LUTS: Lower Urinary Tract Symptoms最新文献_第3页

Prescription Trends of Initial Pharmacotherapy for Benign Prostatic Hyperplasia Among Treatment-Naïve Patients in South Korea: A Retrospective Analysis 韩国Treatment-Naïve良性前列腺增生患者初始药物治疗处方趋势：回顾性分析

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-09-05 DOI: 10.1111/luts.70030

Yeon Hee Kim, Nam Kyung Je

Background

Benign prostatic hyperplasia (BPH) is a common urological condition in aging men that causes lower urinary tract symptoms. Pharmacotherapy is central to BPH management; however, considering updated guidelines, recent prescription trends remain insufficiently explored. This study aimed to assess initial pharmacotherapy trends in patients newly diagnosed with BPH.

Methods

This cross-sectional analysis used 2015–2020 data from the Health Insurance Review and Assessment Service to examine the trends and influencing factors of BPH drug utilization among South Korean patients aged ≥ 40 years with no prior history of BPH. Subgroup analyses were performed by categorizing patients into five age groups (40–49, 50–59, 60–69, 70–79, and ≥ 80 years) to evaluate age-specific prescription patterns.

Results

Of the 1,445,144 patients newly diagnosed with BPH, 1,336,695 (92.4%) initiated treatment within 60 days of diagnosis. Among those treated, 54.9% received α-blocker (AB) monotherapy and 17.9% received 5α-reductase inhibitor (5-ARI)/AB combinations. Use of 5-ARI/AB combinations increased with age, from 8.0% in patients in their 40s to 25.4% in those aged ≥ 80 years. Tamsulosin (a selective AB), dutasteride (a 5-ARI), and mirabegron (a β3-agonist) were the most frequently prescribed agents.

Conclusion

Recent American Urological Association (AUA) guidelines recommend combination therapy as an effective strategy for reducing the risk of BPH-related complications. Although the largest proportion of patients was prescribed AB monotherapy, the growing adoption of combination therapy in South Korea, particularly among older age groups, suggests a shift toward more guideline-concordant and effective therapeutic approaches.

背景：良性前列腺增生（BPH）是老年男性常见的泌尿系统疾病，可引起下尿路症状。药物治疗是BPH管理的核心；然而，考虑到最新的指南，最近的处方趋势仍然没有得到充分的探讨。本研究旨在评估新诊断的前列腺增生患者的初始药物治疗趋势。方法采用2015-2020年健康保险审查与评估服务（Health Insurance Review and Assessment Service）的数据进行横断面分析，研究年龄≥40岁、无前列腺增生史的韩国患者前列腺增生药物使用趋势及影响因素。亚组分析通过将患者分为5个年龄组（40-49岁、50-59岁、60-69岁、70-79岁和≥80岁）来评估年龄特异性处方模式。结果在1445144例新诊断的BPH患者中，1336695例（92.4%）在诊断后60天内开始治疗。在接受治疗的患者中，54.9%接受α-受体阻滞剂（AB）单药治疗，17.9%接受5α-还原酶抑制剂(5-ARI)/AB联合治疗。5-ARI/AB联合用药的使用随着年龄的增长而增加，从40岁患者的8.0%增加到≥80岁患者的25.4%。坦索罗新（一种选择性AB）、度他雄胺（一种5-ARI）和米拉贝龙（一种β3激动剂）是最常用的处方药物。结论近期美国泌尿学会（AUA）指南推荐联合治疗作为降低前列腺肥大相关并发症风险的有效策略。尽管最大比例的患者使用单方单方治疗，但韩国越来越多地采用联合治疗，特别是在老年群体中，这表明朝着更符合指南和更有效的治疗方法的转变。

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引用次数: 0

A Comparison of Spinal Alignment and Trunk Mobility in Parkinson's Disease Patients With and Without Lower Urinary Tract Symptoms 有和无下尿路症状的帕金森病患者脊柱直线和躯干活动度的比较

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-09-03 DOI: 10.1111/luts.70028

Betül Kuz, Mustafa Ertuğrul Yaşa, Rıza Sonkaya, Selman Aktaş

Introduction

Lower urinary tract symptoms (LUTS) in Parkinson's disease (PD) primarily result from neurological abnormalities. Yet, the impact of postural abnormalities and muscular rigidity on lower urinary tract symptoms remains unclear. This study aims to compare spinal alignment and trunk mobility in PD patients with and without LUTS.

Methods

A total of 93 patients were included in this cross-sectional study. Two groups were created based on the presence of LUTS. The study was completed with 57 symptomatic and 36 asymptomatic patients. The presence of LUTS was determined using the International Prostate Symptom Score. The Urinary Symptom Profile questionnaire was used for LUTS classification. Spinal posture and trunk mobility were measured using the Spinal Mouse.

