Voiding patterns in men and women with lower urinary tract symptoms combined with nocturia

AIM: We evaluated differences between men and women with lower urinary tract symptoms (LUTS) combined with nocturia. METHODS: A total of 71 age-matched female-male pairs (median 58, range 20-81 years) who had moderate to severe LUTS and nocturia of more than once per night were enrolled in this study. RESULTS: In the younger group (<50 years), the International Prostate Symptom Score (I-PSS) results of the sexes were not significantly different. However, although total I-PSS results in the elderly group (> or =50 years) were not significantly different, quality of life index scores for women were higher (P = 0.002). On frequency-volume (FV) charts, mean total daytime voided volume (DVV) was significantly higher in younger men than in younger women (P = 0.017), but the mean nocturnal polyuria index (NPi) for women was higher than that for men (P = 0.047). However, maximum DVV (P = 0.009), mean DVV (P < 0.0001), total DVV (P < 0.0001), and mean nocturnal urine volume (P = 0.009) were significantly higher in elderly men than in elderly women. However, numbers of daytime voids were not different. CONCLUSION: Elderly women with LUTS have lower functional bladder capacities than elderly men, as suggested by their smaller mean voided volumes. However, no significant differences were observed between numbers of daytime voids, which was probably due to the smaller total daytime voided volumes of elderly women. In addition, although NPi for younger women and nocturnal urine volume for elderly men was higher, no other differences were observed in terms of other night-time parameters.     

Normal voiding patterns and determinants of increased diurnal and nocturnal voiding frequency in elderly men

PURPOSE: We determined the normal value of diurnal and nocturnal voiding frequency, and its determinants in a population based sample of elderly men. MATERIALS AND METHODS: We collected data on 1,688 men 50 to 78 years old recruited from the population of Krimpen, The Netherlands. Measurements consisted of self-administered questionnaires, including the International Prostate Symptom Score (I-PSS), a 3-day frequency-volume chart, transrectal prostatic ultrasound, uroflowmetry and post-void residual urine volume measurement. RESULTS: Diurnal voiding frequency is independent of age and more frequent in men with benign prostatic hyperplasia (BPH). Nocturia 2 or more times is present in 30% of men 50 to 54 and in 60% of those 70 to 78 years old, while nocturia 3 or more times is present in 4% and 20%, respectively. In addition, nocturia is strongly associated with BPH and nocturnal polyuria but apparently not with cardiovascular symptoms, hypertension or diabetes mellitus. We noted poor agreement of the responses on the frequency-volume charts and the I-PSS question on nocturia. Using the I-PSS leads to a higher prevalence of nocturia. CONCLUSIONS: Diurnal frequency is independent of age (median 5 voids, interquartile range 4 to 6) but higher in men with BPH. Nocturia increases with advancing age and is more frequent in men with nocturnal polyuria. BPH is an independent risk factor for nocturia and increased diurnal voiding frequency. In those with nocturia there is a great difference in subjective symptoms and objective data, indicating that the weight of the I-PSS question on nocturia for making treatment decisions should be reconsidered.     

瑜伽呼吸锻炼联合补肺益肾汤对慢性肺源性心脏病患者心脏功能及生活质量的影响

目的 探究瑜伽呼吸锻炼联合补肺益肾汤对慢性肺源性心脏病患者心脏功能及生活质量的影响.方法 选取医院收治的肺心病患者90例,按随机数字表法将其分为对照组45例和观察组45例.对照组给予常规治疗及护理干预,观察组在对照的基础上给予瑜伽呼吸锻炼联合补肺益肾汤,治疗1个月.观察两组患者心功能、肺功能及生活质量等.结果 与干预前...     

Urological symptoms among 23,240 men in the general danish population – concerns about symptoms,their persistence and influence on primary care contacts

Objective: To analyse possible associations between men’s likelihood of contacting a general practitioner (GP) for urological symptoms and the persistence of the symptoms, the influence on daily activities and the level of concern about the symptoms.

Design: Web-based nationwide cross-sectional questionnaire study.

Setting: The general population in Denmark.

Subjects: 48,910 randomly selected men aged 20+ years.

Main outcome measures: Urological symptom prevalence and odds ratios for GP contact with urological symptoms in regard to concern for the symptom, influence on daily activities and the persistence of the symptom.

Results: Some 23,240 men responded to the questionnaire, yielding a response rate of 49.8%. The prevalence of at least one urological symptom was 59.9%. Among men experiencing at least one urological symptom almost one-fourth reported contact to general practice regarding the symptom. Approximately half of the symptoms reported to be extremely concerning were discussed with a GP.

Conclusion: Increased symptom concern, influence on daily activities and long-term persistence increased the likelihood of contacting a GP with urological symptoms. This research points out that guidelines for PSA testing might be challenged by the high prevalence of urological symptoms.

• Key points

• ?The decision process of whether to contact the general practitioner (GP) is influenced by different factors, but contradictory results has been found in triggers and barriers for help-seeking with urological symptoms.

• ??Increased symptom concern, influence on daily activities and long-term persistence consistently increased the likelihood of contacting a general practitioner with urological symptoms in men.

• ??Only 50% of the symptoms reported to be extremely concerning were however discussed with the GP.

• ??Guidelines for PSA testing might be challenged by the high prevalence of urological symptoms.

     

多系统萎缩非运动症候的临床研究

目的总结多系统萎缩(multiple system atrophy,MSA)以非运动症候和运动症候为首发症状的构成比和MSA非运动症候的具体症候构成比。方法选择MSA患者31例,其中MSA-P型18例,MSA-C型13例。进行详细病史记录和神经系统体检,记录运动症候及非运动症候具体表现及出现时间。结果 23例MSA以非运动症候首发。非运动症候的首发症状以快速眼动睡眠异常、排尿障碍、性功能障碍及直立性低血压常见。31例MSA患者均有非运动症候表现。以直肠功能障碍(93.5%)、排尿障碍(90.3%)、直立性低血压(64.5%)、睡眠呼吸暂停(61.3%)、快速眼动睡眠异常(48.4%)最为常见。MSA-P型与MSA-C型在年龄、性别、首发病程、就诊病程及非运动症候构成比较,差异无统计学意义(P>0.05)。结论 MSA患者普遍存在自主神经功能障碍等非运动症候表现,且以首发症状多见。MSA-C型患者中以非运动症候起病较MSA-P型患者更为多见。     

医护合作门诊在帕金森病伴排尿障碍病人延续护理中的实践探索

[目的]介绍医护合作门诊在帕金森病伴排尿障碍病人中的应用效果。[方法]采用方便抽样法选取我院帕金森病伴排尿障碍病人90例,随机分为对照组和观察组,对照组实施常规护理,观察组实施医护合作门诊随访管理模式,强化医护合作的门诊指导。比较两组病人满意度、排尿功能及生活质量。[结果]出院后3个月及6个月,观察组病人夜间排尿次数、尿急评分低于对照组,观察组病人的生活质量运动功能、情感障碍、病耻感及社会交流各项评分均低于对照组,观察组病人满意度优于对照组,差异均有统计学意义(P<0.05)。[结论]医护合作门诊管理模式可改善帕金森病伴排尿障碍病人的排尿状况及生活质量,提高病人满意度。     

李中梓治疗泄泻学术思想探析

李中梓将湿邪作为泄泻的主要病因,并从理论和实践上进一步加以深化和完善,阐明了泄泻、湿邪、脾土三者之间的辨证关系.治疗上力主辨证求因、审因论治,总结出渗利、升提、清凉、疏利、甘缓、酸收、燥脾、温肾、固涩等治泻九法.