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Lifestyle and behavioral interventions for urinary incontinence in frail older adults: An integrative review of recent evidence
Continence (Amsterdam, Netherlands) Pub Date : 2025-02-06 DOI: 10.1016/j.cont.2025.101749
Kristine M.C. Talley , Janie Thompson
{"title":"Lifestyle and behavioral interventions for urinary incontinence in frail older adults: An integrative review of recent evidence","authors":"Kristine M.C. Talley ,&nbsp;Janie Thompson","doi":"10.1016/j.cont.2025.101749","DOIUrl":"10.1016/j.cont.2025.101749","url":null,"abstract":"<div><h3>Background:</h3><div>Frail older adults rely on conservative management to treat urinary incontinence (UI). Understanding the evidence on lifestyle and behavioral interventions for this population will inform optimal care and direct needed research.</div></div><div><h3>Aims:</h3><div>To conduct an integrative review summarizing recent research and evidence on lifestyle and behavioral interventions for UI in frail older adults published in recent clinical practice guidelines, systematic reviews, and clinical trial registries.</div></div><div><h3>Materials and Methods:</h3><div>We searched PubMed and professional organization websites for systematic reviews and clinical practice guidelines published since 2020. We searched the ClinicalTrials.gov and the International Clinical Trials Registry Platform registries to find clinical trials on the topic registered in the past 10 years.</div></div><div><h3>Results:</h3><div>We found two clinical practice guidelines both from the 7th International Consultation on Incontinence, five systematic reviews, and five registered clinical trials. The systematic reviews included 53 individual trials conducted between 1981 and 2021 with 82% published before 2010. The most evidence existed for prompted voiding and individualized combination therapy that includes functional training.</div></div><div><h3>Discussion:</h3><div>Frail older adults are rarely included in research on lifestyle and behavioral interventions for incontinence and are overlooked in clinical practice guidelines. There remains a paucity of evidence on the effectiveness of lifestyle and behavioral interventions for frail older adults with UI. We urge professionals to include considerations for frail older adults in their clinical practice guidelines, systematic reviews, and future research studies.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101749"},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS)
Continence (Amsterdam, Netherlands) Pub Date : 2025-02-05 DOI: 10.1016/j.cont.2025.101748
Christabel Egemba , Edie Duncan , Katherine Amin , Alan Wein , Alberto J. Caban-Martinez , Raveen Syan
{"title":"Disparities in surgical treatments for stress, urge and mixed urinary incontinence: Evidence from the 2019 National Ambulatory Surgery Sample (NASS)","authors":"Christabel Egemba ,&nbsp;Edie Duncan ,&nbsp;Katherine Amin ,&nbsp;Alan Wein ,&nbsp;Alberto J. Caban-Martinez ,&nbsp;Raveen Syan","doi":"10.1016/j.cont.2025.101748","DOIUrl":"10.1016/j.cont.2025.101748","url":null,"abstract":"<div><h3>Purpose:</h3><div>Treatment of urinary incontinence (UI) is influenced by severity of symptoms and knowledge of available treatments. However, the relationship between race/ethnicity, socioeconomic status and receiving treatment is poorly understood. We aim to characterize differences in surgical management of urinary incontinence subtypes (Stress UI (SUI), overactive bladder (OAB), Mixed UI (MUI)) and identify predictors of receiving the indicated surgical treatment for each.</div></div><div><h3>Methods:</h3><div>Using the 2019 National Ambulatory Surgery Sample (NASS) we used weighted data to identify 44,996 adult females with OAB, 87,737 with SUI, and 22,873 with MUI. Chi-square analysis was used to compare surgical treatments for each diagnosis, with significance assessed at &lt;0.05. Multivariable logistic regression models estimated the associations between socioeconomic factors of receiving the indicated treatment for OAB, SUI, or MUI.