Results

Compared to the asymptomatic controls, decreased lumbar lordosis (p = 0.022) and increased anterior trunk tilt (p = 0.026) were evident in symptomatic patients. However, no significant differences were found in thoracic kyphosis or lateral spinal curvatures (p > 0.05). Asymptomatic patients demonstrated greater lumbar mobility and total trunk mobility in both the sagittal plane (p = 0.002; p = 0.023) and the frontal plane (p = 0.024; p = 0.046), respectively.

Conclusions

PD patients with LUTS demonstrate distinct alterations in spinal alignment and trunk mobility compared to those without symptoms. These biomechanical differences may reflect compensatory mechanisms or additional motor involvement contributing to urinary dysfunction in this population.

帕金森病（PD）的下尿路症状（LUTS）主要由神经系统异常引起。然而，姿势异常和肌肉僵硬对下尿路症状的影响尚不清楚。本研究旨在比较伴有和不伴有LUTS的PD患者的脊柱对齐和躯干活动度。方法对93例患者进行横断面研究。根据LUTS的存在创建了两组。57例有症状患者和36例无症状患者完成了研究。使用国际前列腺症状评分来确定LUTS的存在。泌尿症状问卷用于LUTS分类。使用脊髓鼠测量脊柱姿势和躯干活动度。结果与无症状对照组相比，有症状组腰椎前凸明显减小（p = 0.022），前干倾斜明显增加（p = 0.026）。然而，在胸椎后凸或脊柱侧弯方面没有发现显著差异（p > 0.05）。无症状患者在矢状面（p = 0.002; p = 0.023）和额位面（p = 0.024; p = 0.046）均表现出较大的腰椎活动度和躯干总活动度。结论：与无症状的PD患者相比，伴有LUTS的PD患者在脊柱对齐和躯干活动方面表现出明显的改变。这些生物力学差异可能反映了代偿机制或额外的运动参与导致了该人群的尿功能障碍。

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引用次数: 0

Systemic Immune-Inflammation Index and Neutrophil-To-Lymphocyte Ratio: U-Shaped Association With Overactive Bladder 全身免疫炎症指数和中性粒细胞与淋巴细胞比值：u型与膀胱过度活跃的关系

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-09-03 DOI: 10.1111/luts.70029

Qinglong Yang, Haolin Chen, Hanyuan Lin, Haoxian Tang, Nan Luo, Xuan Zhang, Jingtao Huang, Xuxia Sui, Qingtao Yang

Objectives

This study aims to examine the association of systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) with the prevalence of overactive bladder (OAB).

Methods

This cross-sectional study analyzed data from 22,343 participants (≥ 20 years) in the National Health and Nutrition Examination Survey (2005–2018). We applied weighted multivariate logistic regression, restricted cubic spline (RCS) regression, subgroup, and sensitivity analyses to assess the associations between SII, NLR, and OAB.

Results

RCS analysis revealed U-shaped relationships with inflection points at 6.13 for ln(SII) and 0.65 for ln(NLR). In the fully adjusted model, ln(SII) ≤ 6.13 showed a negative correlation with OAB (OR = 0.83; 95% CI: 0.70–0.99), while ln(SII) > 6.13 was positively correlated (OR = 1.32; 95% CI: 1.10–1.58). Similarly, ln(NLR) > 0.65 correlated positively with OAB (OR = 1.40; 95% CI: 1.16–1.71). Subgroup analyses revealed significant differences in alcohol use subgroups for ln(SII) ≤ 6.13 and ln(NLR) ≤ 0.65 (P for interaction < 0.05).

Conclusions

SII and NLR may serve as biomarkers for assessing OAB risk.

目的探讨全身免疫炎症指数（SII）和中性粒细胞与淋巴细胞比值（NLR）与膀胱过动症（OAB）患病率的关系。方法本横断面研究分析了2005-2018年全国健康与营养检查调查中22343名参与者（≥20岁）的数据。我们应用加权多元逻辑回归、限制性三次样条（RCS）回归、亚组和敏感性分析来评估SII、NLR和OAB之间的关系。结果RCS分析显示，ln（SII）和ln（NLR）与拐点呈u型关系，分别为6.13和0.65。在完全调整模型中，ln(SII)≤6.13与OAB呈负相关（OR = 0.83, 95% CI: 0.70-0.99）， ln(SII) >； 6.13呈正相关（OR = 1.32, 95% CI: 1.10-1.58）。同样，ln(NLR) >； 0.65与OAB呈正相关（OR = 1.40; 95% CI: 1.16-1.71）。亚组分析显示，在ln(SII)≤6.13和ln(NLR)≤0.65时，酒精使用亚组间存在显著差异（相互作用P < 0.05）。结论SII和NLR可作为评估OAB风险的生物标志物。

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引用次数: 0

Impact of Lower Urinary Tract Symptoms on Daily Life in Individuals With Co-Existence Overactive and Underactive Bladder, Overactive Bladder, and Underactive Bladder 膀胱过动与欠动、膀胱过动与欠动共存个体下尿路症状对日常生活的影响

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-08-10 DOI: 10.1111/luts.70026

Noritoshi Sekido, Kenji Omae, Nobuhiro Haga, Yasue Kubota, Motoaki Saito, Ryuji Sakakibara, Mikako Yoshida, Takahiko Mitsui, Naoya Masumori, Satoru Takahashi

Objectives

To explore the particular lower urinary tract symptoms (LUTS) that impact daily life in co-existent overactive and underactive bladder (COUB), overactive bladder (OAB), and underactive bladder (UAB) as symptom syndromes.

