özen, Mehmet Ali; Mutluer, Tuba; Necef, Işıl; Shabsog, Mohammed; Taşdemir, Mehmet; Bilge, İlmay; Eroğlu, Egemen

doi:10.1016/j.jpurol.2019.03.025

Cited by 21 publications

(32 citation statements)

References 23 publications

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“…focused on children (18,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) and only one article had the required information for metaanalysis (18). Hence, we could not perform a child-specific meta-analysis.…”

Section: Of the 94 Articles That Investigated An Association Between mentioning

confidence: 99%

“…qualitative review of these studies shows that between 1-20% of children with LUTS had clinical anxiety (18,21,28,29,(31)(32)(33)(34), and 19-46% had at least one psychiatric comorbidity, with attention-deficit/hyperactivity disorder (ADHD) having the highest rate (21,23,28,31,33,34).…”

Section: Of the 94 Articles That Investigated An Association Between mentioning

confidence: 99%

“…articles discussing this association (19,22,25,27,30,32,35,(37)(38)(39)(40)(41), of which 6 focused on children (22,25,27,30,32,35). Only one of these 12 articles was suitable for meta-analysis although there did appear to be an association between OCD and LUTS based on the content.…”

Section: Association Of Luts and Ocdmentioning

confidence: 99%

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Systematic Review and Meta-Analysis Identifies Significant Relationships Between Anxiety Disorders and Daytime Lower Urinary Tract Symptoms

Mahjani

Koskela

Batuure

et al. 2020

Preprint

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Background: Clinically, lower urinary tract symptoms (LUTS), such as voiding symptoms, overactive bladder, and interstitial cystitis, are associated with anxiety disorders. However, the existing evidence for the overlap of these conditions has not been systematically evaluated. The aim of this study was to examine this relationship. Methods: We conducted a systematic review and meta-analysis to examine the relationship between LUTS and anxiety. We searched for articles published from January 1990 to July 2019 in PubMed, CENTRAL, PsycINFO, and Google Scholar. Outcomes were anxiety-related disorders and symptoms "clinical anxiety") and subtypes of LUTS. We performed random-effect meta-analyses, and inspected funnel plots and applied the Egger's test to evaluate publication bias. We followed PRISMA guidelines and recorded our protocol on PROSPERO (ID=CRD42019118607). Results: We identified 814 articles, of which 94 fulfilled inclusion criteria and 23 had sufficient data for meta-analysis. The odds ratio for clinical anxiety among individuals with LUTS was 2.87 (95% CI: 2.38,3.46, P < 0.001). Very few studies looked at LUTS among individuals ascertained for clinical anxiety, but there appear to be significantly elevated odds ratio here as well. A large I2 value suggests high heterogeneity between studies. Conclusions: The results demonstrate a clinically significant association between clinical anxiety and LUTS. There were limited data on youth, which should motivate further study in this area. Understanding the co-occurrence of these conditions will lead to better prevention and interventions to ameliorate the progression of the symptoms and to improve quality of life.

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Section: Of the 94 Articles That Investigated An Association Between mentioning

confidence: 99%

Section: Of the 94 Articles That Investigated An Association Between mentioning

confidence: 99%

See 1 more Smart Citation

Systematic Review and Meta-Analysis Identifies Significant Relationships Between Anxiety Disorders and Daytime Lower Urinary Tract Symptoms

Mahjani

Koskela

Batuure

et al. 2020

Preprint

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“…Children and adolescents with LUTD may also express emotional and behavioral disorders such as anxiety, depression, aggressiveness, and social isolation. It's unknown which one is the cause and the consequence (8); the pathological condition underlying this association is a complex problem. In a trial, 29.4% of patients with LUTD were diagnosed with concomitant psychiatric disorders, mainly attention deficient hyperactivity disorder (8).…”

Section: Introductionmentioning

confidence: 99%

“…It's unknown which one is the cause and the consequence (8); the pathological condition underlying this association is a complex problem. In a trial, 29.4% of patients with LUTD were diagnosed with concomitant psychiatric disorders, mainly attention deficient hyperactivity disorder (8). In addition, they run an increased risk of experiencing bullying (4, 9).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Management of Bladder Dysfunction in Neurologically Normal Children

