RESUMEN

AIM: To linguistically validate the translation of the Lower Urinary Tract Symptoms (LUTS) Tool from English to 10 European languages and assess whether the translations adequately reflected the concepts in the original version and if urological terms and the individual items were readily understood. METHODS: Residents of the target countries who spoke the native language and had LUTS were asked to evaluate a harmonized translation of the LUTS Tool, which was developed in 10 languages: Danish (Denmark), Dutch (Belgium, Netherlands), Finnish (Finland), French (Belgium, France, Luxembourg, and Switzerland), German (Germany, Switzerland), Greek (Greece), Icelandic (Iceland), Italian (Italy), Norwegian (Norway), and Spanish (Spain). After reviewing the language-appropriate version, participants were asked to explain why any words were difficult to understand and to paraphrase each sentence during a standardized cognitive debriefing interview. Linguistic validation teams (original translators, back translator, project manager, interviewer, and survey research expert) conducted a qualitative analysis of the cognitive debriefing findings. RESULTS: The terminology and concepts in the English-language version of the LUTS Tool were adequately captured in all language translations. The overall item comprehension rate, across languages, was 98.5%. Terms related to storage, voiding, and post-micturition LUTS were comprehensible. Minor difficulties with comprehension were identified in 9 of 10 translations, and those changes were made to improve clarity. CONCLUSIONS: Individuals with LUTS from 10 countries understood the individual items captured in translated versions of the LUTS Tool. The overall comprehension rate was high. Most changes were made to improve conceptual clarity based on country-specific linguistic and cultural nuances.

Asunto(s)

Síntomas del Sistema Urinario Inferior/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Traducciones

RESUMEN

OBJECTIVE: To determine the bother associated with overactive bladder (OAB) symptoms and its influence on health-related quality of life (HRQL), anxiety, depression, and treatment seeking in adults in the United States. METHODS: Data from U.S. respondents aged ≥ 40 years participating in the Epidemiology of Lower Urinary Tract Symptoms survey, a population-based, cross-sectional Internet survey, were analyzed to assess OAB prevalence, OAB-associated bother, and effect of OAB on HRQL, anxiety, depression, and healthcare use. Likert data were categorized as no/minimal OAB symptoms, OAB without bother, and OAB with bother at least "somewhat." RESULTS: Of 31 588 completed surveys, 20 000 participants (9416 men and 10 584 women) were randomly selected and matched to U.S. census demographics. Of the respondents with OAB at least "sometimes," the women were more likely than the men to be bothered by OAB, with 68% of the women and 60% of the men bothered at least "somewhat." Men and women with OAB with bother were more likely to report that their bladder condition caused at least some problems; had worse scores on HRQL, anxiety, and depression assessments; and had the greatest number of healthcare visits annually compared with those with OAB without bother and those with no/minimal symptoms. The strongest correlation between bother and symptom frequency was seen for urinary urgency, followed by urgency urinary incontinence and nocturia. CONCLUSION: OAB symptoms can be quite bothersome, especially for women, and can negatively affect HRQL, increase anxiety and depression, and increase healthcare usage. In the present study, the strongest predictor of OAB-associated bother was urinary urgency.

Asunto(s)

Ansiedad/etiología , Depresión/etiología , Aceptación de la Atención de Salud , Calidad de Vida , Vejiga Urinaria Hiperactiva/complicaciones , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Vejiga Urinaria Hiperactiva/diagnóstico , Vejiga Urinaria Hiperactiva/terapia

RESUMEN

AIMS: To evaluate the utility of the International Prostate Symptom Score (IPSS) and the LUTS Tool when assessing lower urinary tract symptoms (LUTS). Secondary objectives were to examine associations of LUTS and treatment seeking. METHODS: Analyses were performed using EpiLUTS data, a population-based, cross-sectional, Internet survey of men and women (aged ≥40) in Sweden, UK, and US with a sample of 30,000 participants. Participants completed the IPSS and the LUTS Tool. Prevalence rates of symptoms captured by the LUTS Tool were compared using IPSS summary scores: 0, 1-7, 8-19, and ≥20. LUTS Tool subscale scores were calculated. Pearson correlations between the LUTS Tool symptoms and subscales and IPSS symptoms were performed. Logistic regressions evaluated the associations of IPSS scores and LUTS Tool subscales with treatment seeking for LUTS. RESULTS: The IPSS did not assess some symptoms (i.e., incontinence) for which there was a high prevalence among participants. Correlations between the 7 symptoms assessed by the IPSS and LUTS Tool were moderate to high ranging between 0.37 (nocturia women) and 0.77 (weak stream men), indicating concordance. While the LUTS Tool subscales and the total IPSS score were all significantly associated with treatment seeking, the LUTS Tool OAB subscale in men and Voiding subscale in women most strongly predicted treatment seeking. CONCLUSION: 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.