Methods

Using data from a nationwide, cross-sectional internet survey of adults aged ≥ 20 conducted in Japan, participants were categorized into COUB, OAB alone, UAB alone, and non-OAB/UAB groups according to the OAB symptom score and the provisional UAB definition of the International Continence Society working group. Participants were asked what symptoms affected their daily lives. The prevalence of LUTS and the particular LUTS affecting daily life were evaluated in each group.

Results

Substantial proportions of participants in all groups had increased daytime frequency and nocturia. Even in the male OAB alone group, the prevalence of voiding symptoms was substantial. In almost all of the groups, storage symptoms accounted for more than approximately 80% of the particular LUTS that had the greatest impact on daily life, and nocturia ranked first, except for the male OAB alone group, with a 32% rate of urgency.

Conclusions

Although multiple LUTS affected daily life in individuals with COUB and UAB, storage symptoms, particularly nocturia, are likely to have the greatest impact of LUTS on daily life in those not only with OAB but also with UAB and COUB.

目的探讨膀胱过动与欠动（COUB）、膀胱过动（OAB）、膀胱欠动（UAB）共存症状综合征中影响日常生活的特定下尿路症状（LUTS）。方法根据OAB症状评分和国际禁尿学会工作组的临时UAB定义，使用日本全国范围内20岁以上成年人的横断面网络调查数据，将参与者分为COUB组、单独OAB组、单独UAB组和非OAB/UAB组。参与者被问及哪些症状影响了他们的日常生活。评估各组的LUTS患病率和影响日常生活的特定LUTS。结果：所有组中有相当比例的参与者日间尿频和夜尿增多。即使在男性OAB组中，排尿症状的发生率也很高。在几乎所有组中，储存症状占对日常生活影响最大的特定LUTS的约80%以上，夜尿症排在第一位，除了男性OAB组，急症发生率为32%。结论：虽然多发性LUTS影响COUB和UAB患者的日常生活，但储存症状，特别是夜尿症，可能对不仅有OAB而且有UAB和COUB的患者的日常生活影响最大。

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引用次数: 0

Investigating the Antihyperplastic, Anti-Inflammatory and Antioxidant Properties of Cucurbita Pepo L. Seed Oil on Testosterone- Induced Benign Prostatic Hyperplasia (BPH) in Castrated Rat Model 研究瓜籽油对睾丸激素诱导的良性前列腺增生（BPH）模型大鼠的抗增生性、抗炎和抗氧化作用

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-08-05 DOI: 10.1111/luts.70024

Hajji Noura, Khémiri Ikram

Objective

The present study investigates the therapeutic potential of Cucurbita Pepo L. Seeds' Oil (CPSO) extracted by petroleum ether on testosterone-induced hyperplasia (BPH) in a castrated Wistar rat model.

Materials and Methods

Animals underwent two stages of treatment (28 days each): the testosterone treatment stage, to promote BPH, and the therapeutic stage, which consisted of an oral administration of CPSO. Forty-eight Wistar rats were equally divided into six groups: the negative control; groups 2–6 underwent a bilateral orchidectomy (induced via the scrotal route), then were redistributed into the castrated-control group and the castrated and testosterone-treated groups BPH induction (10 mg/kg). Twenty-eight days after BPH induction, the BPH rats were orally treated with Finasteride (FINA group: 5 mg/kg/d) and CPSO (CPSO-1 group: 40 mg/kg/d; CPSO-2 group: 80 mg/kg/d) for 28 additional days. Plasma biochemical parameters, circulating testosterone (T) and prostate-specific antigen (PSA), prostate oxidative markers, and inflammation were analyzed.

Results

CPSO administration exhibited a decrease in prostate weight, normalized the plasma total proteins, lipids, calcium and glucose, testosterone, and PSA levels, and attenuated the disturbances of liver and kidney functions in BPH rats. At the prostate level, CPSO showed a notably decreased prostate oxidation and inflammation. The histological study showed that CPSO restored prostatic lesions caused by BPH.

Conclusion

According to the present results, we suggest that CPSO could have a protective potential related to its proven anti-oxidant, anti-hyperplastic, and anti-inflammatory properties on preventing testosterone-induced BPH in castrated rats and might be used as an herbal remedy or nutraceutical agent in BPH management.

