General Obstetrics and Gynecology: GynecologyThe standardisation of terminology of lower urinary tract function: Report from the standardisation sub-committee of the international continence society☆,☆☆
Section snippets
Lower urinary tract symptoms (LUTS)
Symptoms are the subjective indicator of a disease or change in condition as perceived by the patient, carer or partner and may lead him/her to seek help from health care professionals. (NEW)
Symptoms may either be volunteered or described during the patient interview. They are usually qualitative. In general, Lower Urinary Tract Symptoms cannot be used to make a definitive diagnosis. Lower Urinary Tract Symptoms can also indicate pathologies other than lower urinary tract dysfunction, such as
Signs suggestive of lower urinary tract dysfunction (LUTD)
Signs are observed by the physician including simple means, to verify symptoms and quantify them. (NEW)
For example, a classical sign is the observation of leakage on coughing. Observations from frequency volume charts, pad tests and validated symptom and quality of life questionnaires are examples of other instruments that can be used to verify and quantify symptoms.
Urodynamic observations
Urodynamic observations are observations made during urodynamic studies. (NEW)
For example, an involuntary detrusor contraction (detrusor overactivity) is a urodynamic observation. In general, a urodynamic observation may have a number of possible underlying causes and does not represent a definitive diagnosis of a disease or condition and may occur with a variety of symptoms and signs, or in the absence of any symptoms or signs.
Conditions
Conditions are defined by the presence of urodynamic observations associated with characteristic symptoms or signs and/or non-urodynamic evidence of relevant pathological processes. (NEW)
Treatment
Treatment for lower urinary tract dysfunction: these definitions are from the 7th ICS report on Lower Urinary Tract Rehabilitation Techniques [Andersen et al., 1992].
1. Lower urinary tract symptoms (LUTS)
Lower urinary tract symptoms are defined from the individual's perspective, who is usually, but not necessarily a patient within the healthcare system. Symptoms are either volunteered by, or elicited from, the individual or may be described by the individual's caregiver.
Lower urinary tract symptoms are divided into three groups, storage, voiding, and post micturition symptoms.
2.1 Measuring the Frequency, Severity and Impact of Lower Urinary Tract Symptoms
Asking the patient to record micturitions and symptomsfor a period of days provides invaluable information. The recording of micturition events can be in three main forms:
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Micturition time chart: this records only the times of micturitions, day and night, for at least 24 hours. (NEW)
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Frequency volume chart (FVC): this records the
3.1 Urodynamic techniques
There are two principal methods of urodynamic investigation:
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Conventional urodynamic studies normally take place in the urodynamic laboratory and usually involve artificial bladder filling. (NEW)
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Artificial bladder filling is defined as filling the bladder, via a catheter, with a specified liquid at a specified rate. (NEW)
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Ambulatory urodynamic studies are defined as a functional test of the lower urinary tract, utilising natural filling, and reproducing the subject's every day activities.
4. Conditions
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Acute retention of urine is defined as a painful, palpable or percussable bladder, when the patient is unable to pass any urine. (NEW)
5. Treatment
The following definitions were published in the 7th ICS report on Lower Urinary Tract Rehabilitation Techniques(3) and remain in their original form.
Acknowledgements
The authors of this report are very grateful to Vicky Rees, Administrator of the ICS, for her typing and editing of numerous drafts of this document.
ADDENDUM
Formation of the ICS Terminology Committee
The terminology committee was announced at the ICS meeting in Denver 1999 and expressions of interest were invited from those who wished to be active members of the committee and they were asked to comment in detail on the preliminary draft (the discussion paper published Neurourology and
References (17)
- et al.
ICS standardisation of terminology of lower urinary tract function
Neurourol Urodyn
(1988) - et al.
ICS 6th report on the standardisation of terminology of lower urinary tract function
Neurourol Urodyn
(1992) - et al.
ICS 7th report on the standardisation of terminology of lower urinary tract rehabilitation techniques
Neurourol Urodyn
(1992) - et al.
The standardisation of terminology of female pelvic organ prolapse and pelvic floor dysfunction
Am J Obstet Gynecol
(1996) - Fonda D, Resnick NM, Colling J, Burgio K, Ouslander JG, Norton C, Ekelund P, Versi E, Mattiasson A. 1998. Outcome...
- Griffiths D, Höfner K, van Mastrifgt R, Rollema HJ, Spangberg A, Gleason D. 1997. ICS report on the standardisation of...
- International Classification of Functioning, Disability and Health. ICIDH-2 website...
Natural pressure: volume curves and conventional cystometry
Scand J Urol Nephrol Suppl
(1999)
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Reprinted with permission from Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A. The standardisation of terminology of lower urinary tract function: Report from the Standardisation Sub-committee of the International Continence Society. Neurobiol Urodynam 2002;21:167-78.
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Am J Obstet Gynecol 2002;187:116-26.