Asunto(s)

Síntomas del Sistema Urinario Inferior/diagnóstico , Índice de Severidad de la Enfermedad , Trastornos Urinarios/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Síntomas del Sistema Urinario Inferior/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Encuestas y Cuestionarios , Suecia/epidemiología , Micción/fisiología , Trastornos Urinarios/epidemiología

RESUMEN

OBJECTIVES: To estimate the prevalence of overactive bladder (OAB) in men and women in the United States (US) to determine whether there were racial differences. METHODS: This was a secondary analysis of data from the EpiLUTS (Epidemiology of Lower Urinary Tract Symptoms) survey, an Internet-based cross-sectional, population-representative epidemiologic survey conducted in the US, UK, and Sweden. These analyses were limited to the data of men and women aged 40 and older from the US. The presence of OAB was defined as experiencing urinary urgency or urinary urgency incontinence. Case definitions of OAB symptoms were categorized as occurring at least "sometimes." Prevalence rates of OAB were estimated by race. Logistic regression analyses were conducted for each gender to examine the role of race on OAB status, controlling for risk factors and comorbid conditions. RESULTS: The response rate in the US was 59.6%. A total of 9237 men and 10,407 women self-identified their race and were included in the analytic sample. The prevalence of OAB at least "sometimes" ranged from 26% in Asian men to 33% in African American men. Similarly, the prevalence of OAB at least "sometimes" was lowest in Asian women (27%) and highest in African American women (46%). Race was predictive of OAB in men but not for women. CONCLUSIONS: The prevalence of OAB ranged from 26-33% across races for men and from 27-46% across races for women. African American and Hispanic race is predictive of OAB for men but not for women.

Asunto(s)

Grupos Raciales/estadística & datos numéricos , Vejiga Urinaria Hiperactiva/diagnóstico , Vejiga Urinaria Hiperactiva/etnología , Adulto , Negro o Afroamericano/estadística & datos numéricos , Distribución por Edad , Anciano , Pueblo Asiatico/estadística & datos numéricos , Estudios Transversales , Cistoscopía/métodos , Bases de Datos Factuales , Métodos Epidemiológicos , Femenino , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Modelos Logísticos , Síntomas del Sistema Urinario Inferior/diagnóstico , Síntomas del Sistema Urinario Inferior/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Índice de Severidad de la Enfermedad , Distribución por Sexo , Estados Unidos , Vejiga Urinaria Hiperactiva/epidemiología , Urodinámica , Población Blanca/estadística & datos numéricos

RESUMEN

BACKGROUND: Differences in health burden associated with urinary incontinence (UI) subtypes have been previously described, but the majority of studies are in women. Additional research is needed to examine the prevalence and burden of UI subtype including postmicturition incontinence, nocturnal enuresis, coital incontinence, and incontinence for unspecified reasons. OBJECTIVE: Examine the burden of UI in men and women in Sweden, the United Kingdom, and the United States. DESIGN, SETTING, AND PARTICIPANTS: Secondary analyses of the Epidemiology of Lower Urinary Tract Symptoms (EpiLUTS), a cross-sectional Internet survey, were performed. Participants who reported UI were categorized as (1) urgency urinary incontinence (UUI) only, (2) stress urinary incontinence (SUI) only, (3) mixed urinary incontinence (MUI), (4) UUI plus other incontinence (OI), (5) SUI plus OI, or (6) OI. Differences in health outcomes across UI groups were explored by gender using descriptive statistics and general linear models. MEASUREMENTS: Outcomes included treatment seeking for urinary symptoms, perception of bladder condition, depression, anxiety, and health-related quality of life (HRQL). RESULTS AND LIMITATIONS: Of 14 140 men and 15 860 women, 6479 men (45.8%) and 10 717 women (67.6%) reported UI. The most prevalent UI subgroups were OI in men and SUI in women. MUI and SUI plus OI had the greatest treatment seeking among men, whereas MUI and UUI plus OI had the greatest treatment seeking among women. Men with MUI had the highest rates of anxiety, followed by those with UUI plus OI and SUI plus OI, and OI with a similar trend observed for depression. Anxiety and depression were highest in SUI plus OI and MUI women. MUI and UUI plus OI men and women had significantly lower HRQL compared with other UI groups. CONCLUSIONS: UI is common in men and women aged >40. Individuals with UUI combined with SUI or OI bear a greater mental health burden and report poorer HRQL.