目的探讨石油醚提取葫芦籽油（CPSO）对阉割Wistar大鼠睾丸激素诱导增生症（BPH）的治疗作用。材料与方法动物分为两个治疗阶段（每个阶段28天）：睾酮治疗阶段，以促进BPH，治疗阶段，包括口服CPSO。48只Wistar大鼠平均分为6组：阴性对照组；2-6组行双侧睾丸切除术（经阴囊途径诱导），然后重新分为去势对照组和去势组和睾酮组BPH诱导（10 mg/kg）。BPH诱导28 d后，分别口服非那雄胺（FINA组：5 mg/kg/d）和CPSO (CPSO-1组：40 mg/kg/d)；CPSO-2组：80 mg/kg/d)，增加28 d。分析血浆生化指标、循环睾酮(T)、前列腺特异性抗原（PSA）、前列腺氧化标志物及炎症反应。结果CPSO能降低前列腺肥大大鼠的前列腺重量，使血浆总蛋白、血脂、钙、葡萄糖、睾酮和PSA水平正常化，减轻前列腺肥大大鼠肝肾功能紊乱。在前列腺水平，CPSO显示前列腺氧化和炎症明显减少。组织学研究表明，CPSO能恢复前列腺增生引起的前列腺病变。结论CPSO具有抗氧化、抗增生、抗炎等作用，可作为一种中药或营养品治疗去势大鼠BPH。

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引用次数: 0

Pharmacological Targeting of Hyperpolarization-Activated Cyclic Nucleotide-Gated Cation Channels on Bladder Afferent Sensory Transmission 超极化激活环核苷酸门控阳离子通道对膀胱传入感觉传递的药理靶向作用

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-08-05 DOI: 10.1111/luts.70025

Eric Woon, Jorge Villalobos Santeli, Jia Liu, Longtu Chen, George Kuchel, Bin Feng

Objective

This study aimed to investigate the potential role of cesium chloride (CsCl), ivabradine (IVA), and isoproterenol (ISO) on the sensory transmission of bladder afferents to graded urinary bladder distension (UBD). We specifically selected these drugs to target the hyperpolarization-activated cyclic nucleotide-gated (HCN) cation channels to determine their role in afferent encoding.

Methods

The bladders of C57BL/6 female mice were harvested with attached pelvic nerves in continuity, and the stimulus–response function (SRF) of bladder afferents to stepped bladder distension (20, 40, 60, 80 cmH₂O) was recorded by single-fiber recordings. Their changes in SRF to bath application of CsCl, IVA, and ISO were then evaluated. The presence of HCN on bladder afferent endings was assessed through immunohistological staining on bladder sections from mice with genetically labeled bladder afferents.

Results

IVA and ISO did not significantly reduce afferent responses to UBD, whereas CsCl increased afferent responses. Bladder afferents in the pelvic nerve pathway were categorized into low-firing (LF, < 10 Hz) and high-firing (HF, > 10 Hz) groups. SRF in both the LF and HF groups showed similar trends with no significant changes in response to IVA and ISO. CsCl increased SRF only in the HF group but not in the LF group. Immunohistological staining revealed that HCN1 does not extensively co-localize with afferent endings, showing only sporadic presence.

Conclusion

Our targeted pharmacological studies with single-fiber recordings and immunohistological staining collectively suggest that HCN channels do not play a significant role in bladder afferent sensory transmission.

目的探讨氯化铯（CsCl）、伊伐布雷定（IVA）和异丙肾上腺素（ISO）在膀胱传入神经对分级膀胱膨胀（UBD）的感觉传递中的潜在作用。我们特别选择这些药物来靶向超极化激活的环核苷酸门控（HCN）阳离子通道，以确定它们在传入编码中的作用。方法取C57BL/6雌性小鼠膀胱，连续连接盆腔神经，单纤维记录膀胱传入神经对膀胱扩张（20、40、60、80 cmH2O）的刺激反应功能（SRF）。然后评估他们的SRF在CsCl、IVA和ISO应用后的变化。通过对基因标记膀胱传入的小鼠膀胱切片进行免疫组织学染色，评估HCN在膀胱传入末梢的存在。结果IVA和ISO没有显著降低UBD的传入反应，而CsCl则增加了传入反应。盆腔神经通路膀胱传入神经分为低放电（LF, < 10 Hz）组和高放电（HF, > 10 Hz）组。LF组和HF组的SRF表现出相似的趋势，IVA和ISO对SRF的反应没有显著变化。CsCl仅在HF组增加SRF，而在LF组没有增加。免疫组织染色显示HCN1不广泛地与传入末梢共定位，仅显示零星存在。结论我们的单纤维记录和免疫组织染色的靶向药理学研究共同表明，HCN通道在膀胱传入感觉传递中没有显着作用。

