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1.
目的:分析青年女性人群下尿路症状(LUTS)的发病率和相关影响因素。方法:对广东省深圳市某社区青年女性人群进行随机抽样问卷凋查(问卷设计参考女性下尿路症状国际尿失禁标准问卷(ICIQFLUT)、国际前列腺状问卷(IPSS)布里斯托女性下尿路症状(BFLUTS)问卷及生活质量(QoL)等],根据具体情况进行调整。问卷由被调查者独立填写。结果:调查共发出问卷1500份,回收有效问卷1387份。储尿症状总患病率为91.2%,随年龄的增加,总储尿症状患病率呈增高趋势(P〈0.01),与年龄和分娩方式有关;排尿症状总患病率为65.2%,随年龄的增加,总储尿症状患病率呈增高趋势(P〈0.01),与生育情况、分娩方式以及文化水平有关。受调查者以刺激症状和梗阻症状的生活质量进行评分,分别为(2.87±1.32)分和(2.23±1.05)分;刺激症状和梗阻症状与生活质量评分的关联系数分别为0.51和0.23。结论:青年女性人群中的LUTS患病率很高,且不同程度影响青年女性的生活质量。  相似文献   

2.
OBJECTIVE: To identify health problems associated with lower urinary tract symptoms (LUTS) in an older female population. DESIGN: Population-based cross-sectional survey. SETTING: Third wave for the Tampere Longitudinal Study on Ageing (TamELSA) in 1999-2000. SUBJECTS: A total of 203 women aged 70 years and over. MAIN OUTCOME MEASURES: LUTS categorized as urge symptoms only, voiding symptoms only, and urge and voiding symptoms combined. The health indicators were polypharmacy (> 3 medications), use of sleeping medication, constipation, treated urinary tract infections (UTIs), and neurological, cardiovascular, and musculoskeletal diseases. RESULTS: Of the respondents 16% reported urge symptoms, 22% voiding symptoms, and 26% combined symptoms. In the multinomial logistic regression models, constipation and musculoskeletal diseases were significantly associated with voiding symptoms (OR 4.33; 95% CI 1.62-11.57 and OR 5.25; 95% CI 1.94-14.18, respectively) and with combined symptoms (OR 4.33; 95% CI 1.67-11.21 and OR 2.84; 95% CI 1.17-6.89, respectively). UTIs (OR 2.78; 95% CI 1.09-7.08) were associated with combined symptoms. CONCLUSIONS: Voiding symptoms comprise a significant part of lower urinary tract symptomalogy in older women. Although constipation, musculoskeletal diseases, and UTIs are the main health problems associated with LUTS, other concomitant diseases and medications also need to be assessed in older female patients with LUTS.  相似文献   

3.
A gap between experiencing symptoms and receiving effective treatment persists for people with lower urinary tract symptoms (LUTS), even for those who seek health care. In order to better understand how patients experience treatment seeking for LUTS, we interviewed a racially diverse sample of 90 men and women with a range of LUTS about their experiences seeking care. Thematic analysis revealed that patients often disclosed urinary symptoms first to primary care providers during a general examination or a visit for another health problem. Patients seek provider assistance typically when symptoms have intensified or are causing worry, and a desire for treatment trumps potential embarrassment; among women patients, feeling comfortable with a provider also is important for disclosing LUTS.  相似文献   

4.
How can nurses assess the self-management of lower urinary tract symptoms (LUTS) in patients with cancer after radical prostatectomy (RP)? Patients with prostate cancer who have undergone RP experience multiple LUTS. This study aimed to develop a self-management scale for LUTS in patients with cancer following RP (SMS-LUTS-RP), as well as to verify its reliability and validity. LUTS has physical, social, and psychological consequences for patients. As a result, patients are forced to self-manage their LUTS and LUTS-related issues. However, no indicators exist to assess self-management of LUTS. A total of 246 individuals were surveyed. A 49-item scale draft, whose content validity and face validity were confirmed, was used to develop a questionnaire for patients with LUTS after RP. The reliability and validity were determined using by item analysis, exploratory factor analysis, confirmatory factor analysis, and Cronbach's α coefficient. The exploratory factor analysis produced the following 18 items on five extracted factors: ‘monitoring of urinary status,’ ‘coping with daily life difficulties due to LUTS,’ ‘collaboration with medical professionals,’ ‘continued training to improve LUTS,’ and ‘living with LUTS.’ The goodness-of-fit-index (GFI) for confirmatory factor analysis was 0.876, and the root mean square error of approximation was 0.075. Cronbach's α coefficient was 0.754–0.820. SMS-LUTS-RP has desirable psychometric properties and can assess the cognitive and behavioural aspects of self-management of LUTS in patients with cancer who have undergone a RP. This scale can be used to provide individualized self-management support according to living conditions.  相似文献   