Asunto(s)

Ansiedad/psicología , Depresión/psicología , Salud Mental , Calidad de Vida , Incontinencia Urinaria/psicología , Adulto , Anciano , Ansiedad/epidemiología , Ansiedad/fisiopatología , Ansiedad/terapia , Comorbilidad , Costo de Enfermedad , Estudios Transversales , Depresión/epidemiología , Depresión/fisiopatología , Depresión/terapia , Femenino , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Encuestas Epidemiológicas , Humanos , Internet , Modelos Lineales , Masculino , Persona de Mediana Edad , Aceptación de la Atención de Salud , Percepción , Prevalencia , Medición de Riesgo , Factores de Riesgo , Encuestas y Cuestionarios , Suecia/epidemiología , Reino Unido/epidemiología , Estados Unidos/epidemiología , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/fisiopatología , Incontinencia Urinaria/terapia

RESUMEN

OBJECTIVES: • To evaluate the effects of long-term fesoterodine treatment on health-related quality of life (HRQL) and treatment satisfaction in subjects with overactive bladder (OAB) symptoms. • To determine the impact of gender and age on these effects. PATIENTS AND METHODS: • This is a post hoc analysis of data pooled from identically designed open-label extensions of two randomized, double-blind, 12-week fesoterodine studies. • Initial treatment was once-daily fesoterodine 8 mg; subjects had the opportunity to receive open-label fesoterodine for ≥24 months. • After 1 month, subjects could elect dose reduction to 4 mg and subsequent re-escalation to 8 mg; dose reduction and re-escalation were each allowed once annually. • Changes in scores on the King's Health Questionnaire (KHQ), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and a Likert scale evaluating severity of bladder-related problems were assessed at open-label baseline and months 12 and 24; treatment satisfaction was assessed at open-label baseline and at months 4, 12 and 24. RESULTS: • A total of 864 enrolled subjects were included (men, n= 182; women, n= 682; aged <45 years, n= 134; 45-64 years, n= 432; 65-74 years, n= 204; ≥75 years, n= 94); most subjects (77%) who continued treatment maintained the 8-mg dose. • Among subjects in the overall population, there were significant improvements in all KHQ domains, ICIQ-SF scores, and bladder-related problems at open-label baseline vs double-blind baseline (P < 0.05); additional significant improvements were observed at months 12 and 24 vs open-label baseline in all outcomes (P < 0.05) except for the KHQ General Health Perception domain. • When data were stratified by gender or age, significant improvements at open-label baseline vs double-blind baseline were further significantly enhanced or sustained at months 12 and 24 for most KHQ domains, and for ICIQ-SF scores and bladder-related problems for all groups. Women had significantly greater improvements than men in the KHQ Emotion (P= 0.0173) and Severity/Coping (P= 0.0112) domains and ICIQ-SF scores (P= 0.0276) during open-label treatment. Subjects aged <45 years had significantly greater improvement in the Personal Relationships domain compared with those aged 45-64 years (P= 0.0357) and in the Sleep/Energy domain compared with all other groups (all P < 0.02). • Treatment satisfaction was high (≥92%) throughout open-label treatment regardless of gender or age. CONCLUSIONS: • Long-term fesoterodine treatment was associated with sustained improvement in measures of health-related quality of life and bladder-related problems and with high treatment satisfaction in subjects with overactive bladder symptoms. • Effects of gender and age were minimal.

Asunto(s)

Compuestos de Bencidrilo/uso terapéutico , Antagonistas Muscarínicos/uso terapéutico , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Anciano , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Encuestas y Cuestionarios , Resultado del Tratamiento

RESUMEN

INTRODUCTION AND HYPOTHESIS: As shorter recall periods are sometimes preferable to longer recall periods, the objective of this study was to evaluate the psychometric characteristics and measurement properties of the 1-week recall version of the Overactive Bladder Questionnaire (OAB-q). METHODS: Secondary analyses were performed on data for three 12-week clinical trials of fesoterodine. Patients completed the Patient Perception of Bladder Condition (PPBC), the Patient Perception of Urgency Scale (PPUS), and 3-day bladder diaries in addition to the OAB-q at baseline, 4 and 12 weeks. Analyses were conducted to evaluate the reliability, concurrent and discriminant validity and responsiveness of the OAB-q 1-week recall version. RESULTS: The patients in the three studies (Study 1: N=516, Study 2: N=441; Study 3: N=882) had a mean age of 59.6, 59.4, and 59.9 years, respectively; and most of the patients were female (77.1%, 88.9%, and 82.9%) and White (76.6%, 90.0%, and 88.0%). Patients had been diagnosed with OAB for a mean of 5.2, 8.3, and 9.1 years, respectively. Cronbach's alpha values were greater than 0.85 across all samples and subscales. Correlations between the 1-week recall version of the OAB-q and the PPBC, PPUS, and most of the bladder diary variables were moderate to strong. Discriminant validity of the OAB-q was good, with significant differences in mean OAB-q scores across all response categories of the PPUS. The OAB-q was highly responsive to changes in patients' conditions as indicated by moderate to large effect sizes. The OAB-q 1-week recall version has a similar factor structure to the 4-week recall version with each subscale model demonstrating acceptable fit. CONCLUSION: The 1-week recall version of the OAB-q appears to be reliable, valid, and responsive and is psychometrically equivalent to the 4-week recall version. The validation of the 1-week recall version offers researchers and clinicians an additional option for using the OAB-q.

