The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.
TL;DR: The standardisation of terminology of lower urinary tract function: Report from the standardistation sub-committee of the International Continence Society.
Abstract: The standardisation of terminology of lower urinary tract function: Report from the standardistation sub-committee of the International Continence Society.
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TL;DR: The OABSS, the sum score of four symptoms (daytime frequency, nighttime frequency, urgency, and urgency incontinence), has been developed and validated and may be a useful tool for research and clinical practice.
584 citations
University of Alabama at Birmingham1, University of California, San Diego2, University of Pittsburgh3, Loyola University Chicago4, University of Utah5, Beaumont Hospital6, University of Texas at San Antonio7, University of Maryland, Baltimore8, University of Texas Southwestern Medical Center9, Kaiser Permanente10, National Institutes of Health11, Dartmouth College12
TL;DR: The 12-month rates of objectively assessed success of treatment for stress incontinence with the retropubic and transobturator approaches met the prespecified criteria for equivalence; the rates of subjectively assessed success were similar between groups but did not meet the criteria for interchange.
Abstract: Background Midurethral slings are increasingly used for the treatment of stress incontinence, but there are limited data comparing types of slings and associated complications. Methods We performed a multicenter, randomized equivalence trial comparing outcomes with retropubic and transobturator midurethral slings in women with stress incontinence. The primary outcome was treatment success at 12 months according to both objective criteria (a negative stress test, a negative pad test, and no retreatment) and subjective criteria (self-reported absence of symptoms, no leakage episodes recorded, and no retreatment). The predetermined equivalence margin was ±12 percentage points. Results A total of 597 women were randomly assigned to a study group; 565 (94.6%) completed the 12-month assessment. The rates of objectively assessed treatment success were 80.8% in the retropubic-sling group and 77.7% in the transobturator-sling group (3.0 percentage-point difference; 95% confidence interval [CI], −3.6 to 9.6). The r...
575 citations
TL;DR: The OAB-q demonstrates that both continent and incontinent OAB symptoms cause significant symptom bother and have a negative impact on HRQL.
Abstract: Objective: Overactive bladder (OAB) is characterized by symptoms of urinary frequency and urgency, with and without incontinence, and has been shown to have significant impact on health-related quality of life (HRQL) Currently, no OAB-specific questionnaires exist to evaluate all symptoms of OAB; thus we sought to evaluate the psychometric properties of a newly developed OAB HRQL questionnaire Methods: The 33-item, self-administered OAB-q contains a symptom bother and HRQL scale Both the OAB-q and SF-36 were completed by participants from two sources: (1) a community sample who screened positive for OAB in a random-digit dial telephone survey and participated in a clinical validation study (n = 254); and (2) a clinical study of patients' seeking treatment for OAB symptoms (baseline assessment) (n = 736) Item and exploratory factor analysis were performed to assess the subscale structure of the questionnaire Psychometric evaluation was conducted to assess reliability and validity Results: Seventy-four percent of the sample were women with mean age of 585 Participants with continent and incontinent symptoms reported significantly greater symptom bother and HRQL impact than normal participants Significant differences were present among all patient groups in all OAB-q subscales (p < 00001) except sleep where the impact of continent and incontinent OAB was similar, but significantly worse than normal participants (p < 00001) Internal consistency was high with the subscale Cronbach α-values ranging from 086 to 094 Conclusion: The OAB-q is a reliable and valid instrument that discriminates between normal and clinically diagnosed continent and incontinent OAB participants The OAB-q demonstrates that both continent and incontinent OAB symptoms cause significant symptom bother and have a negative impact on HRQL
563 citations
Cites background from "The standardisation of terminology ..."
...Overactive bladder (OAB) is characterized by the symptoms of urinary urgency and urge incontinence which are often associated with urinary frequency and nocturia, that appear without a local pathologic or metabolic explanation [1, 2]....
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TL;DR: Intramuscular injections of BTX-A into the detrusor can provide rapid, well tolerated, clinically significant decreases in the signs and symptoms of urinary incontinence caused by neurogenicdetrusor overactivity during a 24-week study period.
550 citations
TL;DR: Urinary incontinence is a prevalent cross‐cultural condition and future studies should rely on universally accepted standardized definitions to produce meaningful evidence‐based conclusions, as well as project the costs of this global healthcare problem.
529 citations
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TL;DR: A standard system of terminology recently approved by the International Continence Society, the American Urogynecologic Society, and the Society of Gynecologic Surgeons for the description of female pelvic organ prolapse and pelvic floor dysfunction is presented.
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TL;DR: This report contains a recommendation for a provisional standard method for defining obstruction on the basis of pressure-flow data and more detailed analyses of Pressure-flow relationships, described below, are advisable to aid diagnosis and to quantify data for research studies.
Abstract: textThe 1988 version of the collated reports on standardisation of terminology, which appeared in Neurourology and Urodynamics, vol. 7, pp. 403–427, contains material relevant to pressure flow studies in many different sections. This report is a revision and expansion of Sections 4.2 and 4.3 and parts of Sections 6.2 and 7 of the 1988 report. It contains a recommendation for a provisional standard method for defining obstruction on the basis of pressure-flow data.
2. Evaluation of Micturition
2.1. Pressure-Flow Studies
At present, the best method of analysing voiding function quantitatively is the pressure-flow study of micturition, with simultaneous recording of abdominal, intravesical and detrusor
pressures and flow rate (Fig. A.1.6.1).
Direct inspection of the raw pressure and flow data before, during and at the end of micturition is essential, because it allows artefacts and untrustworthy data to be recognised and eliminated. More detailed analyses of pressure-flow relationships, described below, are advisable to aid diagnosis and to quantify data for research studies.
The flow pattern in a pressure-flow study should be representative of free flow studies in the same patient. It is important to eliminate artefacts and unrepresentative studies before applying more detailed analyses.
Pressure-flow studies contain information about the behaviour of the urethra and the behaviour of the detrusor.
423 citations