</div></div><div><h3>Results:</h3><div>Approximately 2.5% of the study population received surgical treatment for SUI, OAB or MUI. Sling was the most utilized surgical treatment for both SUI and MUI, at 75.2% and 60.8 % respectively. While SNS was the most utilized surgical treatment for OAB, 75% of OAB patients did not undergo surgical treatment. When considering age, insurance status, and income, Black women were significantly less likely to receive surgical treatment for MUI, OAB and SUI (0.69 [0.59, 0.80], 0.69[0.62, 0.76], 0.71 [0.65, 0.77]) respectively.</div></div><div><h3>Conclusion:</h3><div>Among female patients with UI, certain factors predict whether a patient will receive surgical treatment, including race, insurance status, and income level. These findings could inform further research to examine the factors contributing to the disparities seen.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101748"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Measuring the impact of managing incontinence on people with dementia and informal caregivers: Cognitive debriefing interviews of ‘ICIQ-Cog’ (English translation)
Continence (Amsterdam, Netherlands) Pub Date : 2025-02-04 DOI: 10.1016/j.cont.2024.101739
Miriam Avery , Nikki Cotterill , Mandy Fader , Margaret Macaulay , Ruth Kirschner-Hermanns , Cathy Murphy
{"title":"Measuring the impact of managing incontinence on people with dementia and informal caregivers: Cognitive debriefing interviews of ‘ICIQ-Cog’ (English translation)","authors":"Miriam Avery ,&nbsp;Nikki Cotterill ,&nbsp;Mandy Fader ,&nbsp;Margaret Macaulay ,&nbsp;Ruth Kirschner-Hermanns ,&nbsp;Cathy Murphy","doi":"10.1016/j.cont.2024.101739","DOIUrl":"10.1016/j.cont.2024.101739","url":null,"abstract":"<div><h3>Aim:</h3><div>The ICIQ-Cog questionnaire was developed in German to measure the impact of incontinence and/or toilet use problems on people living with dementia and their paid carers and unpaid caregivers; it has been translated into English. This study aimed to (1) examine the linguistic validity of the ICIQ-Cog English translation and (2) determine whether it addresses what is important to unpaid caregivers.</div></div><div><h3>Methods:</h3><div>Cognitive debriefing interviews were conducted with 13 unpaid caregivers of people with dementia and problems with incontinence or toilet use recruited via Joint Dementia Research. Interviews were conducted across 3 rounds and transcribed then thematically analysed based on the questionnaire framework.</div></div><div><h3>Results:</h3><div>All participants were unpaid caregivers; they highlighted the need for the questionnaire. Changes were made to the title and response options were added to 10 of 12 questions; wording changes were made to 5 questions. One of the questions was deemed difficult to answer as an unpaid caregiver due to the need for more general caring experience; another used phraseology potentially more understandable by professional carers. Several participants emphasised missing questions (such as cost of buying continence aids and extra washing). The interviews were halted because the questionnaire did not fully meet unpaid caregivers needs.</div></div><div><h3>Conclusion:</h3><div>This linguistic validation of the ICIQ-Cog questionnaire identified that it is not appropriate for use among unpaid caregivers. A questionnaire to assess impact of managing incontinence designed purposefully for unpaid caregivers of a person with dementia is needed. Further work is required to finalise the English translation for paid carers.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101739"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What factors are predictive of urinary continence following pregnancy?