5.

Background

Previous studies about the prevalence and impact of lower urinary tract symptoms (LUTS) were focused on urinary incontinence or overactive bladder in the general population. Little research has been focused on the role that the workplace has in employed women's experiences with LUTS or the impact of LUTS on their health-related quality of life (HRQL).

Objectives

To estimate the prevalence of LUTS among employed female nurses in Taipei and to compare the HRQL for nurses with and without LUTS.

Design

This study was a cross-sectional, questionnaire survey.

Settings

Three medical centers and five regional hospitals in Taipei were selected randomly.

Participants

In the selected hospitals, 1065 female nurses were selected randomly. Data analyses were based on 907 usable surveys. All participants were native Taiwanese; most of the female nurses were 26-35 years of age (mean = 31.02, SD = 6.32), had normal body mass index, and had never given birth. Most nurses’ bladder habits were poor or very poor and their personal habits of fluid consumption at work were inadequate.

Methods

Data were collected using the Taiwan Nurse Bladder Survey and the Short Form 36 Taiwan version. Chi-square tests were used to compare the prevalence rates of different LUTS for nurses in different age groups. Student's t-tests were conducted to compare the mean scores of HRQL for nurses with and without LUTS.

Results

Based on 907 usable surveys, 590 (65.0%) experienced at least one type of LUTS. The prevalence for different LUTS ranged from 8.0% to 46.5%. Nurses who reported LUTS also reported lower HRQL, more so on physical health than mental health, than nurses who did not report LUTS.

Conclusions

Although most of the nurses in this study were young (≦35 years) and nulliparous, LUTS were common among this group. The high prevalence rate of LUTS leads to concerns about nurses’ possible dysfunctional voiding patterns and possible effects of working environment and poor bladder and personal habits on LUTS. Study results showed a possible negative impact of LUTS on nurses’ physical health. Designing a continence-related education program for this group is essential for delivering information about LUTS prevention and management.  相似文献   

6.
Benign prostatic hyperplasia is a common cause of urinary flow obstruction in aging men and may lead to lower urinary tract symptoms (LUTS). Benign prostatic hyperplasia has 2 physiological components: a static component related to increased prostate size and a dynamic component related to increased prostate smooth muscle tone. alpha1-Adrenoceptors (alpha1ARs) maintain prostate smooth muscle tone; hence, alpha1-antagonists (blockers) relax prostate smooth muscle and decrease urethral resistance, ultimately leading to relief of LUTS. This review focuses on alpha1AR subtypes and their location in lower urinary tract tissues involved in LUTS (prostate, bladder, spinal cord); it also summarizes major clinical trials published to date on the efficacy of alpha1AR blockers for LUTS. Benefits and adverse effects of clinically available alpha1AR antagonists are reviewed, followed by recent information on interactions between alpha1AR subtype antagonists and type 5 phosphodiesterase inhibitors used for impotence. alpha1-Adrenoceptor antagonists have become the mainstay of therapy for LUTS; knowledge about specific alpha1AR subtypes should facilitate rational choice of alpha1AR blocker therapy by clinicians.  相似文献   