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引用次数: 0

Tolerability and Efficacy of Duloxetine Compared to Amitriptyline in Women With Chronic Pelvic Pain Syndrome: Findings From a Clinical Trial 与阿米替林相比，度洛西汀对女性慢性盆腔疼痛综合征的耐受性和疗效：来自一项临床试验的发现

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-07-27 DOI: 10.1111/luts.70023

Maede Mohseni, Rojan Ghaderzadeh, Kimia Bakhtiari, Maryam Zamanirafe, Mona Doostizadeh, Aliasghar Tabatabaeii Mohammadi, Kiumarth Amini, Maryam Mehrpooya

Objectives

Duloxetine has demonstrated efficacy in treating various types of chronic pain conditions. A double-blind clinical trial was conducted to assess the effectiveness and tolerability of duloxetine compared to amitriptyline in women suffering from chronic pelvic pain (CPP) syndrome.

Methods

Sixty-nine eligible women diagnosed with CPP syndrome were randomly assigned to receive either duloxetine or amitriptyline. Duloxetine was initiated at 30 mg/day and amitriptyline at 25 mg/day, with dosages increased to 60 mg/day for duloxetine and 50 mg/day for amitriptyline after the first week and maintained throughout weeks 2 to 8 of the treatment phase. The effectiveness of the treatment was assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and its domain scores at weeks 4 and 8 after treatment. The safety and tolerability of the study medications were assessed using an antidepressant side effect checklist and spontaneous participant reports of adverse effects. All analyses were conducted on an Intention-to-Treat (ITT) analysis data set.

Results

Patients undergoing both medications experienced similar improvements in their total NIH-CPSI scores at weeks 4 and 8. The proportions of patients achieving a response, defined as at least a 6-point reduction in the total NIH-CPSI score at both weeks 4 and 8, were also comparable between the duloxetine and amitriptyline treatments. Further, at the end of the study period, a similar proportion of subjects reported marked or moderate overall symptom improvements with both treatments. However, in the analysis of NIH-CPSI domain scores, duloxetine-treated patients exhibited lower pain domain scores at both study endpoints, while amitriptyline-treated patients achieved better scores in the urinary symptoms domain. Regarding quality of life domain scores, no significant differences were observed between the groups. In terms of safety and tolerability, duloxetine demonstrated more favorable outcomes, with fewer patients experiencing adverse effects and a lower withdrawal rate due to adverse effects compared to amitriptyline.

Conclusions

These findings suggest that duloxetine is as effective as amitriptyline for managing CPP syndrome in women, with the added advantage of a more favorable safety profile.

Trial Registration

The trial was registered at the Iranian Registry of Clinical Trials (identifie

目的：度洛西汀治疗多种慢性疼痛的疗效已得到证实。进行了一项双盲临床试验，以评估度洛西汀与阿米替林在慢性盆腔疼痛（CPP）综合征妇女中的有效性和耐受性。方法69例确诊为CPP综合征的女性患者随机分为度洛西汀组和阿米替林组。度洛西汀起始剂量为30 mg/天，阿米替林起始剂量为25 mg/天，第一周后剂量增加至度洛西汀60 mg/天，阿米替林50 mg/天，并在治疗期的第2至8周保持。在治疗后第4周和第8周，使用美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）及其域评分来评估治疗的有效性。研究药物的安全性和耐受性通过抗抑郁药物副作用检查表和参与者自发报告的不良反应进行评估。所有分析均在意向治疗（ITT）分析数据集上进行。结果接受两种药物治疗的患者在第4周和第8周的NIH-CPSI总评分有相似的改善。达到缓解的患者比例（定义为在第4周和第8周NIH-CPSI总评分至少降低6分）在度洛西汀和阿米替林治疗之间也具有可比性。此外，在研究期结束时，相似比例的受试者报告两种治疗均显著或中度改善整体症状。然而，在NIH-CPSI结构域评分分析中，度洛西汀治疗的患者在两个研究终点均表现出较低的疼痛结构域评分，而阿米替林治疗的患者在泌尿系统症状领域得分较高。在生活质量领域得分方面，两组间无显著差异。在安全性和耐受性方面，与阿米替林相比，度洛西汀表现出更有利的结果，出现不良反应的患者较少，不良反应引起的停药率更低。这些发现表明，度洛西汀与阿米替林在治疗女性CPP综合征方面同样有效，并且具有更有利的安全性。试验在伊朗临床试验注册中心注册（识别码：IRCT20120215009014N457）。报名日期：2023-01-10

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引用次数: 0

Knowledge, Attitudes, and Practices of Physiotherapists Regarding the Management of Urinary Incontinence in Elderly Patients in France: A Cross-Sectional Study 物理治疗师对法国老年患者尿失禁管理的知识、态度和实践：一项横断面研究

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-07-22 DOI: 10.1111/luts.70022

Julie Swiderski, Joëlle Lansonneur Leterme, Fréderic Bloch, François-Régis Sarhan

Context

Studies on nurses' and nursing assistants' perceptions of urinary incontinence (UI) in the elderly are well-documented; however, little to no research focuses specifically on physiotherapists. This study aims to explore physiotherapists' perspectives on UI among elderly patients.