Continence (Amsterdam, Netherlands) Pub Date : 2025-01-30 DOI: 10.1016/j.cont.2025.101746
Ian Milsom, Maria Gyhagen
{"title":"What factors are predictive of urinary continence following pregnancy?","authors":"Ian Milsom,&nbsp;Maria Gyhagen","doi":"10.1016/j.cont.2025.101746","DOIUrl":"10.1016/j.cont.2025.101746","url":null,"abstract":"<div><h3>Introduction:</h3><div>The growing pregnant uterus exerts increasing pressure on the pelvic floor as pregnancy advances and in addition hormonal changes influence muscle and connective tissue function. Vaginal delivery may cause pelvic floor damage by several mechanisms such as muscle trauma, connective tissue damage, nerve injury and vascular damage. Thus, it is perhaps not surprising that pregnancy and in particular vaginal birth have been proposed as important risk factors for urinary incontinence (UI) and other forms of pelvic floor dysfunction such as pelvic organ prolapse and fecal incontinence</div></div><div><h3>Purpose of this review:</h3><div>The aim of this review was to summarize our current knowledge regarding pregnancy and childbirth as important risk factors for urinary incontinence.</div></div><div><h3>Summary:</h3><div>Urinary incontinence is more common in women than men and there is strong epidemiological evidence demonstrating an increased prevalence of UI during pregnancy. The prevalence of UI is higher in women who had undergone a pregnancy compared to nulliparous women of the same age. The risk of developing UI was higher after vaginal delivery (VD) than after caesarean section (CS) and the prevalence of UI&gt;10 years almost tripled after VD compared to CS.</div><div>Maternal body mass index and age and infant birth weight were other important risk factors. Nulliparous women and women who have undergone caesarean-only delivery rarely undergo urinary incontinence surgery.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101746"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Defining Nocturnal Polyuria in Adolescents
Continence (Amsterdam, Netherlands) Pub Date : 2025-01-23 DOI: 10.1016/j.cont.2025.101744
Tasmia Promi , Anthony Brooks , Gulzhan Tologonova , Marie-Claire Roberts , Sarita Dhuper , Meseret Tena , Oluwatoyin Bamgbola , Monique Hanono , Jeffrey P. Weiss , Karel Everaert , Tine DeBacker , Thomas F. Monaghan , Louis Salciccioli , Stephen Wadowski , Elka Jacobson-Dickman , Jason M. Lazar
{"title":"Defining Nocturnal Polyuria in Adolescents","authors":"Tasmia Promi ,&nbsp;Anthony Brooks ,&nbsp;Gulzhan Tologonova ,&nbsp;Marie-Claire Roberts ,&nbsp;Sarita Dhuper ,&nbsp;Meseret Tena ,&nbsp;Oluwatoyin Bamgbola ,&nbsp;Monique Hanono ,&nbsp;Jeffrey P. Weiss ,&nbsp;Karel Everaert ,&nbsp;Tine DeBacker ,&nbsp;Thomas F. Monaghan ,&nbsp;Louis Salciccioli ,&nbsp;Stephen Wadowski ,&nbsp;Elka Jacobson-Dickman ,&nbsp;Jason M. Lazar","doi":"10.1016/j.cont.2025.101744","DOIUrl":"10.1016/j.cont.2025.101744","url":null,"abstract":"<div><div>Nocturnal polyuria (NP) is a leading cause of nocturia in adults. While diagnostic criteria for NP have been established in adult men, they have not been validated in other demographic groups including women, adolescents, and children, and little is known about appropriate reference values in these populations. Accordingly, the present study aimed to determine an hourly nocturnal urine production (NUP) rate in adolescents most predictive of the presence of nocturia. We analyzed prospectively collected data of 100 male and female adolescents aged 10-18 years. All subjects completed nocturnal voiding diaries and significant nocturia was defined as <span><math><mo>≥</mo></math></span>1 or more voids per night. Receiver operating characteristic (ROC) curves were used to test the performance of different NUP values in predicting nocturia. On ROC, the area under curve (AUC) was 0.85. On multivariable logistic regression with variables of sex, obesity, and elevated blood pressure, adding NUP as a categorical variable maximally increased the predictive value of the model upon utilizing a cutoff of 50 ml/h, increasing the R<sup>2</sup> from 0.491 to 0.683. A NUP <span><math><mo>&gt;</mo></math></span>50 ml/h had a sensitivity of 62.2% and a specificity of 96.4% in predicting nocturia. A cut-off value of NUP <span><math><mo>&gt;</mo></math></span>50 ml/h may be relevant to the clinical management of adolescents with nocturia.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101744"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143298519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comprehensive management of neurogenic stress urinary incontinence in women