Asunto(s)

Compuestos de Bencidrilo/uso terapéutico , Recuerdo Mental , Psicometría/métodos , Autoinforme , Encuestas y Cuestionarios , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Antagonistas Muscarínicos/uso terapéutico , Calidad de Vida , Reproducibilidad de los Resultados , Factores de Tiempo , Resultado del Tratamiento

RESUMEN

Overactive bladder syndrome (OAB) is a condition that involves urinary urgency and affected individuals are usually treated with behavioral therapy and antimuscarinic agents as first-line therapies. Existing evidence from clinical trial data suggests that a positive placebo effect occurs in patients receiving treatment for OAB. In our systematic Review of placebo-controlled, randomized trials in OAB, we show statistically significant improvements in three patient-reported outcomes-incontinence episodes per day, micturition episodes per day and mean micturition volume from baseline-after placebo in randomized studies for OAB. The findings could highlight the brain's role in the pathophysiology of OAB or the role of additional bladder training conducted as part of OAB clinical trials. More research is needed to determine the underlying mechanisms of the placebo effect in OAB.

Asunto(s)

Efecto Placebo , Vejiga Urinaria Hiperactiva/fisiopatología , Vejiga Urinaria Hiperactiva/terapia , Animales , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Síndrome , Resultado del Tratamiento , Vejiga Urinaria Hiperactiva/epidemiología , Micción/fisiología

RESUMEN

INTRODUCTION: Prior research suggests that overactive bladder (OAB) is common and adversely affects sexuality in both men and women. However, more data are needed from population-based studies to evaluate the impact OAB on sexual health. AIM: To describe sexual health outcomes in men and women with continent and incontinent OAB (C-OAB, I-OAB) compared to those with no/minimal urinary symptoms (NMS) and to evaluate correlates of decreased sexual activity and enjoyment in men and women, and correlates of erectile dysfunction (ED), ejaculatory dysfunction (EjD), and premature ejaculation (PE) in men. METHODS: A cross-sectional, population-representative survey was conducted via the Internet in the United Kingdom, Sweden, and United States. OAB was assessed via a questionnaire based on current International Continence Society definitions. Descriptive statistics were used to compare outcomes for those with I-OAB, C-OAB and NMS, and logistic regressions were used to evaluate predictors of sexual functioning. MAIN OUTCOME MEASURES: Participants responding to the sexual health portion of the survey were asked questions about sexual activity and satisfaction. Other outcomes included two domains from the Abbreviated Sexual Function Questionnaire, the erectile function domain of the International Index of Erectile Function, and questions assessing EjD and PE. RESULTS: Survey response was 59.2%; 6,326 men and 8,085 women participated in the sexual health portion of the survey. Across outcomes, I-OAB and C-OAB were associated with worse sexual health as compared to those with NMS. Logistic regressions showed that those with I-OAB and C-OAB were significantly (P<0.0001) more likely to report diminished sexual activity and enjoyment of sex. I-OAB and C-OAB were also significant predictors of ED and EjD in men, but not PE. CONCLUSIONS: The impact of OAB is evident across domains of sexual health in both men and women. Sexual health should be assessed in men and women presenting with OAB.

Asunto(s)

Calidad de Vida/psicología , Disfunciones Sexuales Fisiológicas/epidemiología , Disfunciones Sexuales Psicológicas/epidemiología , Disfunciones Sexuales Psicológicas/psicología , Vejiga Urinaria Hiperactiva/epidemiología , Vejiga Urinaria Hiperactiva/psicología , Incontinencia Urinaria/epidemiología , Incontinencia Urinaria/psicología , Adulto , Anciano , Comorbilidad , Comparación Transcultural , Estudios Transversales , Eyaculación , Disfunción Eréctil/epidemiología , Disfunción Eréctil/psicología , Femenino , Encuestas Epidemiológicas , Humanos , Internet , Masculino , Persona de Mediana Edad , Conducta Sexual , Disfunciones Sexuales Fisiológicas/psicología , Encuestas y Cuestionarios , Suecia , Reino Unido , Estados Unidos

RESUMEN

INTRODUCTION AND HYPOTHESIS: The Self-Assessment Goal Achievement (SAGA) questionnaire was developed to identify treatment goals and assess goal-achievement in patients with lower urinary tract symptoms (LUTS). METHODS: This study consisted of (1) gathering information on goal setting/attainment concepts, (2) goal elicitation (n = 41 patients with LUTS), (3) cognitive debriefing of draft questionnaire (n = 11), and (4) pilot testing (n = 104). RESULTS: SAGA consists of baseline (goal-assessment; ranking) and follow-up (goal-achievement) modules. In addition to goals most frequently mentioned, patients can list up to five open goals. Goals most commonly reported as "very important" in pilot testing included reducing urgency (72%), incontinence (65%), and nocturia (64%). Treatment goals spontaneously reported as "very important" were reducing incontinence (45%), nocturia (40%), and frequency (26%). CONCLUSIONS: SAGA may be used to identify treatment goals and assess goal-achievement in patients with LUTS in the clinic and for research (with additional validation). This information may promote patient-physician interaction and help patients establish realistic treatment goals, which may in turn improve treatment adherence and outcomes.