7.
Aim: The purpose of this study was to clarify changes in lower urinary tract symptoms (LUTS) before and after the use of indwelling urethral catheters. Methods: Subjects were 39 inpatients (13 males and 26 females) who underwent laparoscopic cholecystectomy. Lower urinary tract symptoms was measured by using the International Prostate Symptom Score (IPSS). Demographic variables, abdominal pain, quality of life (QOL), and anxiety were also measured. Results: On admission, 84.6% (n = 36) of subject had LUTS, and 71.8% (n = 28) of subject still had LUTS even after use of the catheter. We found no correlation between LUTS and physical or psychological factors. Quality of life because of urinary symptoms was poor in patients with LUTS. After the use of catheters, IPSS decreased (P < 0.01), and in six cases, subjects exhibited intensified LUTS. Conclusions: The IPSS score significantly decreased in this group of participants after the removal of the indwelling urethral catheter. However, we must assess the LUTS of all patients who did or do not have a chief urinary compliant when the indwelling urethral catheter is/was used because there were many inpatients with LUTS, and the QOL because of LUTS was low in patients. Moreover, there were six patients whose symptoms of LUTS deteriorated after the use of a catheter. We could not find the causes of worsening symptoms of LUTS. It is necessary to investigate the long‐term effects following the use of the indwelling urethral catheter. In future, we have to thoroughly examine patients with severe LUTS and other diseases, which require essential treatment.  相似文献   

8.
Aims: This study investigated the influence of sociodemographic and lifestyle factors on the lower urinary tract symptom (LUTS) self‐perception period and International Prostate Symptom Score. Method: This cross‐sectional study examined 209 men aged ≥ 40 years with non‐treated LUTS who participated in a prostate examination survey. Questions included International Prostate Symptom Score (IPSS) items with self‐perception periods for each item. Sociodemographic and lifestyle factors were also assessed. Participants were divided by mild LUTS (IPSS less than 8) and moderate‐to‐severe LUTS (IPSS 8 or higher). Results: Self‐perception period of the moderate‐to‐severe LUTS (n = 110) was affected by BMI; the self‐perception period of the mild LUTS (n = 90) was affected by age, income, occupation and concomitant disease. Moderate‐to‐severe LUTS were affected by self‐perception period (p = 0.03). Self‐perception period was affected by concern for health (p = 0.005) by multivariate analysis, and self‐perception period of mild LUTS was affected by BMI (p = 0.012). Moderate‐to‐severe LUTS were affected by age, number of family members, concern for health and drinking (p < 0.05, respectively) by multivariate analysis. Conclusion: Lower urinary tract symptom was affected by self‐perception period. In moderate‐to‐severe LUTS, age, concern for health and drinking were affecting factors of self‐perception period.  相似文献   

9.
10.
Introduction: Lower urinary tract symptoms (LUTS) affect 18–26% of men aged 40–79 years, many of whom present with a fear of having cancer. Current guidelines for the assessment of LUTS focus mainly upon benign prostatic hypertrophy. It has been our practice to perform an abdominal ultrasound scan (USS), a prostate‐specific antigen (PSA) blood test and urine cytology during the assessment of males presenting with LUTS to investigate the alternative potentially life‐threatening causes for LUTS. We report on the added value of these tests during the assessment of men with LUTS. Results: A total of 263/3976 (6.6%) patients investigated for LUTS were found to have incidental urological malignancies, urinary tract calculi or abdominal aortic aneurysms (AAA). Abdominal USSs resulted in the incidental diagnosis of four renal carcinomas (0.1%), 45 AAAs (incidence = 1.1%) and 44 urinary tract calculi (1.1%). Urine cytology testing and bladder USSs helped diagnose 17 new bladder cancers (0.4%), five of which did not present with haematuria. Patients found to have an elevated age‐specific PSA had a 23.6% chance of being diagnosed with prostate cancer (3.8%). Conclusion: The addition of abdominal ultrasound scanning, urine cytology and PSA testing as part of an LUTS assessment protocol can help to diagnose significant, potentially life‐threatening conditions in up to 6.6% of patients. While the pick up rate of each individual condition is not higher in the LUTS patient than in the general population, the combined pick up rate may justify these additional investigations.  相似文献   