Continence (Amsterdam, Netherlands) Pub Date : 2025-01-09 DOI: 10.1016/j.cont.2024.101742
Vicktor Bruno Pereira Pinto, Luísa Resende Tenório de Albuquerque, Bernardo Sachet de Andrade, Cristiano Mendes Gomes
{"title":"Comprehensive management of neurogenic stress urinary incontinence in women","authors":"Vicktor Bruno Pereira Pinto,&nbsp;Luísa Resende Tenório de Albuquerque,&nbsp;Bernardo Sachet de Andrade,&nbsp;Cristiano Mendes Gomes","doi":"10.1016/j.cont.2024.101742","DOIUrl":"10.1016/j.cont.2024.101742","url":null,"abstract":"<div><div><strong>Purpose of review:</strong> The management of neurogenic stress urinary incontinence (NSUI) in women presents significant challenges due to the complexity of underlying conditions, the variability in patient responses to treatments, and the limited evidence supporting various therapeutic options. Accurate diagnosis and tailored interventions are crucial, given the coexistence of bladder and bowel dysfunctions and the necessity to consider individual social circumstances. This review aims to update the current strategies for the surgical management of NSUI in women, emphasizing the importance of an individualized, patient-centered approach.</div><div><strong>Recent findings:</strong> The existing scientific literature on NSUI remains limited in both volume and quality, with most studies being retrospective, involving small patient populations and short follow-up periods. These studies often feature heterogeneous groups and varied definitions of success, complicating result interpretation. Promising outcomes have been observed with synthetic midurethral slings and robotic implantation of artificial urinary sphincters (AUS), while autologous fascial slings continue to be regarded as a reliable option. Despite the efficacy of the AUS, device-related complications remain a concern. Other treatments, such as bulking agents and adjustable continence devices, have shown limited success.</div><div><strong>Summary:</strong> A multidisciplinary, patient-tailored approach is essential for managing NSUI in women, aiming to enhance quality of life and protect urinary tract function. Regular follow-up is crucial to monitor and address potential complications, including declining continence rates and other treatment-related adverse events.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101742"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Microbiome profiling in patients with Bladder Pain Syndrome/Interstitial cystitis
Continence (Amsterdam, Netherlands) Pub Date : 2025-01-06 DOI: 10.1016/j.cont.2024.101743
Puck Oude Elferink , Aida Javan Balegh Marand , John Heesakkers , Ellen van den Munckhof , Wilco Knetsch , Frank Martens , Mohammad Sajjad Rahnama’i , Dick Janssen
{"title":"Microbiome profiling in patients with Bladder Pain Syndrome/Interstitial cystitis","authors":"Puck Oude Elferink ,&nbsp;Aida Javan Balegh Marand ,&nbsp;John Heesakkers ,&nbsp;Ellen van den Munckhof ,&nbsp;Wilco Knetsch ,&nbsp;Frank Martens ,&nbsp;Mohammad Sajjad Rahnama’i ,&nbsp;Dick Janssen","doi":"10.1016/j.cont.2024.101743","DOIUrl":"10.1016/j.cont.2024.101743","url":null,"abstract":"<div><div>We conducted a microbiome study on BPS/IC patients with Hunner’s lesions to investigate the differences in local microbiome compositions within a single bladder. In addition, we compared BPS/IC urine samples with matched controls and overactive bladder (OAB) patients with or without detrusor overactivity. Furthermore, we performed a small pilot to evaluate the stability of the microbiome composition over time in a single BPS/IC patient.</div><div>Tissue samples were obtained from bladder mucosa from five adult female BPS/IC patients with confirmed Hunner’s lesions. From each patient one biopsy was taken from within the Hunner’s lesion area and one from outside the Hunner’s lesion area.</div><div>Urine samples from all five BPS/IC patients were compared to urine samples from normal age and sex matched controls (n <span><math><mo>=</mo></math></span> 12), female OAB patients with detrusor overactivity (n <span><math><mo>=</mo></math></span> 12) and female OAB patients without detrusor overactivity (n <span><math><mo>=</mo></math></span> 9). The 16S rRNA V1–V2 region amplification and gel electrophoresis were used to determine the microbiota.