Asunto(s)

Autoevaluación Diagnóstica , Prolapso de Órgano Pélvico/terapia , Dolor Pélvico/terapia , Encuestas y Cuestionarios , Trastornos Urinarios/terapia , Logro , Adulto , Anciano , Femenino , Objetivos , Humanos , Masculino , Persona de Mediana Edad , Prolapso de Órgano Pélvico/psicología , Dolor Pélvico/psicología , Proyectos Piloto , Trastornos Urinarios/psicología , Adulto Joven

RESUMEN

OBJECTIVE: • To examine the prevalence and burden of overactive bladder (OAB) with bother in the UK and Sweden compared to OAB without bother and no/minimal OAB/lower urinary tract (LUTS) symptoms, respectively. PATIENTS AND METHODS: • A cross-sectional population-representative survey was conducted via the Internet in the UK, Sweden and USA. • Participants rated the frequency and bother of OAB and LUTS. Patient outcomes included the Overactive Bladder Questionnaire Short Form, Patient Perception of Bladder Condition, Short Form-12, Hospital Anxiety and Depression Scale-Anxiety and Hospital Anxiety and Depression Scale-Depression, as well as questions about treatment seeking and work productivity. • OAB was defined as urgency at least sometimes or the presence of urinary urgency incontinence. Three subgroups were compared: no/minimal symptoms, OAB without bother and OAB with bother. • Analyses were conducted by gender and country using general linear and logistic regression models to examine bothersome OAB and treatment seeking. RESULTS: • Survey response was 59.2%; 10,000 people (4724 men and 5276 women) participated. • The prevalence of OAB with bother at least 'somewhat' was 10.9% and 14.6% for men in the UK and Sweden, and 22.5% and 33.7% for women in the UK and Sweden, respectively. • Men and women with bothersome OAB were significantly more likely to seek treatment, report the lowest levels of health-related quality of life and work productivity and the highest levels of anxiety and depression compared to those with no/minimal symptoms and OAB without bother. • Greater symptom severity of urgency, urgency urinary incontinence, frequency, nocturia, and increasing levels of anxiety were strongly predictive of OAB bother in both men and women. • Predictors of treatment seeking included frequency, bother as a result of urgency, and lower levels of depressive symptoms in men, and frequency, nocturia and urgency in women. CONCLUSIONS: • OAB is common in the UK and Sweden, and women are more likely to be affected then men. • The impact of OAB is evident across generic and condition-specific domains of health-related quality of life.

Asunto(s)

Eficiencia , Estado de Salud , Calidad de Vida , Vejiga Urinaria Hiperactiva/psicología , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , Internet , Síntomas del Sistema Urinario Inferior/epidemiología , Síntomas del Sistema Urinario Inferior/psicología , Masculino , Persona de Mediana Edad , Prevalencia , Encuestas y Cuestionarios , Suecia/epidemiología , Reino Unido/epidemiología , Vejiga Urinaria Hiperactiva/epidemiología , Vejiga Urinaria Hiperactiva/fisiopatología

RESUMEN

OBJECTIVE: • To estimate and predict worldwide and regional prevalence of lower urinary tract symptoms (LUTS), overactive bladder (OAB), urinary incontinence (UI) and LUTS suggestive of bladder outlet obstruction (LUTS/BOO) in 2008, 2013 and 2018 based on current International Continence Society symptom definitions in adults aged ≥20 years. PATIENTS AND METHODS: • Numbers and prevalence of individuals affected by each condition were calculated with an estimation model using gender- and age-stratified prevalence data from the EPIC study along with gender- and age-stratified worldwide and regional population estimates from the US Census Bureau International Data Base. RESULTS: • An estimated 45.2%, 10.7%, 8.2% and 21.5% of the 2008 worldwide population (4.3 billion) was affected by at least one LUTS, OAB, UI and LUTS/BOO, respectively. By 2018, an estimated 2.3 billion individuals will be affected by at least one LUTS (18.4% increase), 546 million by OAB (20.1%), 423 million by UI (21.6%) and 1.1 billion by LUTS/BOO (18.5%). • The regional burden of these conditions is estimated to be greatest in Asia, with numbers of affected individuals expected to increase most in the developing regions of Africa (30.1-31.1% increase across conditions, 2008-2018), South America (20.5-24.7%) and Asia (19.7-24.4%). CONCLUSIONS: • This model suggests that LUTS, OAB, UI and LUTS/BOO are highly prevalent conditions worldwide. Numbers of affected individuals are projected to increase with time, with the greatest increase in burden anticipated in developing regions. • There are important worldwide public-health and clinical management implications to be considered over the next decade to effectively prevent and manage these conditions.