11.
Lowe FC 《Clinical therapeutics》2004,26(11):1701-1713
BACKGROUND: Although initially introduced for the management of hypertension, alpha(1)-adrenergic-receptor antagonists (alpha1-blockers) have become the standard of care for the medical management of benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS). However, these agents have the potential to produce orthostatic hypotension and other blood pressure-related adverse effects in normotensive patients and in those receiving concurrent treatment with other antihypertensive agents. As a result, more "uroselective," less vasoactive alpha(1)-blockers have been developed. OBJECTIVE: This article reviews current information on the role of alpha(1)-blockers in the treatment of BPH-related LUTS. The focus is on tamsulosin and alfuzosin, newer "uroselective" agents in this class that have a decreased potential for cardiovascular adverse effects. METHODS: Relevant articles were identified through a search of the English-language literature indexed on MEDLINE and the proceedings of scientific meetings from 1976 to 2003. The search terms were benign prostatic hyperplasia treatment, alpha(1)-adrenergic-receptor blocker, uroselectivity, lower urinary tract symptoms, complications, and cardiovascular. RESULTS: Tamsulosin has selectivity for the a alpha(1) and alpha(1d) receptor subtypes. Alfuzosin, although not receptor subtype selective, is clinically "uroselective" and does not significantly affect vascular alpha-adrenergic receptors. Both agents are efficacious in relieving LUTS and have a decreased potential for such cardiovascular adverse effects as postural hypotension. Common adverse events with these agents include dizziness and asthenia. CONCLUSION: Based on the available data, "uroselective" alpha(1)-blockers should be considered over older, more vasoactive agents for the medical management of LUTS, particularly in patients with BPH and hypertension.  相似文献   

12.
Benign prostatic hyperplasia (BPH) is one of the most common conditions affecting middle-aged men. This condition can be microscopic, macroscopic, symptomatic, or asymptomatic. Up to 15% to 25% of men aged 50–65 years have lower urinary tract symptoms (LUTS) consisting of nocturia, urgency, frequency, a sensation of not completely emptying the bladder, stop-start urination, straining to urinate, a need to urinate soon after voiding, and weak urinary stream. These symptoms usually are associated with benign enlargement of the prostate gland that is of sufficient severity to interfere with a man’s quality of life. Although LUTS is often associated with BPH, LUTS can also be due to various unrelated syndromes such as heart failure, urinary tract infections, and diabetes. Most men will have benign hyperplasia of the prostate gland and this benign growth compresses the urethra resulting in LUTS. This article will discuss the evaluation, pharmacological management, minimally invasive treatment, and surgical therapy of this common condition affecting millions of American men.  相似文献   

13.
The neurological control of the lower urinary tract is mainly due to the autonomic nervous system (ANS), however, this one remains often unexplored in the analysis of lower urinary tract symptoms (LUTS). The analysis of the ANS function is simple to accomplish by means of cardiovascular tests such as the 30: 15 ratio or the blood pressure response to standing. The disturbance of two tests confirms an autonomic dysfunction, with a peripheral origin (e.g. diabetes) or with a central origin.  相似文献   

14.
Two articles appeared in the November 2012 edition of the journal evaluating aspects relating to the use of two important pharmacotherapeutic classes for lower urinary tract symptoms (LUTS) in real life clinical practice (1,2). LUTS is a non‐specific term that encompasses urine storage, voiding and postmicturition symptoms (3). LUTS is a common bothersome problem affecting both men and women with a comparable prevalence in age‐matched patients of both sexes that increases with ageing (4,5).  相似文献   

15.
PURPOSE: Men with lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia often do not discuss their symptoms with their primary care physicians (PCPs). The primary objectives of this study were to estimate the prevalence of LUTS, prostate enlargement, and prostate-specific antigen (PSA) > or = 1.5 ng/ml in men visiting their PCP and to assess patients' intent to discuss LUTS with their PCP. METHODS: Men over age 50 presenting for a routine office visit at one of six PCP offices during the 8-week data collection period were invited to participate in this cross-sectional study. Men with prostate cancer, bladder cancer, indwelling urethral catheter or previous pelvic irradiation were excluded. Four hundred and forty-four men were enrolled and completed a self-administered questionnaire [including the International Prostate Symptom Score (IPSS)], provided a blood sample for PSA, and underwent a digital rectal examination (DRE), with the prostate classified as enlarged or non-enlarged by their PCP. RESULTS: Forty-two per cent of men had IPSS > 7; 48% had an enlarged prostate based on DRE and 43% had PSA > or = 1.5 ng/ml. Twenty-nine per cent (n = 129) of men had IPSS > 7 and enlarged prostate or PSA > or = 1.5 ng/ml. Of these men, 33% (n = 42) intended to discuss their symptoms with their PCP. CONCLUSIONS: Although a significant percentage of men in this older population had enlarged prostate and LUTS, only one-third of them intended to discuss their symptoms with their physician. PCPs may need to increase efforts to detect LUTS and enlarged prostate in older men.  相似文献   