</div><div>Our results showed the small tissue size from a cold-cup mucosal biopsy yielded insufficient microbial DNA for 16S rRNA gene sequence analysis. Urine microbiome analyses demonstrated that there was no single bacterial genus that was specific for BPS/IC patients compared to the other groups. There was a wide variability in microbiome composition between the BPS/IC patients, but no significant difference was observed in the Shannon numerical analyses (microbiome diversity) in BPS/IC patients compared to controls. The small pilot that was done to evaluate microbiome stability over time in a single BPS/IC patient, showed remarkable stability of microbiome composition during a one-year follow-up.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"14 ","pages":"Article 101743"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A retrospective, single-centre safety audit of the Altis® single incision sling in the surgical treatment of female stress urinary incontinence
Continence (Amsterdam, Netherlands) Pub Date : 2024-12-18 DOI: 10.1016/j.cont.2024.101741
E. Collier , S. Housmans , F. Van der Aa
{"title":"A retrospective, single-centre safety audit of the Altis® single incision sling in the surgical treatment of female stress urinary incontinence","authors":"E. Collier ,&nbsp;S. Housmans ,&nbsp;F. Van der Aa","doi":"10.1016/j.cont.2024.101741","DOIUrl":"10.1016/j.cont.2024.101741","url":null,"abstract":"<div><h3>Background:</h3><div>Single incision slings (SIS) and adjustable single incision slings (ASIS) are the latest generation of midurethral slings (MUS), used for the surgical treatment of female stress urinary incontinence, that seek to minimize the morbidity and complications associated to the conventional retropubic and transobturator midurethral slings. Its use has recently come under scrutiny following concerns about long-term complications.</div></div><div><h3>Aims:</h3><div>We conducted an internal audit of the short-to-medium term safety and absence of reported complications of the Altis® SIS in our medical centre (University Hospital of Leuven, Belgium). Secondary outcome was treatment efficacy, defined as no self-reported SUI symptoms.</div></div><div><h3>Methods:</h3><div>A file review of all patients implanted with an Altis® sling at our institution between 2014 and May 2021 was performed. Baseline characteristics and outcomes were reported with the use of descriptive statistics.</div></div><div><h3>Results:</h3><div>212 women were included in our safety analysis, 192 women in the efficacy analysis. The safety analysis showed 74 complications of any kind. Mesh exposure occurred in 16 women (7.5%) after a mean period of 15 months. Eleven of them (5.2%) underwent excision of the exposed mesh. Arterial haemorrhage requiring embolization, and mesh infection, both occurred once. Dyspareunia for the patient (3.3%) or her partner (1.4%) was encountered in nine cases. Four cases were linked to mesh exposure, of which three underwent partial sling excision. De novo urgency (5.7%) and urge incontinence (7.3%) were reported in 25 women (13%) and were managed with anticholinergic drugs. Regarding efficacy outcomes, 161 women (83.8%) reported no residual urine loss at the first post-operative consultation. Thirteen women (6.7%) had persistent SUI. Eight women (4.2%) underwent reintervention receiving a second sling.</div></div><div><h3>Conclusion:</h3><div>We can conclude that the short-to-medium term results in our centre align with those reported in existing literature.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101741"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimizing care for LUTS in older patients: Diagnostics, challenges of frailty and patient priorities—NOPIA meeting (ICI-RS 2024)
Continence (Amsterdam, Netherlands) Pub Date : 2024-12-17 DOI: 10.1016/j.cont.2024.101737
Andries Van Huele , Michael Samarinas , Wendy F. Bower , Roger Dmochowski , Dudley Robinson , Mauro Van den Ende , François Hervé , William Gibson , Adrian Wagg , Alan Wein , Karel Everaert , George Bou Kheir
