Determinants of Seeking of Primary Care for Lower Urinary Tract Symptoms: The Krimpen Study in Community-Dwelling Men

IntroductionLower urinary tract symptoms (LUTS) is a bothersome condition affecting older men which can lead to poor quality of life. General practitioners (GPs) currently have no easily available assessment tools to help effectively diagnose causes of LUTS and aid discussion of treatment with patients. Men are frequently referred to urology specialists who often recommend treatments that could have been initiated in primary care. GP access to simple, accurate tests and clinician decision tools are needed to facilitate accurate and effective patient management of LUTS in primary care.Methods and analysisPRImary care Management of lower Urinary tract Symptoms (PriMUS) is a prospective diagnostic accuracy study based in primary care. The study will determine which of a number of index tests used in combination best predict three urodynamic observations in men who present to their GP with LUTS. These are detrusor overactivity, bladder outlet obstruction and/or detrusor underactivity. Two cohorts of participants, one for development of the prototype diagnostic tool and other for validation, will undergo a series of simple index tests and the invasive reference standard (invasive urodynamics). We will develop and validate three diagnostic prediction models based on each condition and then combine them with management recommendations to form a clinical decision support tool.Ethics and disseminationEthics approval is from the Wales Research Ethics Committee 6. Findings will be disseminated through peer-reviewed journals and conferences, and results will be of interest to professional and patient stakeholders.Trial registration numberISRCTN10327305.

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SERUM ANDROGENS AND RISK OF LOWER URINARY TRACT SYMPTOMS IN COMMUNITY DWELLING OLDER MEN

The Journal of Urology ◽

10.1016/s0022-5347(09)61484-1 ◽

2009 ◽

Vol 181 (4S) ◽

pp. 526-526

Author(s):

J. Kellogg Parsons ◽

Michael D Trifiro ◽

Jaclyn Bergstrom ◽

Kerrin Palazzi-Churas ◽

Elizabeth Barrett-Connor

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Older Men ◽

Community Dwelling ◽

Urinary Tract Symptoms ◽

Serum Androgens ◽

Lower Urinary

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Lower Urinary Tract Symptoms in Subjects with Subclinical Cerebral White Matter Lesions

Journal of Aging Research ◽

10.1155/2018/1582092 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Chi-Hang Yee ◽

Ching Leung ◽

Yuki Yu-Ting Wong ◽

Sylvia Lee ◽

Jenny Li ◽

...

Keyword(s):

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

White Matter Lesions ◽

Community Dwelling ◽

Urinary Symptoms ◽

Cerebral White Matter ◽

Mri Brain ◽

Urinary Tract Symptoms ◽

Lower Urinary

Aim. We assessed the impact of cerebral white matter lesions (WMLs) on lower urinary tract symptoms in subjects with normal neurological and cognitive function.Methods. A cohort of community-dwelling subjects aged ≥65 years were recruited to undergo MRI brain assessment. WMLs were graded using the Fazekas scale from 0 to 3. A separate telephone interview was carried out to assess the urinary symptoms in these subjects using the questionnaire Overactive Bladder-Validated 8-Question Awareness Tool (OAB-V8).Results. 800 community-dwelling elderly subjects were recruited to undergo MRI brain. In this cohort, 431 subjects responded to the telephone interview concerning their urinary symptoms. Among the respondents, 21.1% did not exhibit any WML on their MRI brain. Most of the subjects (52.6%) exhibited grade 1 WML. On logistic regression, age was found to be positively correlated with the Fazekas score (correlation coefficient 0.203,p≤0.01). Using a cutoff of 8 on OAB-V8, 22% of the respondents experienced OAB. Presence of WML, hypertension, or diabetes mellitus was not found to be correlated with storage urinary symptoms or OAB-V8 total score. Multiple logistic regression analysis did not show the presence of WML to be associated with the diagnosis of OAB (adjusted OR 1.13, 95% CI 0.65–1.96,p=0.659).Conclusions. WML is associated with age and is common in the elderly population. Mild WML is subclinical, with no obvious neurological and urinary symptoms. Our cohort did not demonstrate a relationship between WML and lower urinary tract symptoms.

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