Objectives

To assess the knowledge, attitudes, and practices of physiotherapists in France regarding managing UI in elderly patients, and to explore how training influences their confidence and clinical behaviors.

Methods

A cross-sectional online survey was conducted among physiotherapists practicing in France. The questionnaire addressed sociodemographic characteristics, experience with elderly patients with UI, and training in pelvic-perineal rehabilitation. Descriptive statistics and χ² analyses were used to identify associations.

Results

A total of 106 responses were collected. Among respondents, 80 (75.5%) reported knowing UI in elderly patients, but 62 (58.5%) expressed feeling powerless when managing such cases. Only 62 (58.5%) reported having the skills to help patients with UI, and just 10 (9.4%) used validated assessment tools. Physiotherapists who had received prior training—whether through initial education, continuing education, or self-directed study—were significantly more likely to report confidence, satisfaction, and proper use of tools (p < 0.01). A majority, 75 (70.8%), indicated a need for further training, and 60 (56.6%) expressed the need for clinical guidelines.

Discussion

This study reveals a gap between physiotherapists' knowledge of UI and their ability to manage it confidently in elderly patients. Training was significantly associated with greater competence and use of recommended practices. The underuse of assessment tools and expressed need for clearer guidelines suggest structural gaps in support and education.

Conclusion

Improving UI training and access to standardized tools could enhance physiotherapists' confidence and quality of care. Although conducted in France, these findings may inform international strategies to address similar gaps in geriatric continence care.

关于护士和护理助理对老年人尿失禁（UI）的认知的研究有充分的文献记录；然而，很少甚至没有专门针对物理治疗师的研究。本研究旨在探讨物理治疗师对老年患者尿失速的看法。目的评估法国物理治疗师对老年患者尿失尿管理的知识、态度和做法，并探讨培训如何影响他们的信心和临床行为。方法对在法国执业的物理治疗师进行横断面在线调查。调查问卷涉及社会人口学特征、老年尿失禁患者的经验以及盆腔会阴康复培训。采用描述性统计和χ2分析确定相关性。结果共收集问卷106份。在受访者中，80人（75.5%）表示了解老年患者的尿失禁，但62人（58.5%）表示在处理此类病例时感到无能为力。只有62人（58.5%）报告有技能帮助尿失尿患者，只有10人（9.4%）使用有效的评估工具。接受过前期培训的物理治疗师——无论是通过初始教育、继续教育还是自主学习——都更有可能报告信心、满意度和正确使用工具（p < 0.01）。大多数，75人（70.8%）表示需要进一步培训，60人（56.6%）表示需要临床指南。本研究揭示了物理治疗师对老年患者尿失速的知识与他们自信地管理尿失速的能力之间的差距。培训与更强的能力和推荐做法的使用显著相关。评估工具的使用不足和明确指导方针的需要表明在支助和教育方面存在结构性差距。结论改进用户界面培训和使用标准化工具可提高物理治疗师的信心和护理质量。虽然是在法国进行的，但这些发现可能为解决老年失禁护理方面类似差距的国际战略提供信息。MESH尿失禁；岁的;老年的评估;盆底;物理治疗方式；卫生知识、态度和做法；调查和问卷；教育、专业;教育、继续;临床能力;法国。

{"title":"Knowledge, Attitudes, and Practices of Physiotherapists Regarding the Management of Urinary Incontinence in Elderly Patients in France: A Cross-Sectional Study","authors":"Julie Swiderski, Joëlle Lansonneur Leterme, Fréderic Bloch, François-Régis Sarhan","doi":"10.1111/luts.70022","DOIUrl":"https://doi.org/10.1111/luts.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Studies on nurses' and nursing assistants' perceptions of urinary incontinence (UI) in the elderly are well-documented; however, little to no research focuses specifically on physiotherapists. This study aims to explore physiotherapists' perspectives on UI among elderly patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the knowledge, attitudes, and practices of physiotherapists in France regarding managing UI in elderly patients, and to explore how training influences their confidence and clinical behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey was conducted among physiotherapists practicing in France. The questionnaire addressed sociodemographic characteristics, experience with elderly patients with UI, and training in pelvic-perineal rehabilitation. Descriptive statistics and <i>χ</i><sup>2</sup> analyses were used to identify associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 106 responses were collected. Among respondents, 80 (75.5%) reported knowing UI in elderly patients, but 62 (58.5%) expressed feeling powerless when managing such cases. Only 62 (58.5%) reported having the skills to help patients with UI, and just 10 (9.4%) used validated assessment tools. Physiotherapists who had received prior training—whether through initial education, continuing education, or self-directed study—were significantly more likely to report confidence, satisfaction, and proper use of tools (<i>p</i> < 0.01). A majority, 75 (70.8%), indicated a need for further training, and 60 (56.6%) expressed the need for clinical guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study reveals a gap between physiotherapists' knowledge of UI and their ability to manage it confidently in elderly patients. Training was significantly associated with greater competence and use of recommended practices. The underuse of assessment tools and expressed need for clearer guidelines suggest structural gaps in support and education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Improving UI training and access to standardized tools could enhance physiotherapists' confidence and quality of care. Although conducted in France, these findings may inform international strategies to address similar gaps in geriatric continence care.</p>\u0000 </s","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is Vaginal Prosthetic Surgery Always to Be Avoided? Analysis of the Efficacy and Safety of Vaginal Mesh With 3 Levels-De Lancey Attachment in Women With Recurrent Vaginal Vault Prolapse 阴道修复手术总是要避免的吗？三级de Lancey附着阴道补片治疗复发性阴道穹窿脱垂的疗效和安全性分析