16.
AIMS: Lower urinary tract symptoms (LUTS) are categorised as storage (urgency, frequency, nocturia and incontinence), voiding (sensation of incomplete emptying, hesitancy, weak stream and straining) or mixed symptoms. METHODS: In this US population-based study, we investigated the prevalence of male LUTS and the relative frequency of the LUTS subtypes, and we evaluated associations between LUTS and age, race/ethnicity and erectile dysfunction (ED). The Male Attitudes Regarding Sexual Health study included a nationally representative sample of non-Hispanic black, non-Hispanic white and Hispanic men aged>or=40 years. Participants completed a questionnaire including items on ED and the International Prostate Symptom Score (IPSS). The prevalence and subtypes of LUTS were investigated post hoc by age, race/ethnicity and the presence of ED. RESULTS: The overall prevalence rates of storage (13%) and mixed (9%) symptoms were higher than that of voiding symptoms (6%). The prevalence of storage symptoms was similar across age groups, whereas voiding and mixed symptoms increased with age. Among men with IPSS>or=8, the rates of storage (29%) and mixed (38%) symptoms were also higher than voiding symptoms (23%). Distributions of the LUTS subtypes were comparable among black, white and Hispanic respondents with IPSS>or=8. The overall prevalence rate of ED (40%) increased with age among those with IPSS>or=8. Isolated storage symptoms were more than twice as common as isolated voiding symptoms among US men>or=40 years of age. CONCLUSION: Careful attention to individual symptoms may help distinguish storage LUTS from voiding LUTS, a distinction that has important implications for treatment.  相似文献   

17.
OBJECTIVES: To evaluate the cross-sectional association between lower urinary tract symptoms (LUTS) severity and sexual function in a population-based sample of men and the extent to which this association might be explained by age. SUBJECTS AND METHODS: Subjects in The Olmsted County Study of Urinary Symptoms and Health Status Among Men (55% participation rate) included 2115 white men aged 40 to 79 years; subjects were recruited on January 1, 1990, from a random sample identified through the Rochester Epidemiology Project. At baseline in 1990 and biennially thereafter, these men completed a self-administered questionnaire that assessed LUTS severity with questions similar to those of the American Urological Association Symptom Index. At the 6-year follow-up, 11 previously validated questions about male sexual function from the Brief Sexual Function Inventory were added. RESULTS: Overall, each of the sexual function domains (sexual drive, erectile function, ejaculatory function, problem assessment, and overall sexual satisfaction) was inversely associated with the severity of LUTS, with Spearman correlation coefficients ranging from -0.21 to -0.31 (all P<.001). In age-adjusted analyses, the ejaculatory function and problem assessment domains were most strongly associated with overall LUTS severity, whereas the association with sexual drive was substantially diminished. Little difference was noted in the magnitude of association between sexual function and either obstructive or irritative symptoms. CONCLUSIONS: The cross-sectional data suggest that sexual function is inversely associated with LUTS severity and that this association is only partially attributable to the confounding effects of age.  相似文献   

18.
氯胺酮导致下尿路症状是一种由于长期吸食氯胺酮导致的一种以尿频、尿急、夜尿增多伴有耻骨上疼痛的综合征。近几年临床工作者开始重视氯胺酮对于泌尿系统的损害,开展了一系列调查和研究,包括对发病机制、病理特点、治疗方案的研究。但该病的病因、命名和诊断仍不清楚,治疗多为对症治疗。本文检索了近年来发表的相关文献,以探究氯胺酮导致下尿路症状。  相似文献   