{"title":"Optimizing care for LUTS in older patients: Diagnostics, challenges of frailty and patient priorities—NOPIA meeting (ICI-RS 2024)","authors":"Andries Van Huele ,&nbsp;Michael Samarinas ,&nbsp;Wendy F. Bower ,&nbsp;Roger Dmochowski ,&nbsp;Dudley Robinson ,&nbsp;Mauro Van den Ende ,&nbsp;François Hervé ,&nbsp;William Gibson ,&nbsp;Adrian Wagg ,&nbsp;Alan Wein ,&nbsp;Karel Everaert ,&nbsp;George Bou Kheir","doi":"10.1016/j.cont.2024.101737","DOIUrl":"10.1016/j.cont.2024.101737","url":null,"abstract":"<div><div>As the global population ages, the prevalence of lower urinary tract symptoms (LUTS) in older adults is increasing, with frailty adding complexity to this challenge. There is a recognized paucity of data addressing LUTS in older adults with frailty.</div><div>This literature review, summarizing insights from a panel of experts at the 2024 NOPIA — Nocturia and Polyuria research group meeting at the International Consultation on Incontinence-Research Society (ICI-RS) congress in Bristol, addresses the need to optimize care for LUTS in older adults by refining diagnostics, adapting approaches for frail patients, considering patient priorities and identify indicators and predictors for LUTS.</div><div>The concept of lifelong LUTS underscores the persistence of urinary dysfunction across life stages, highlighting the importance of distinguishing age-related changes from pathology for accurate diagnosis. Due to age-related physiological changes, comorbidities, and cognitive decline, traditional diagnostics like frequency-volume charts may be challenging, emphasizing the value of a holistic, patient-centered approach. Treatments in frail populations require caution, as common medications can pose increased risks, often lacking safety data for this group, emphasizing the need for tailored approaches. Recognizing predictors and indicators of LUTS helps to prevent complications, understand progression and to aid in early intervention. Key patient priorities include effective symptom relief, low-risk management, and clear communication, with a strong preference for shared decision-making to accommodate individual needs, considering possible health illiteracy.</div><div>In conclusion, managing LUTS in older, frail adults requires a comprehensive approach that includes improving diagnostics, recognizing frailty’s impact, and aligning treatment with patient expectations. Future research should develop frailty-specific strategies to enhance quality of life, while a multidisciplinary, patient-centered approach can better address the complex needs of this population.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101737"},"PeriodicalIF":0.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A survey of end user and health care professionals experience of discomfort as related to intermittent catheterisation
Continence (Amsterdam, Netherlands) Pub Date : 2024-12-12 DOI: 10.1016/j.cont.2024.101740
Angie Rantell , Barbara Kearns , Hanny Cobussen-Boekhorst , Kay Willard , Rene Zonderland
{"title":"A survey of end user and health care professionals experience of discomfort as related to intermittent catheterisation","authors":"Angie Rantell ,&nbsp;Barbara Kearns ,&nbsp;Hanny Cobussen-Boekhorst ,&nbsp;Kay Willard ,&nbsp;Rene Zonderland","doi":"10.1016/j.cont.2024.101740","DOIUrl":"10.1016/j.cont.2024.101740","url":null,"abstract":"<div><h3>Background and Methods:</h3><div>Clinical evidence around discomfort experienced at the various stages of the intermittent catheterisation (IC) journey is limited. This research aimed to gain insights into discomforts encountered at initiation of IC and when products were changed/swapped during their lifetime of use. To gather a range of viewpoints, digital questionnaires were distributed to End Users and to Health Care Professionals (HCP’s) to consider how discomfort has/may be experienced and managed.</div></div><div><h3>Results:</h3><div>The surveys were completed by ninety nine End Users and 113 HCP’s. The results highlighted the variety of different ways in which discomfort may be described. For those End Users with urethral sensation, 89% stated the discomfort experienced acclimated i.e. they no longer felt the discomfort after a couple of days catheterising. Elements associated with improved experienced included End user education and how expectations were managed.</div></div><div><h3>Conclusions:</h3><div>The findings highlight the need to ensure that all End Users receive adequate education and counselling to manage all aspects of IC not only when they start their journey of IC, but also on product switching and during their lifetime of use and that this should be tailored to their individual needs. By having a better understanding in relation to discomfort it may help HCP’s to understand challenges faced, prepare End Users and set their expectations, and aid the development of more evidence-based education and training for IC users.</div></div>","PeriodicalId":72702,"journal":{"name":"Continence (Amsterdam, Netherlands)","volume":"13 ","pages":"Article 101740"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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