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      The Value of Urodynamic Study for Diagnosing the Causes of Lower Urinary Tract Symptoms in Male Patients: A Study From Iran

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          Abstract

          Background

          Most disorders of the lower urinary tract are functional, so diagnoses are typically based on urodynamic findings. Treatment is likely to fail if the pathology is not correctly diagnosed.

          Objectives

          There are various diagnostic tests for lower urinary tract symptoms (LUTS). In this study, we evaluated the value of urodynamic testing to diagnose the causes of lower urinary symptoms in male patients.

          Patients and Methods

          Urodynamic tests were performed in 407 patients referred to the urology clinic in Baqiyatallah in 2014 with complaints of LUTS, and the diagnosis was based on the findings of the tests.

          Results

          The mean age of patients in this study was 50.88 years, and most patients were in their third decade (20 - 30 years of age). Urinary frequency (28.8%), enuresis (22.22%), and incontinence (16.12%) were the most common complaints. The most prevalent disorder was bladder sensation disorder.

          Conclusions

          Patients made various complaints, and several pathologies were diagnosed, which emphasizes the importance of using urodynamic tests for subsequent medical approaches as a non-invasive, accessible, and inexpensive tool.

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          Most cited references23

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          The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study.

          Karin S Coyne, Chris C Sexton, Christine L Thompson … (2009)
          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. 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. 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. 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.
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            Reviewing the ICS 2002 terminology report: the ongoing debate.

            Paul Abrams, , P Kerrebroeck … (2008)
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              Pharmacological treatment of overactive bladder: report from the International Consultation on Incontinence.

              R H Chapple, Cara Tannenbaum, Linda Cardozo … (2009)
              Treatment options for the overactive bladder were recently discussed at the 4th International Consultation on Incontinence (ICI) held in Paris, 5-8 July 2008. This article will overview current thoughts on the pharmacological and clinical basis for the different classes of drugs currently used for the treatment of lower urinary tract symptoms/overactive bladder syndrome/and detrusor overactivity. Individual drugs are not discussed in detail; particular consideration is given to therapeutic aspects of the management of the elderly patient. An extensive literature review confirms the rationale for using antimuscarinic drugs, and that the currently used drugs are efficacius with an acceptable tolerability and safety. In patients resistant to antimuscarinics, botulinum toxin may be an alternative--the vanilloids resiniferatoxin and capsaicin have very limited use. New therapeutic options with positive proof-of-concept studies, but with limited clinical experience, are beta3 adrenoceptor agonists and phosphodiesterase type 5 inhibitors. Positive signals have been found for other classes of drugs (e.g., gonadotropin-releasing hormone antagonists, neurokinin receptor-1 antagonists), but available information is not sufficient for proper assessment. Antimuscarinic drugs remain the first-line treatment of the overactive bladder and a favorable efficacy/tolerability-safety ratio can be confirmed. Promising new alternatives are emerging and future controlled studies will decide their place in the therapeutic arsenal.
              Article 0 comments Cited 29 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Nephrourol Mon
                Journal ID (iso-abbrev): Nephrourol Mon
                Journal ID (doi): 10.5812/numonthly
                Journal ID (publisher-id): Kowsar
                Title: Nephro-urology Monthly
                Publisher: Kowsar
                ISSN (Print): 2251-7006
                ISSN (Electronic): 2251-7014
                Publication date (Electronic): 10 May 2016
                Publication date Collection: July 2016
                Volume: 8
                Issue: 4
                Electronic Location Identifier: e34342
                Affiliations
                [1 ]Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
                Author notes
                [* ]Corresponding author: Alireza Ghadian, Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-2181262073, Fax: +98-2181262073, E-mail: p_ghadian@ 123456yahoo.com
                Article
                DOI: 10.5812/numonthly.34342
                PMC ID: 5039782
                SO-VID: 35a8235e-b82d-45c6-aaea-0b4325a2a386
                Copyright © Copyright © 2016, Nephrology and Urology Research Center
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                Date received : 03 November 2015
                Date revision received : 23 February 2016
                Date accepted : 06 April 2016
                Categories
                Subject: Research Article

                Keywords: urodynamic,lower urinary tract symptom,voiding disorders
                Data availability:
                Keywords: urodynamic, lower urinary tract symptom, voiding disorders

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