Asunto(s)

Obstrucción del Cuello de la Vejiga Urinaria/epidemiología , Vejiga Urinaria Hiperactiva/epidemiología , Incontinencia Urinaria/epidemiología , Femenino , Salud Global , Humanos , Masculino , Prevalencia , Estudios Prospectivos

RESUMEN

OBJECTIVE: To estimate the prevalence of and bother associated with overactive bladder (OAB) in adults aged ≥40 years in the United States, using current International Continence Society definitions. METHODS: Internet-based panel members were selected randomly to participate in EpiLUTS, a cross-sectional, population-representative survey. Participants used Likert scales to rate how often they experienced individual lower urinary tract symptoms during the previous 4 weeks and how much bother they experienced. Based on responses to questions regarding urgency and urgency urinary incontinence, OAB symptoms were categorized as occurring at least "sometimes" or at least "often." Symptom bother was categorized as at least "somewhat" or at least "quite a bit." RESULTS: The response rate was 59.6%, with a final sample of 9416 men and 10,584 women. Prevalence of OAB symptoms at least "sometimes" was 27.2% and 43.1% for men and women, respectively; prevalence of OAB at least "often" was 15.8% and 32.6%, respectively. Among men with OAB symptoms at least "sometimes," 60.0% were bothered at least "somewhat" and 27.8% were bothered at least "quite a bit." Among women, bother rates were 67.6% and 38.9%, respectively. Among respondents with OAB at least "often," 67.8% and 38.2% of men and 73.0% and 47.1% of women reported being bothered at least "somewhat" and at least "quite a bit," respectively. We estimate that 29.8 million adults aged ≥40 years in the United States have bothersome OAB symptoms. CONCLUSIONS: Bothersome OAB symptoms are highly prevalent among men and women aged ≥40 years in the United States.

Asunto(s)

Vejiga Urinaria Hiperactiva/epidemiología , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Vejiga Urinaria Hiperactiva/diagnóstico

RESUMEN

OBJECTIVE: Little research has focused on the impact of overactive bladder (OAB) on work productivity. Consequently, the impact of OAB and other lower urinary tract symptoms (LUTS) on work productivity was evaluated in employed men and women aged 40 to 65 in the United States. STUDY DESIGN: Data from a population-based, cross-sectional Internet survey were used to examine the impact of OAB symptoms on work productivity. US participants aged 40 to 65 working full- or part-time were included in the analysis. Participants were asked about the incidence of OAB and other LUTS and a series of questions about work productivity. METHODS: Descriptive statistics and linear and logistic regressions were used to evaluate outcome differences for men and women by the OAB groups of no/minimal symptoms, continent OAB, and incontinent OAB. RESULTS: The response rate was 60%, and a total of 2876 men and 2820 women were analyzed. Men and women with incontinent OAB reported the lowest levels of work productivity and highest rates of daily work interference. Storage symptoms associated with OAB were most consistently associated with work productivity outcomes; however, significant associations were also found for other storage, voiding, and postmicturition LUTS. CONCLUSION: In this large US population-based study, OAB was highly prevalent and was associated with lower levels of work productivity. These findings add to the literature documenting the burden of OAB and other LUTS, underscoring the need for increased screening and treatment.

Asunto(s)

Eficiencia Organizacional , Vejiga Urinaria Hiperactiva/economía , Vejiga Urinaria Hiperactiva/epidemiología , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Suecia/epidemiología , Reino Unido/epidemiología , Estados Unidos/epidemiología

RESUMEN

Accurate prevalence data on illnesses are of paramount importance for medical decision-making, healthcare planning, and the appropriate allocation of healthcare resources. When assessing the prevalence of any illness or health condition, it is important to base prevalence data on an assessment of the general population at large and not on selected groups of the population. Previous estimates of the prevalence of lower urinary tract symptoms (LUTS) have used postal surveys, telephone and in-person interviews, and, more recently, the Internet. Determining the mode of data collection for a research study is dictated by several factors, including target population, topic sensitivity, timeliness, and available resources. The purpose of this report is to document the rationale for conducting a large prevalence study of LUTS and its impact on patient outcomes using Internet- or Web-based surveys. A brief overview of important survey considerations is provided, and previous survey methods used in assessing the prevalence of LUTS discussed. The research objectives and sampling approach used in the EpiLUTS study in the USA, the UK and Sweden are presented, with a discussion of the advantages and disadvantages of this Internet-based sampling approach in relation to other epidemiological methods.