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-07-10 DOI: 10.1111/luts.70021

Lorenzo Campanella, Giovanni Grossi, Passarello Alessandra, Pietro Cignini, Fabio Manganelli, Pierluigi Palazzetti, M. A. Zullo, Andrea Morciano, Carlo Rappa, Francesco Deltetto, M. C. Schiavi

Objectives

The purpose of this research is to determine the effectiveness and safety of a vaginal mesh intended to resolve multicompartmental prolapse in individuals with substantial vaginal vault prolapse.

Methods

From 2015 to 2020, 67 patients with recurrent apical prolapse ≥ III stage (POP-Q grading) underwent transvaginal vault repair using the isoelastic mesh InGYNious. Operative time, blood transfusions, spontaneous voiding, perioperative issues, postoperative hospital stay, and postoperative complications (early within 30 days and late after 30 days) were also investigated. Following the first preoperative examination, clinical and QoL questionnaires were examined both before and after surgery at the long-term follow-up (> 60 months).

Results

The average surgery duration was 41 ± 21 min, with an estimated blood loss of 50 ± 21 mL. The total number of surgical complications was eight (11.9%). The study discovered significant reductions in the apical (from 1.88 ± 2.59 to −6.73 ± 1.77) and anterior (from 1.34 ± 1.67 to −2.25 ± 0.95) deficiencies, as well as improvements in PQOL (from 67.72 ± 19.25 to 33.74 ± 7.48), PISQ-12 (from 29 to 36), FSFI (from 20 to 29), and FSDS (from 21 to 8). Finally, we identified three cases of full recurrence and only two occurrences needed reoperation.

Conclusions

Transvaginal mesh repair is a safe and effective surgical technique that can treat multi-compartment prolapse, improve anatomical success, and reduce the risk of recurrence in certain patient populations, such as those with significant comorbidities, elderly patients, patients with recurrent POP, or patients with very challenging cases of POP.

目的：本研究的目的是确定阴道网状物用于解决严重阴道穹窿脱垂患者多室脱垂的有效性和安全性。方法2015 - 2020年对67例复发性根尖脱垂≥III期（POP-Q分级）患者行阴道穹窿修复术。手术时间、输血、自然排尿、围手术期问题、术后住院时间和术后并发症（30天内早期和30天后晚期）也进行了调查。术前第一次检查后，术后长期随访（60个月）分别进行临床和生活质量问卷调查。结果手术时间平均为41±21 min，出血量约50±21 mL。手术并发症共8例（11.9%）。研究发现根尖缺陷（从1.88±2.59降至- 6.73±1.77）和前侧缺陷（从1.34±1.67降至- 2.25±0.95）显著降低，PQOL（从67.72±19.25降至33.74±7.48）、PISQ-12（从29降至36）、FSFI（从20降至29）和FSDS（从21降至8）均有改善。最后，我们发现3例完全复发，只有2例需要再次手术。结论经阴道补片修复术是一种安全有效的手术技术，可以治疗多腔室脱垂，提高解剖成功率，并降低某些患者的复发风险，如有明显合并症的患者、老年患者、复发性POP患者或极具挑战性的POP患者。

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引用次数: 0

A Repeatability Study of Measurement of Micturition With Voiding Sonography and Uroflowmetry of Asymptomatic Women 无症状妇女排尿超声和尿流测量排尿的可重复性研究

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2025-07-08 DOI: 10.1111/luts.70020

Bernadette Dellar, Ryan Stafford, Eric Chung, Gabriel Schaer, Margret Sherburn, Roxanna Turner, Handoo Rhee, Anna Page, Paul W. Hodges

Aims

This study aimed to assess the intra- and inter-tester repeatability of voiding sonography measures in asymptomatic women and to examine the effect of perineal transducer placement on uroflowmetry.

