Bharti Vishrut, Tiwari Rajesh K, Gupta Sanjay, Upadhyay Rohit, Singh Manoj K, Singh Deelip K
Department of Urology, Indira Gandhi, Institute of Medical Sciences, Patna, India.
Curr Urol. 2023 Sep;17(3):179-183. doi: 10.1097/CU9.0000000000000196. Epub 2023 Mar 28.
Although the prevalence of lower urinary tract symptoms (LUTS) is high in the female population, it is even higher in postmenopausal females. The frequency, severity, and etiology of LUTS vary among populations and individuals. This study aimed to define the characteristics of LUTS in postmenopausal women and their underlying etiologies.
Overall, 74 postmenopausal patients presenting with LUTS in the urological outpatient department were included in the study. A detailed evaluation of LUTS and their underlying etiologies was performed. Patients were divided into 2 groups based on age (<65 and ≥65 years), and the variation in different factors was compared across the groups. Variables were compared using the test and 1-way analysis of variance.
Nocturia was the most common symptom (89.2%) followed by frequency (83.8%). Among voiding LUTS, the most common was a weak stream (63.5%). Frequency, nocturia, urgency, urge urinary incontinence (UI), stress UI, and nocturnal enuresis were more common in patients older than 65 years. Urgency and urge UI were recognized to be the most bothersome symptoms by 37% of the study population followed by straining (32%). The mean storage scores, incontinence scores, and quality of life (QoL) scores for patients younger than 65 years and 65 years or older were 6.9 and 8.5 ( < 0.01), 1.8 and 4.1 ( ≤ 0.01), 4.9 and 6.1, respectively. The most common diagnosis was bladder outlet obstruction due to urethral/meatal stenosis (40.5%) followed by an overactive bladder (32.4%), urinary tract infection (10.8%), cystocele (8.1%), urethral prolapse (4.1%), and urethral caruncle (4.1%).
Storage LUTS were the most common and increased in both frequency and severity with age. The QoL was also more severely affected in older postmenopausal women. Bladder outlet obstruction due to meatal with or without distal urethral stenosis was the most common underlying cause of LUTS followed by an overactive bladder. Overactive bladder had the most severe impact on patients' QoL among all the etiologies.
尽管下尿路症状（LUTS）在女性人群中患病率较高，但在绝经后女性中更为常见。LUTS的频率、严重程度和病因在不同人群和个体之间存在差异。本研究旨在明确绝经后女性LUTS的特征及其潜在病因。
本研究纳入了74例在泌尿外科门诊就诊的有LUTS的绝经后患者。对LUTS及其潜在病因进行了详细评估。根据年龄（<65岁和≥65岁）将患者分为两组，并比较两组不同因素的差异。使用检验和单因素方差分析对变量进行比较。
夜尿是最常见的症状（89.2%），其次是尿频（83.8%）。在排尿期LUTS中，最常见的是尿流无力（63.5%）。尿频、夜尿、尿急、急迫性尿失禁（UI）、压力性尿失禁、夜间遗尿在65岁以上患者中更为常见。37%的研究人群认为尿急和急迫性尿失禁是最困扰的症状，其次是排尿费力（32%）。65岁以下和65岁及以上患者的平均储尿期评分、尿失禁评分和生活质量（QoL）评分分别为6.9和8.5（P<0.01）、1.8和4.1（P≤0.01）、4.9和6.1。最常见的诊断是尿道/尿道口狭窄导致的膀胱出口梗阻（40.5%），其次是膀胱过度活动症（32.4%）、尿路感染（10.8%）、膀胱膨出（8.1%）、尿道脱垂（4.1%）和尿道肉阜（4.1%）。
储尿期LUTS最为常见，且频率和严重程度均随年龄增加。绝经后老年女性的生活质量也受到更严重的影响。尿道口狭窄伴或不伴远端尿道狭窄导致的膀胱出口梗阻是LUTS最常见的潜在病因，其次是膀胱过度活动症。在所有病因中，膀胱过度活动症对患者生活质量的影响最为严重。