Asunto(s)

Internet , Prostatismo/epidemiología , Calidad de Vida , Trastornos Urinarios/epidemiología , Adulto , Anciano , Métodos Epidemiológicos , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología

RESUMEN

OBJECTIVE: To evaluate the impact of lower urinary tract symptoms (LUTS) on urinary-specific health-related quality of life (HRQL), generic health indices, depression and anxiety in a population-representative sample of men and women, as research has linked LUTS with reduced HRQL and depression, but little is known about the effects of individual LUTS on HRQL, depression and anxiety. SUBJECTS AND METHODS: A cross-sectional population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Participants rated the frequency and symptom-specific bother of individual LUTS and condition-specific HRQL, generic health status, anxiety and depression. Descriptive statistics were used to evaluate outcome differences by International Continence Society LUTS subgroups; logistic regressions were used to determine associations of LUTS and perception of bladder problems, anxiety and depression. RESULTS: The overall survey response rate was 59.2%; 30 000 subjects (14 139 men and 15 861 women) participated. Men and women with LUTS in the all LUTS subgroup (storage, voiding and postmicturition) reported the lowest levels of HRQL and highest levels of anxiety and depression, with 35.9% of men and 53.3% of women meeting self-reported screening criteria for clinical anxiety (Hospital Anxiety and Depression Scale, HADS, Anxiety > or =8), and 29.8% of men and 37.6% of women meeting self-reported criteria for clinical depression (HADS Depression > or =8). In both men and women, storage symptoms were significantly associated with greater perceived bladder impact, whereas voiding symptoms were not. Significant predictors of anxiety included nocturia, urgency, stress urinary incontinence, leaking during sexual activity, weak stream and split stream in women; and nocturia, urgency, incomplete emptying and bladder pain in men. For depression, weak stream, urgency and stress urinary incontinence were significant for women, and perceived frequency and incomplete emptying were significant for men. CONCLUSION: The negative effect of LUTS is apparent across several domains of HRQL and on overall perception of bladder problems, general health status and mental health. The high level of psychiatric morbidity in patients with multiple LUTS has important implications for treatment and highlights the need for further research to pinpoint specific mechanisms underlying this association.

Asunto(s)

Trastornos de Ansiedad/etiología , Trastorno Depresivo/etiología , Calidad de Vida , Trastornos Urinarios/psicología , Actividades Cotidianas , Adulto , Anciano , Trastornos de Ansiedad/epidemiología , Trastorno Depresivo/epidemiología , Métodos Epidemiológicos , Europa (Continente)/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Escalas de Valoración Psiquiátrica , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Trastornos Urinarios/epidemiología

RESUMEN

OBJECTIVE: To assess the (i) the overlap between voiding, storage, and postmicturition symptoms; and (ii) the relative effect of bother and implications for treatment seeking within these symptom groups, using data from the EpiLUTS study. SUBJECTS AND METHODS: This cross-sectional population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Participants were asked to rate the frequency and symptom-specific bother of individual LUTS. Descriptive statistics were used to examine differences in International Continence Society LUTS subgroups. Logistc regressions were used with treatment seeking as the dependent variable and the bother of individual symptoms as predictors. RESULTS: The survey response rate was 59%. The sample included 30,000 participants (14,139 men and 15,861 women); 71% of men and 75% of women reported at least one LUTS, and about half reported LUTS from more than one symptom group. Rates of bother were greatest for those who reported multiple storage, voiding and postmicturition LUTS (men 83%, women 89%). Less than a third of participants with LUTS from all three groups reported seeking treatment. Consistent correlates of treatment seeking across genders included bother due to weak stream, incomplete emptying, perceived daytime frequency, nocturia and urgency. There were also significant associations for several types of incontinence, most commonly stress incontinence in women and leaking during sexual activity in men. Despite high rates of symptom overlap and symptom-specific bother, few participants sought treatment for LUTS. CONCLUSION: Common conditions such as BPH and OAB are treatable, and clinicians should proactively ask patients about urinary symptoms. Given the many types of LUTS that patients experience, it is imperative that clinicians assess all LUTS to ensure that appropriate treatments are prescribed.

Asunto(s)

Aceptación de la Atención de Salud/estadística & datos numéricos , Trastornos Urinarios/epidemiología , Adulto , Anciano , Métodos Epidemiológicos , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Trastornos Urinarios/terapia

RESUMEN

OBJECTIVE: To explore the risk factors and comorbid conditions associated with subgroups of lower urinary tract symptoms (LUTS) in men and women aged > or =40 years in three countries, using data from the EpiLUTS study, as LUTS are common amongst men and women and increase in prevalence with age. SUBJECTS AND METHODS: This cross-sectional, population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Participants were asked to rate how often they experienced individual LUTS during the past 4 weeks on a 5-point Likert scale. Eight LUTS subgroups were created. Descriptive statistics and logistic regressions within each LUTS subgroup were used to assess the data. RESULTS: The survey response rate was 59%. The final sample was 30,000 (men and women). The voiding + storage + postmicturition (VSPM) group reported the highest rates of comorbid conditions for both men and women, and the fewest were reported in the no/minimal LUTS and the postmicturition-only groups. Increasing age was associated with increasing LUTS in men, but not in women. Comorbid conditions significantly associated with the VSPM group were arthritis, asthma, chronic anxiety, depression, diabetes (men only), heart disease, irritable bowel syndrome, neurological conditions, recurrent urinary tract infection, and sleep disorders. Risk factors, such as body mass index, exercise level and smoking, played less of a role, except for childhood nocturnal enuresis, which was significantly associated with most LUTS subgroups. CONCLUSION: In this large population study, many comorbid conditions and risk factors were significantly associated with LUTS among both men and women. Further longitudinal investigations of the associations noted here would help physicians to understand the pathophysiology of LUTS and comorbid conditions, and provide clinical guidelines for patient management of comorbid conditions sharing common pathophysiological pathways.