19.
BACKGROUND: Benign prostatic hyperplasia (BPH) is a common disorder in older men and may be associated with lower urinary tract symptoms (LUTS) and sexual dysfunction. Men who present with symptomatic BPH and LUTS are at increased risk for sexual dysfunction, including erectile dysfunction (ED) and ejaculatory dysfunction (EjD). OBJECTIVE: This review describes treatment options recommended by the 2003 American Urological Association (AUA) guideline panel for the relief of LUTS associated with BPH, with a focus on the effects of each treatment on ED and EjD. METHODS: Relevant articles were identified via MEDLINE searches of all English-language articles published from January 1984 to January 2005 using the following search terms: benign prostatic hyperplasia and sexual dysfunction, lower urinary tract symptoms and sexual dysfunction, alfuzosin, doxazosin, terazosin, tamsulosin, dutasteride, finasteride, transurethral resection of prostate, erectile dysfunction, and ejaculatory dysfunction. Data on the effects of BPH treatments on sexual function were extracted from the articles and summarized. Because properly designed, adequately powered, direct-comparator studies have not yet been conducted, the AUA's report provides the most comprehensive analyses regarding the efficacy and safety of the current BPH treatment options. RESULTS: LUTS are an independent risk factor for sexual dysfunction in aging men, even after controlling for age and comorbidities. Although surgery, minimally invasive therapies, and pharmacologic therapies can all improve LUTS and the peak urinary flow rate, some can cause or exacerbate ED (incidence rates: surgery, 10%; minimally invasive therapies, 1%-3%; pharmacologic monotherapy or combination therapy, 3%-10%) and EjD (incidence rates: surgery, 65%; minimally invasive therapies, 4%-16%; pharmacologic monotherapy or combination therapy, 0%-10%). Among pharmacologic therapies for BPH, the frequency of EjD appears to be greater with tamsulosin (10%) than with other alpha(1)-blockers (0%-1%) or the 5alpha-reductase inhibitor finasteride (4%), based on data from a single-arm meta-analysis conducted by the AUA. CONCLUSION: Sexual function should be assessed and discussed with the patient when contemplating the appropriate management strategy for LUTS associated with BPH, as well as when evaluating the patient's response to treatment.  相似文献   

20.
BackgroundUnhealthy toileting behaviours exist among women, and lower urinary tract symptoms have a high prevalence and significant effects on quality of life. However, the relationship between toileting behaviours and lower urinary tract symptoms is unclear.ObjectivesThis study aimed to investigate the prevalence of lower urinary tract symptoms among female nurses, and the association between toileting behaviours and lower urinary tract symptoms.DesignA cross-sectional stratified cluster sampling study.ParticipantsA total of 636 female clinical nurses from tertiary hospitals in Jinan (the capital city of Shandong Province, China).MethodsThe Toileting Behaviour-Women’s Elimination Behaviours and the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms scales were used to assess the participants’ toileting behaviours and lower urinary tract symptoms, respectively. Multiple linear regression analysis was used to evaluate the association between toileting behaviours and lower urinary tract symptoms.ResultsUnhealthy toileting behaviours were common among the female nurses, with delayed voiding being the unhealthiest toileting behaviour, which was followed by place and position preference for voiding. Nearly 68% of the female nurses had at least one lower urinary tract symptom, nearly 50% had incontinence symptoms, 40% had filling symptoms, and 18% had voiding symptoms. Unhealthy toileting behaviours (premature voiding, delayed voiding, and straining to void) were positively associated with lower urinary tract symptoms. However, lower urinary tract symptoms were not significantly associated with voiding place or position preference. Among the control variables, being married or having a history of a urinary tract infection was associated with lower urinary tract symptoms. Having a higher income and regular menstrual period were negatively associated with lower urinary tract symptoms. Compared with vaginal delivery, caesarean delivery had a protective association with lower urinary tract symptoms.ConclusionLower urinary tract symptoms among female nurses should not be overlooked, because their prevalence among female clinical nurses exceeded that among the general population of women. These findings highlight the importance of avoiding unhealthy toileting behaviours (especially premature voiding, delayed voiding, and straining to void), as these unhealthy toileting behaviours were significantly associated with susceptibility to lower urinary tract symptoms.  相似文献   

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