无急迫性尿失禁的急迫性尿失禁患者的表型分析及其与急迫性尿失禁患者的比较：来自 LURN 研究的结果。
Phenotyping of Urinary Urgency Patients Without Urgency Incontinence, and Their Comparison to Urgency Incontinence Patients: Findings From the LURN Study.
机构信息
Division of Urologic Surgery, Departments of Surgery and Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
Arbor Research Collaborative for Health, Ann Arbor, Michigan.
出版信息
J Urol. 2023 Jan;209(1):233-242. doi: 10.1097/JU.0000000000002939. Epub 2022 Sep 6.
PURPOSE
We characterize patients with urinary urgency with vs without urgency urinary incontinence who presented to clinics actively seeking treatment for their symptoms.
MATERIALS AND METHODS
Participants who enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network were categorized into urinary urgency with vs without urgency urinary incontinence. Participants were followed for 1 year; their urinary symptoms, urological pain, psychosocial factors, bowel function, sleep disturbance, physical activity levels, physical function, and quality of life were compared. Mixed effects linear regression models were used to examine the relationships between urgency urinary incontinence and these factors.
RESULTS
Among 683 participants with urinary urgency at baseline, two-thirds (n=453) also had urgency urinary incontinence; one-third (n=230) had urinary urgency-only without urgency urinary incontinence. No differences were detected in urological pain between urinary urgency-only and urgency urinary incontinence. Those with urgency urinary incontinence had more severe urgency and frequency symptoms, higher depression, anxiety, perceived stress scores, more severe bowel dysfunction and sleep disturbance, lower physical activity levels, lower physical function, and worse quality of life than those with urinary urgency-only. Among those with urinary urgency-only at baseline, 40% continued to have urinary urgency-only, 15% progressed to urgency urinary incontinence, and 45% had no urgency at 12 months. Fifty-eight percent with urgency urinary incontinence at baseline continued to report urgency urinary incontinence at 12 months, while 15% improved to urinary urgency-only, and 27% had no urgency.
CONCLUSIONS
Patients with urgency urinary incontinence have severe storage symptoms, more psychosocial symptoms, poorer physical functioning, and worse quality of life. Our data suggested urgency urinary incontinence may be a more severe manifestation of urinary urgency, rather than urinary urgency and urgency urinary incontinence being distinct entities.
目的
我们对主动就诊治疗症状的急迫性尿失禁伴或不伴急迫性尿失禁患者的临床特征进行了描述。
材料和方法
参加下尿路症状研究网络的参与者被分为急迫性尿失禁伴或不伴急迫性尿失禁。对参与者进行了为期 1 年的随访，比较了他们的尿症状、尿通科疼痛、社会心理因素、肠功能、睡眠障碍、体力活动水平、身体功能和生活质量。采用混合效应线性回归模型来研究急迫性尿失禁与这些因素之间的关系。
结果
在基线时有急迫性尿症状的 683 名参与者中，有三分之二（n=453）同时伴有急迫性尿失禁；三分之一（n=230）仅有急迫性尿症状而无急迫性尿失禁。仅有急迫性尿症状与急迫性尿失禁患者的尿通科疼痛无差异。有急迫性尿失禁的患者具有更严重的急迫性和频发性症状，更高的抑郁、焦虑、感知压力评分，更严重的肠功能障碍和睡眠障碍，更低的体力活动水平，更低的身体功能和更差的生活质量。在基线时仅有急迫性尿症状的患者中，有 40%在 12 个月时仍仅有急迫性尿症状，15%进展为急迫性尿失禁，45%在 12 个月时无急迫性尿症状。基线时有急迫性尿失禁的患者中有 58%在 12 个月时仍报告有急迫性尿失禁，15%改善为仅有急迫性尿症状，27%无急迫性尿症状。
结论
急迫性尿失禁患者具有严重的储尿症状、更多的社会心理症状、更差的身体功能和更差的生活质量。我们的数据表明，急迫性尿失禁可能是急迫性尿症状的一种更严重表现，而不是两种不同的疾病实体。
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