Asunto(s)

Calidad de Vida , Trastornos Urinarios/complicaciones , Actividades Cotidianas , Adulto , Anciano , Métodos Epidemiológicos , Europa (Continente)/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Trastornos Urinarios/epidemiología

RESUMEN

OBJECTIVE: To evaluate the association between International Continence Society categories of lower urinary tract symptoms (LUTS; storage, voiding, and postmicturition) and individual LUTS (associated with decreased sexual activity and sexual satisfaction in men) with erectile dysfunction (ED), ejaculatory dysfunction (EjD) and premature ejaculation (PE). SUBJECTS AND METHODS: The impact of LUTS on men's sexual health was captured as part of a cross-sectional epidemiological study to assess the prevalence LUTS among men and women aged > or =40 years in the USA, the UK and Sweden. RESULTS: The analysis included 11 834 men with a mean age of 56.1 years, 71% of whom reported being currently sexually active. The primary reason for not being sexually active was no partner (35%), followed by personal health (23%) and no desire (23%). Of the men, 26% had mild to severe ED, 7% had EjD, and 16% PE. Men with multiple LUTS had more severe ED and more frequent EjD and PE. Logistic regression analysis showed that greater age, hypertension, diabetes, depression, urgency with fear of leaking, and leaking during sexual activity were significantly associated with ED. The results were similar in the logistic regression analysis for EjD, whereas being younger and the absence of prostatitis were significantly associated with PE, as were the presence of terminal dribble, incomplete emptying, and split stream. CONCLUSION: LUTS are associated with common sexual dysfunctions in men. The results of this study highlight the importance of assessing the sexual health of men presenting with LUTS.

Asunto(s)

Prostatismo/complicaciones , Calidad de Vida , Disfunciones Sexuales Fisiológicas/etiología , Adulto , Factores de Edad , Anciano , Métodos Epidemiológicos , Europa (Continente)/epidemiología , Humanos , Masculino , Salud del Hombre , Persona de Mediana Edad , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/epidemiología , Prostatismo/epidemiología , Índice de Severidad de la Enfermedad , Conducta Sexual , Disfunciones Sexuales Fisiológicas/epidemiología , Encuestas y Cuestionarios , Estados Unidos/epidemiología

RESUMEN

OBJECTIVE: To estimate and compare the prevalence and associated bother of lower urinary tract symptoms (LUTS) in the general populations of the USA, UK and Sweden using current International Continence Society (ICS) definitions, as no previous population-based studies evaluating the prevalence of LUTS in the USA, using the 2002 ICS definitions, have been conducted. SUBJECTS AND METHODS: This cross-sectional, population-representative survey was conducted via the Internet in the USA, the UK and Sweden. Members of Internet-based panels were randomly selected to receive an e-mailed invitation to participate. If interested, respondents selected a link to an informed consent page, followed by the survey. Participants were asked to rate how often they experienced individual LUTS during the previous 4 weeks, on a five-point Likert scale, and, if experienced, how much the symptom bothered them. Descriptive statistics were used to summarize and present the data. RESULTS: Responses rates for the USA, the UK and Sweden were 59.6%, 60.6% and 52.3%, respectively, with a final sample of 30,000 (USA 20,000; UK 7500; Sweden 2500). The mean age (range) of the participants was 56.6 (40-99) years; the mean percentages for race were 82.9% white, 6.7% black, 6.0% Hispanic and 4.4% Asian/other. The prevalence of LUTS was defined by two symptom frequency thresholds, i.e. at least 'sometimes' and at least 'often' for all LUTS except incontinence, where frequency thresholds were at least 'a few times per month' and at least 'a few times per week'. The prevalence of at least one LUTS at least 'sometimes' was 72.3% for men and 76.3% for women, and 47.9% and 52.5% for at least 'often' for men and women, respectively. For most LUTS, at least half of the participants were bothered 'somewhat' or more using a frequency threshold of at least 'sometimes'. For a threshold of at least 'often', 'somewhat' or more bother was reported by > or =70% of participants except for terminal dribble in men and split stream in women. CONCLUSION: In this large population study of three countries, LUTS are highly prevalent among men and women aged >40 years. In general, LUTS experienced 'often' or more are bothersome to most people.

Asunto(s)

Prostatismo/epidemiología , Calidad de Vida , Trastornos Urinarios/epidemiología , Adulto , Anciano , Métodos Epidemiológicos , Femenino , Humanos , Internet , Masculino , Persona de Mediana Edad , Suecia/epidemiología , Reino Unido/epidemiología , Estados Unidos/epidemiología