Association of baseline severity of lower urinary tract symptoms with the success conservative therapy for urinary incontinence in women
Association of baseline severity of lower urinary tract symptoms with the success conservative therapy for urinary incontinence in women
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DOI：
10.1007/s00192-018-3778-0
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发表时间：
2019-05-01
影响因子：
1.8
通讯作者：
Tincello, Douglas
中科院分区：
文献类型：
--
作者：
Obloza, Aneta;Teo, Roderick;Tincello, Douglas
引言和假设确定OAB、SUI和MUI的症状严重程度与保守治疗结局之间的相关性。对于膀胱过度活动症（OAB）、压力性尿失禁（SUI）和混合性尿失禁（MUI），推荐保守治疗。目前尚不清楚疾病的严重程度是否会影响治疗结果。疾病特异性问卷（OAB-q SF、ICIQ-UI SF）和膀胱日记记录基线症状。成功定义为患者改善总体印象问卷（PGI-I）回答“非常好”或“好得多”。结果在50例OAB患者中，成功与较低的症状严重程度[30（0-80）vs. 80（23-100），p=0.0001]，较少的紧迫性发作[4（0-12）vs. 6（0-11），p=0.032]和ICIQ-UI SF较低[5.5（0-20）vs. 15（0-21），p=0.002]，但QoL较高[67（20-101）vs. 24（6-58），p=0.0001]。在50例MUI患者中，变量为尿急发作次数较少[3（0-10）vs. 6（0-16），p=0.004]和ICIQ-UI较低[11（1-18）vs. 15（5-21），p=0.03]。在40例SUI患者中，变量为尿失禁发作次数较少[1（0-4）vs. 2（0-5），p=0.05]和ICIQ-UI较低[11（6-16）vs. 13.5（11-19），p=0.003]。多元回归证实OAB-q QoL [比值比（OR）1.10（95%置信区间1.04，1.1）] OAB，尿急发作[OR 0.74（0.56，0.98）]和ICIQ-UI [OR 0.83 ICIQ-UI [OR 0.57（0.40，0.83）]。结论基线疾病严重程度较轻与成功结局相关。对于不太可能取得成功的妇女，有可能在初步评估时将其分类到二线干预措施。
Introduction and hypothesis To identify the association between the symptom severity and outcome of conservative management for OAB, SUI and MUI. Conservative treatments are recommended for overactive bladder (OAB), stress urinary incontinence (SUI) and mixed incontinence (MUI). It is unclear whether disease severity affects treatment outcome.Methods Patients receiving conservative management were reviewed. Disease-specific questionnaires (OAB-q SF, ICIQ-UI SF) and bladder diaries recorded baseline symptoms. Success was defined by Patient Global Impression of Improvement questionnaire (PGI-I) response of "very much better" or "much better". Non-parametric statistical tests and logistic regression were used.Results In 50 OAB patients success was associated with lower symptom severity [30 (0-80) vs. 80 (23-100), p=0.0001], fewer urgency episodes [4 (0-12) vs. 6 (0-11), p=0.032] and lower ICIQ-UI SF [5.5 (0-20) vs. 15 (0-21), p=0.002], but higher QoL [67 (20-101) vs. 24 (6-58), p=0.0001]. In 50 MUI patients, variables were fewer urgency episodes [3 (0-10) vs. 6 (0-16), p=0.004] and lower ICIQ-UI [11 (1-18) vs. 15 (5-21), p=0.03]. In 40 SUI patients, variables were fewer incontinence episodes [1 (0-4) vs. 2 (0-5), p=0.05] and lower ICIQ-UI [11 (6-16) vs. 13.5 (11-19), p=0.003]. Multiple regression confirmed OAB-q QoL [odds ratio (OR) 1.10 (95% confidence intervals 1.04, 1.1)] for OAB, urgency episodes [OR 0.74 (0.56, 0.98)] and ICIQ-UI [OR 0.83 (0.71, 0.98] for MUI and ICIQ-UI [OR 0.57 (0.40, 0.83)] for SUI.Conclusions Milder baseline disease severity was associated with successful outcome. There is potential for triage at initial assessment to second-line interventions for women unlikely to achieve success.