NorthShore University Health System (BTH, PT), Evanston, Illinois; Feinberg School of Medicine, Northwestern University (JWG), Chicago, Illinois; Arbor Research Collaborative for Health (ARS, VPA), Ann Arbor, Michigan; University of Michigan (APC), Ann Arbor, Michigan; Washington University School of Medicine (HHL), St. Louis, Missouri; University of Washington (CCY, JLG), Seattle, Washington; Department of Urology, University of Iowa (KJK), Iowa City, Iowa; Duke University Medical Center (KPW, AL), Durham, North Carolina; National Institute of Diabetes and Digestive and Kidney Diseases (ZK), Bethesda, Maryland.
NorthShore University Health System (BTH, PT), Evanston, Illinois; Feinberg School of Medicine, Northwestern University (JWG), Chicago, Illinois; Arbor Research Collaborative for Health (ARS, VPA), Ann Arbor, Michigan; University of Michigan (APC), Ann Arbor, Michigan; Washington University School of Medicine (HHL), St. Louis, Missouri; University of Washington (CCY, JLG), Seattle, Washington; Department of Urology, University of Iowa (KJK), Iowa City, Iowa; Duke University Medical Center (KPW, AL), Durham, North Carolina; National Institute of Diabetes and Digestive and Kidney Diseases (ZK), Bethesda, Maryland.
J Urol. 2018 Aug;200(2):397-404. doi: 10.1016/j.juro.2018.02.075. Epub 2018 Mar 1.
Male urinary incontinence is thought to be infrequent. We sought to describe the prevalence of urinary incontinence in a male treatment seeking cohort enrolled in the LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network).
Study inclusion and exclusion criteria, including men with prostate cancer or neurogenic bladder, were previously reported. LURN participants prospectively completed questionnaires regarding lower urinary tract symptoms and other clinical variables. Men were grouped based on incontinence type, including 1) no urinary incontinence, 2) post-void dribbling only and 3) urinary incontinence. Comparisons were made using ANOVA and multivariable regression.
Of the 477 men 24% reported no urinary incontinence, 44% reported post-void dribbling only and 32% reported urinary incontinence. African American men and those with sleep apnea were more likely to be in the urinary incontinence group than in the no urinary incontinence group (OR 3.2, p = 0.02 and OR 2.73, p = 0.003, respectively). Urinary incontinence was associated with significantly higher bother compared to men without leakage (p <0.001). Compared to men without urinary incontinence and men with only post-void dribbling those with urinary incontinence were significantly more likely to report higher scores (more severe symptoms) on the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaires regarding bowel issues, depression and anxiety than men without urinary incontinence (p <0.01).
Urinary incontinence is common among treatment seeking men. This is concerning because the guideline recommended questionnaires to assess male lower urinary tract symptoms do not query for urinary incontinence. Thus, clinicians may be missing an opportunity to intervene and improve patient care. This provides a substantial rationale for a new or updated symptom questionnaire which provides a more comprehensive symptom assessment.
男性尿失禁被认为不常见。我们旨在描述在参与 LURN（下尿路功能障碍症状研究网络）的男性治疗队列中尿失禁的患病率。
先前已报道了研究纳入和排除标准，包括患有前列腺癌或神经源性膀胱的男性。LURN 参与者前瞻性地完成了关于下尿路症状和其他临床变量的问卷。根据尿失禁类型对男性进行分组，包括 1）无尿失禁，2）仅排尿后滴沥和 3）尿失禁。使用 ANOVA 和多变量回归进行比较。
在 477 名男性中，24%报告无尿失禁，44%报告仅排尿后滴沥，32%报告尿失禁。非裔美国男性和患有睡眠呼吸暂停的男性更有可能处于尿失禁组而不是无尿失禁组（OR 3.2，p = 0.02 和 OR 2.73，p = 0.003）。与无漏尿的男性相比，尿失禁男性的困扰明显更高（p <0.001）。与无尿失禁和仅排尿后滴沥的男性相比，有尿失禁的男性更有可能报告 PROMIS（患者报告的结果测量信息系统）问卷中关于肠道问题、抑郁和焦虑的评分更高（症状更严重）（p <0.01）。
在寻求治疗的男性中，尿失禁很常见。这令人担忧，因为指南建议的评估男性下尿路症状的问卷并未询问尿失禁。因此，临床医生可能会错过干预和改善患者护理的机会。这为新的或更新的症状问卷提供了充分的理由，该问卷提供了更全面的症状评估。