Methods

A prospective observational study of 32 asymptomatic women was conducted using ultrasound with simultaneous uroflowmetry. Participants completed four voids (two per day). The ultrasound transducer placed on the perineum assessed bladder neck and urethral displacement during micturition. On Day 1, a void with ultrasound and uroflow recorded by a sonographer was compared to a void recorded with uroflowmetry only to determine whether the transducer placement affected voiding. On Day 2, two sonographers evaluated the voids with ultrasound and uroflowmetry. Each sonographer measured their own images. One sonographer also made measures on the images recorded by the second sonographer. Uroflowmetry measures and void patterns were evaluated. The repeatability of ultrasound measures was analyzed using intraclass correlation coefficient (ICC 2,1) and Bland–Altman analysis, and t tests examined the transducer's impact on uroflowmetry.

Results

Some changes in flow rate and flow pattern (20% of participants) were observed with placement of the transducer. Most sonographic measures showed good to excellent inter- and intra-tester repeatability, and between measures made by the different testers on the same image. During void, bladder neck and urethral diameter were more repeatable if measures were made at the time of maximum flow estimated from the simultaneous uroflowmetry.

Conclusion

Voiding sonography is both feasible and repeatable. Perineal transducer placement affected micturition for some individuals. Voiding sonography combined with uroflowmetry shows promise for a noninvasive urogynecology functional assessment.

目的本研究旨在评估无症状女性排尿超声测量仪内和仪间的可重复性，并探讨会阴换能器放置对尿流测量的影响。方法对32例无症状妇女采用超声联合尿流仪进行前瞻性观察研究。参与者完成了四次问卷调查（每天两次）。将超声换能器置于会阴处，评估排尿时膀胱颈和尿道位移。第1天，超声和尿流仪记录的空腔与尿流仪记录的空腔进行比较，以确定换能器的放置是否影响排尿。第2天，两位超声医师用超声和尿流仪评估空隙。每个超声医师测量他们自己的图像。一名超声医师也对另一名超声医师记录的图像进行测量。评估尿流测量和空洞模式。超声测量的可重复性采用类内相关系数（ICC 2,1）和Bland-Altman分析进行分析，t检验检验换能器对尿流测量的影响。结果换能器放置后，血流速率和流型发生了一定的变化（20%的参与者）。大多数超声测量显示出良好的到优异的测试仪之间和内部的重复性，以及不同测试仪对同一图像的测量之间的重复性。在尿空期间，如果在同时尿流法估计最大流量时进行测量，则膀胱颈和尿道直径的重复性更高。结论超声排尿是可行的，可重复性好。会阴换能器的放置影响了一些个体的排尿。排尿超声联合尿流仪显示了一种无创的泌尿妇科功能评估的前景。

{"title":"A Repeatability Study of Measurement of Micturition With Voiding Sonography and Uroflowmetry of Asymptomatic Women","authors":"Bernadette Dellar, Ryan Stafford, Eric Chung, Gabriel Schaer, Margret Sherburn, Roxanna Turner, Handoo Rhee, Anna Page, Paul W. Hodges","doi":"10.1111/luts.70020","DOIUrl":"https://doi.org/10.1111/luts.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to assess the intra- and inter-tester repeatability of voiding sonography measures in asymptomatic women and to examine the effect of perineal transducer placement on uroflowmetry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective observational study of 32 asymptomatic women was conducted using ultrasound with simultaneous uroflowmetry. Participants completed four voids (two per day). The ultrasound transducer placed on the perineum assessed bladder neck and urethral displacement during micturition. On Day 1, a void with ultrasound and uroflow recorded by a sonographer was compared to a void recorded with uroflowmetry only to determine whether the transducer placement affected voiding. On Day 2, two sonographers evaluated the voids with ultrasound and uroflowmetry. Each sonographer measured their own images. One sonographer also made measures on the images recorded by the second sonographer. Uroflowmetry measures and void patterns were evaluated. The repeatability of ultrasound measures was analyzed using intraclass correlation coefficient (ICC 2,1) and Bland–Altman analysis, and <i>t</i> tests examined the transducer's impact on uroflowmetry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Some changes in flow rate and flow pattern (20% of participants) were observed with placement of the transducer. Most sonographic measures showed good to excellent inter- and intra-tester repeatability, and between measures made by the different testers on the same image. During void, bladder neck and urethral diameter were more repeatable if measures were made at the time of maximum flow estimated from the simultaneous uroflowmetry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Voiding sonography is both feasible and repeatable. Perineal transducer placement affected micturition for some individuals. Voiding sonography combined with uroflowmetry shows promise for a noninvasive urogynecology functional assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18028,"journal":{"name":"LUTS: Lower Urinary Tract Symptoms","volume":"17 4","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/luts.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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