2019

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Normal bladder and urethral sphincter development as well as neural/volitional control over bladder-sphincter function are essential steps for regular lower urinary tract function. These maturational sequences are clinically evident by the age of 5 years. However, in 17–22% of children, symptoms persist beyond that age, characterizing lower urinary tract dysfunction (LUTD). The clinical spectrum is wide and includes overactive bladder, voiding postponement, underactive bladder, infrequent voiding, extraordinary daytime only urinary frequency, vaginal reflux, bladder neck dysfunction, and giggle incontinence. LUTD may lead to vesicoureteral reflux and recurrent urinary tract infections, increasing the likelihood of renal scarring. LUTD is often associated with constipation and emotional/behavioral disorders such as anxiety, depression, aggressiveness, and social isolation, making diagnosis, and treatment imperative. Diagnosis of LUTD is essentially based on clinical history, investigation of bladder storage, voiding symptoms (urinary frequency, daytime incontinence, enuresis, urgency) and constipation. Dysfunctional Voiding Score System (DVSS) is a helpful tool. Physical examination focuses on the abdomen to investigate a distended bladder or palpable fecal mass, the lumbosacral spine, and reflex testing. Bladder diaries are important for recording urinary frequency and water balance, while uroflowmetry is used to assess voided volume, maximum flow, and curve patterns. Bladder ultrasonography to measure post-void residual urine volume and urodynamics are used as supplemental tests. Current first line treatment is urotherapy, a combination of behavioral measures to avoid postponing micturition, and a restricted diet for at least 2 months. Anticholinergics, β3 agonists and neuromodulation are alternative therapies to manage refractory overactive bladder. Cure rates, at around 40%, are considered satisfactory, with daytime symptoms improving in 32% of cases. Furthermore, children who are also constipated need treatment, preferentially with polyethylene glycol at doses of 1–1.5 g/kg in the 1st 3 days and 0.25–0.5 g/kg thereafter until the 2-month period of behavioral therapy is complete. If urotherapy fails in cases of dysfunctional voiding, the next step is biofeedback to teach the child how to relax the external urethral sphincter during micturition. Success rate is around 80%. Children with underactive bladder usually need a combination of clean intermittent catheterization, alpha-blockers, biofeedback and neuromodulation; however, cure rates are uncertain.

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Systematic review and meta‐analysis identify significant relationships between clinical anxiety and lower urinary tract symptoms

et al. 2021

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Background: Lower urinary tract symptoms (LUTS), such as voiding symptoms, overactive bladder, and interstitial cystitis, and anxiety disorders are often comorbid conditions in patients. However, the existing evidence regarding the rates and nature of the co-occurrence of these conditions has not been systematically evaluated. The aim of this study was to examine these relationships. Methods:We conducted a systematic review and meta-analysis to examine the relationship between LUTS and anxiety. We searched for articles published from January 1990 to July 2019 in PubMed, CENTRAL, PsycINFO, and Google Scholar. Outcomes were anxiety-related disorders and symptoms (clinically significant anxiety) and LUTS.We performed random-effects meta-analyses, inspected funnel plots, and applied the Egger's test to evaluate publication bias. We followed PRISMA guidelines and recorded our protocol on PROSPERO (ID = CRD42019118607).This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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The overlooked association between lower urinary tract dysfunction and psychiatric disorders: a short screening test for clinical practice

Cited by 21 publications

References 23 publications

Systematic Review and Meta-Analysis Identifies Significant Relationships Between Anxiety Disorders and Daytime Lower Urinary Tract Symptoms

Systematic Review and Meta-Analysis Identifies Significant Relationships Between Anxiety Disorders and Daytime Lower Urinary Tract Symptoms

Diagnosis and Management of Bladder Dysfunction in Neurologically Normal Children

Systematic review and meta‐analysis identify significant relationships between clinical anxiety and lower urinary tract symptoms

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