nach oben

World Journal of Urology

Erschienen in:

01.06.2012 | Original Article

Urinary urgency: a review of its assessment as the key symptom of the overactive bladder syndrome

verfasst von: Paul Abrams, Christopher R. Chapple, Klaus-Peter Jünemann, Steven Sharpe

Erschienen in: World Journal of Urology | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Overactive bladder (OAB) is a common condition that is associated with a negative impact on quality of life. Urgency is the essential symptom when making a diagnosis, and its effective treatment is a principal aim in OAB management. However, urgency has often been relatively neglected as an outcome measure in clinical trials. The aim of this review is, first, to describe the background to urgency in OAB; second, to determine whether results provided by several tools used to measure urgency in clinical trials could be cross-related to each other in a meaningful way.

Methods

The wording of various tools used to measure urgency in OAB was compared against the definition of urgency proposed by the International Continence Society (ICS). Urgency data were evaluated from two randomised, double-blinded, placebo-controlled trials with solifenacin in which seven tools were used to measure urgency as a primary or secondary outcome. In particular, subanalyses were available from these tools, which measured urgency equating to the ICS definition, excluding data points that could be interpreted as normal/strong desire to void.

Results

Baseline scores for ICS-defined urgency differed between the tools, which might reflect imprecision in their wording and consequent overlap between urgency and normal/strong desire to void. All the tools detected broadly similar mean percentage reductions in the number of urgency episodes from baseline to the endpoint of the studies.

Conclusions

Urgency should be the primary or co-primary endpoint for future studies of OAB and detrusor overactivity. Greater clarity is needed in the development of instruments for measuring urgency, so that they do not confuse urgency with normal bladder sensations; more education and guidance are needed on how urgency is defined.

Irwin DE, Milsom I, Hunskaar S et al (2006) Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 50:1306–1315PubMedCrossRef

Stewart WF, Van Rooyen JB, Cundiff GW et al (2003) Prevalence and burden of overactive bladder in the United States. World J Urol 20:327–336PubMed

Milsom I, Abrams P, Cardozo L, Roberts RG, Thüroff J, Wein AJ (2001) How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 87:760–766PubMedCrossRef

Herschorn S, Gajewski J, Schulz J, Corcos J (2008) A population-based study of urinary symptoms and incontinence: the Canadian urinary bladder survey. BJU Int 101:52–58PubMed

Yu H-J, Liu C-Y, Lee K-L, Lee W-C, Chen TH-H (2006) Overactive bladder syndrome among community-dwelling adults in Taiwan: prevalence, correlates, perception, and treatment seeking. Urol Int 77:327–333PubMedCrossRef

Abrams P, Cardozo L, Fall M et al (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178PubMedCrossRef

Abrams P, Artibani W, Cardozo L, Dmochowski R, van Kerrebroeck P, Sand P (2006) Reviewing the ICS 2002 terminology report: the ongoing debate. Neurourol Urodyn 25:293CrossRef

Chapple CR, Artibani W, Cardozo LD et al (2005) The role of urinary urgency and its measurement in the overactive bladder symptom syndrome: current concepts and future prospects. BJU Int 95:335–340PubMedCrossRef

Andersson K-E (2004) Antimuscarinics for treatment of overactive bladder. Lancet Neurol 3:46–53PubMedCrossRef

10.

Wyndaele JJ, De Wachter S (2002) Cystometrical sensory data from a normal population: comparison of two groups of young healthy volunteers examined with 5 years interval. Eur Urol 42:34–38PubMedCrossRef

11.

Starkman JS, Dmochowski RR (2008) Urgency assessment in the evaluation of overactive bladder (OAB). Neurourol Urodyn 27:13–21PubMedCrossRef

12.

Chapple CR, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D (2008) The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol 54:543–562PubMedCrossRef

13.

Cardozo L, Heßdörfer E, Milani R et al (2008) Solifenacin in the treatment of urgency and other symptoms of overactive bladder: results from a randomized, double-blind, placebo-controlled, rising-dose trial. BJU Int 102:1120–1127PubMedCrossRef

14.

Karram MM, Toglia MR, Serels SR, Andoh M, Fakhoury A, Forero-Schwanhaeuser S (2009) Treatment with solifenacin increases warning time and improves symptoms of overactive bladder: results from VENUS, a randomised, double-blind, placebo-controlled trial. Urology 73:14–18PubMedCrossRef

15.

Andersson K-E, Chapple CR, Cardozo L et al (2009) Pharmacological treatment of urinary incontinence. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) 4th International consultation on incontinence, Paris, July 5–8, 2008, 4th Edition, 633–99

16.

Toglia M, Andoh M, Hussain I (2006) Solifenacin improves urgency symptoms as assessed by voiding diaries and patient-reported outcomes (PRO) in patients with overactive bladder. 36th Annual meeting of the international continence society (ICS). Christchurch, New Zealand, November 27th—December 1st:Abstr 155

17.

Zinner S, Herschorn S, Andoh M, Hussain I (2007) Responder analyses show statistically significant improvements in incontinence and urgency are associated with reduction in symptom bother and improvement in health-related quality of life: VENUS results. Int Urogynecol J 18(Suppl 1):S25–S105 Abstr 123

18.

Cartwright R, Panayi D, Cardozo L, Khullar V (2009) Reliability and normal ranges for the patient’s perception of intensity of urgency scale in asymptomatic women. BJU Int 105:832–836PubMedCrossRef

19.

Nixon A, Colman S, Sabounjian L, Sandage B, Schwiderski UE, Staskin DR et al (2005) A validated patient reported measure of urinary urgency severity in overactive bladder for use in clinical trials. Urol 174:604–607CrossRef

20.

Cardozo L, Coyne KS, Versi E (2005) Validation of the urgency perception scale. BJU Int 95:591–596PubMedCrossRef

21.

Matza LS, Thompson CL, Krasnow J, Brewster-Jordan J, Zyczynski T, Coyne KS (2005) Test-retest reliability of four questionnaires for patients with overactive bladder: the overactive bladder questionnaire (OAB-q), patient perception of bladder condition (PPBC), urgency questionnaire (UQ), and the primary OAB symptom questionnaire (POSQ). Neurourol Urodyn 24:215–225PubMedCrossRef

Titel: Urinary urgency: a review of its assessment as the key symptom of the overactive bladder syndrome
verfasst von: Paul Abrams
Christopher R. Chapple
Klaus-Peter Jünemann
Steven Sharpe
Publikationsdatum: 01.06.2012
Verlag: Springer-Verlag
Erschienen in: World Journal of Urology / Ausgabe 3/2012
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-011-0742-8

Neu im Fachgebiet Urologie

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2012

Oncologic outcomes following radical prostatectomy with intraoperative cell salvage

Prospective comparison of short-term functional outcomes obtained after pure laparoscopic and robot-assisted laparoscopic sacrocolpopexy

Videourodynamic changes of botulinum toxin A in patients with neurogenic bladder dysfunction (NBD) and idiopathic detrusor overactivity (IDO) refractory to drug treatment

Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia

NF-κB signaling in prostate cancer: A promising therapeutic target?