Centre for Nutritional Physiology, Sansom Institute for Health Research, School of Health Sciences, University of South Australia, City East Campus, Adelaide, South Australia, Australia.
J Urol. 2013 Oct;190(4):1165-72. doi: 10.1016/j.juro.2013.04.076. Epub 2013 Apr 30.
Urinary urgency is an adverse sensory experience. Confirmation of the multidimensional nature of other adverse sensory experiences such as pain and dyspnea has improved the understanding of neurophysiological and perceptual mechanisms leading to innovations in assessment and treatment. It has been suggested that the sensation of urgency may include multiple dimensions such as intensity, suddenness and unpleasantness. In this systematic review we determine which dimensions of sensation have been assessed by instruments used to measure urinary urgency.
A systematic search was undertaken of MEDLINE, Embase, AMED, CINAHL, Ageline, Web of Science, InformIT Health and Scopus databases to identify studies that included assessments of urinary urge or urgency. Articles were included in the analysis if they were primary studies that described the method used to measure urge/urgency in adults and published in English in peer reviewed publications since January 1, 2000. Articles were excluded from study if urgency was measured only in conjunction with other symptoms (eg frequency or incontinence) or if there was no English version of the instrument. Secondary analyses and systematic reviews were retained to hand search references for additional primary studies. Data were extracted for the instruments used to measure urge/urgency. For each instrument the items specific to urinary urgency were reviewed using a prospectively developed categorization process for the sensory dimension and the measurement metric. Items used to assess urinary urgency were collated in a matrix (sensory dimensions vs assessment metric). The most frequently used dimensions, metrics and combinations were descriptively analyzed.
After removal of duplicate articles 1,048 full text articles were screened and 411 were excluded, leaving 637 eligible articles from which data were extracted. A total of 216 instruments were identified which were 1 of 6 types, namely 1) wider symptom questionnaires, 2) urgency specific questionnaires, 3) ordinal scales, 4) visual analog scales, 5) event records or 6) body maps. These 216 instruments contained a total of 309 urgency specific items. Of the instruments 51% did not define a dimension of sensation and 26% did not define the metric used. From the remaining instruments 8 dimensions of sensation and 5 types of metrics were identified. From most common to least common, the sensory dimensions assessed were behavioral response, intensity, suddenness, bother, affective response, unpleasantness, quality (descriptors) and problems associated with sensation. Metrics were magnitude, frequency, presence, time frame or location. The most common sensory dimension/metric combinations were frequency of a behavioral response (14% of items) and magnitude of bother caused by the sensation (8% of items).
The hypothesis that urinary urgency is multidimensional is supported by the range of dimensions assessed with available instruments. To clarify the nature of urinary urgency compared with the normal desire to void, prospective studies are required to determine whether sensory dimensions are distinct, and which may delineate between normal and pathological sensation.
尿急是一种不良的感觉体验。对疼痛和呼吸困难等其他不良感觉体验的多维性质的确认，提高了对导致评估和治疗创新的神经生理和感知机制的理解。有人认为，尿急的感觉可能包括强度、突然性和不愉快等多个维度。在本系统评价中，我们确定了用于测量尿急的仪器评估了哪些感觉维度。
系统检索了 MEDLINE、Embase、AMED、CINAHL、Ageline、Web of Science、InformIT Health 和 Scopus 数据库，以确定包括评估尿急迫或尿急的研究。如果是描述了 2000 年 1 月 1 日以后在同行评议出版物中以英文发表的用于测量成人急迫/尿急的方法的原始研究，则将这些文章纳入分析。如果仅在与其他症状（如频率或失禁）一起测量尿急，或者仪器没有英文版本，则将这些文章从研究中排除。保留了二次分析和系统评价，以便对手头的参考文献进行进一步的原始研究检索。提取用于测量急迫/尿急的仪器的数据。对于每种仪器，使用前瞻性开发的感觉维度分类过程和测量指标来审查专门用于评估尿急的项目。尿急评估项目被整理在一个矩阵中（感觉维度与评估指标）。对最常用的维度、指标和组合进行了描述性分析。
去除重复的文章后，共筛选出 1048 篇全文文章，其中 411 篇被排除，共有 637 篇符合条件的文章被提取数据。共确定了 216 种仪器，分为 6 种类型，分别为：1）更广泛的症状问卷，2）专门针对尿急的问卷，3）有序量表，4）视觉模拟量表，5）事件记录或 6）身体图。这 216 种仪器共有 309 项专门针对尿急的项目。在这些仪器中，51%没有定义感觉维度，26%没有定义使用的指标。在其余的仪器中，确定了 8 个感觉维度和 5 种度量类型。从最常见到最不常见，评估的感觉维度分别是行为反应、强度、突然性、困扰、情感反应、不愉快、质量（描述符）和感觉相关的问题。指标是幅度、频率、存在、时间框架或位置。最常见的感觉维度/指标组合是行为反应的频率（占项目的 14%）和感觉引起的困扰程度（占项目的 8%）。
尿急是多维的假设得到了现有仪器评估的各种维度的支持。为了阐明尿急与正常排尿欲望之间的性质，需要前瞻性研究来确定感觉维度是否不同，以及哪些维度可以区分正常和病理性感觉。
