Videourodynamic studies in men with lower urinary tract symptoms

A comparison of community based versus referral urological practices

F. Fusco, A. Groutz, J. G. Blaivas, David Chaikin, J. P. Weiss

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Purpose: We compared the clinical and urodynamic characteristics of men referred for evaluation of lower urinary tract symptoms in community based versus referral urological practices and examined the various pathophysiological mechanisms of these symptoms. Materials and Methods: We reviewed a multicenter urodynamics database of 963 consecutive men referred for the evaluation of persistent lower urinary tract symptoms at 2 community based and 1 urological referral center. Of the 963 patients in the database 422 (44%) were excluded from study due to neurological disorder in 41%, previous urinary or pelvic surgery in 27% and the use of medications known to affect voiding in 24%. A total of 541 patients with a mean age plus or minus standard deviation of 64.4 ± 13.8 years met study inclusion criteria and were analyzed further. We compared the clinical and urodynamic characteristics of patients at the community and referral centers. Results: Lower urinary tract symptoms were equally common in men presenting to community and referral centers. The most common symptom was difficult voiding, followed by frequency, urgency and nocturia in 58%, 54%, 43% and 40% of the study population, respectively. Urodynamic diagnoses were also similar in the 2 groups. Although bladder outlet obstruction was diagnosed in 69% of patients, it was the only urodynamic finding in a third of the patients with obstruction. The main concomitant urodynamic diagnoses were detrusor overactivity, bladder hyposensitivity, impaired detrusor contractility, low bladder compliance and bladder hypersensitivity in 47%, 10%, 10%, 9% and 3% of obstructed cases, respectively. Conclusions: The pathophysiology of lower urinary tract symptoms in men is multifactorial, and similar at community practice and tertiary referral centers. The disparity in urodynamic findings and subjective symptoms emphasizes the need for a thorough and early clinical and urodynamic evaluation.

Original languageEnglish (US)
Pages (from-to)910-913
Number of pages4
JournalJournal of Urology
Volume166
Issue number3
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Fingerprint

Lower Urinary Tract Symptoms
Urodynamics
Referral and Consultation
Urinary Bladder
Databases
Nocturia
Urinary Bladder Neck Obstruction
Nervous System Diseases
Tertiary Care Centers
Compliance
Hypersensitivity

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

@article{dc9a4fe8e2f54fd6b90663aadb05d8f2,
title = "Videourodynamic studies in men with lower urinary tract symptoms: A comparison of community based versus referral urological practices",
abstract = "Purpose: We compared the clinical and urodynamic characteristics of men referred for evaluation of lower urinary tract symptoms in community based versus referral urological practices and examined the various pathophysiological mechanisms of these symptoms. Materials and Methods: We reviewed a multicenter urodynamics database of 963 consecutive men referred for the evaluation of persistent lower urinary tract symptoms at 2 community based and 1 urological referral center. Of the 963 patients in the database 422 (44{\%}) were excluded from study due to neurological disorder in 41{\%}, previous urinary or pelvic surgery in 27{\%} and the use of medications known to affect voiding in 24{\%}. A total of 541 patients with a mean age plus or minus standard deviation of 64.4 ± 13.8 years met study inclusion criteria and were analyzed further. We compared the clinical and urodynamic characteristics of patients at the community and referral centers. Results: Lower urinary tract symptoms were equally common in men presenting to community and referral centers. The most common symptom was difficult voiding, followed by frequency, urgency and nocturia in 58{\%}, 54{\%}, 43{\%} and 40{\%} of the study population, respectively. Urodynamic diagnoses were also similar in the 2 groups. Although bladder outlet obstruction was diagnosed in 69{\%} of patients, it was the only urodynamic finding in a third of the patients with obstruction. The main concomitant urodynamic diagnoses were detrusor overactivity, bladder hyposensitivity, impaired detrusor contractility, low bladder compliance and bladder hypersensitivity in 47{\%}, 10{\%}, 10{\%}, 9{\%} and 3{\%} of obstructed cases, respectively. Conclusions: The pathophysiology of lower urinary tract symptoms in men is multifactorial, and similar at community practice and tertiary referral centers. The disparity in urodynamic findings and subjective symptoms emphasizes the need for a thorough and early clinical and urodynamic evaluation.",
author = "F. Fusco and A. Groutz and Blaivas, {J. G.} and David Chaikin and Weiss, {J. P.}",
year = "2001",
month = "1",
day = "1",
doi = "10.1016/S0022-5347(05)65862-4",
language = "English (US)",
volume = "166",
pages = "910--913",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "3",

}

Videourodynamic studies in men with lower urinary tract symptoms : A comparison of community based versus referral urological practices. / Fusco, F.; Groutz, A.; Blaivas, J. G.; Chaikin, David; Weiss, J. P.

In: Journal of Urology, Vol. 166, No. 3, 01.01.2001, p. 910-913.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Videourodynamic studies in men with lower urinary tract symptoms

T2 - A comparison of community based versus referral urological practices

AU - Fusco, F.

AU - Groutz, A.

AU - Blaivas, J. G.

AU - Chaikin, David

AU - Weiss, J. P.

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Purpose: We compared the clinical and urodynamic characteristics of men referred for evaluation of lower urinary tract symptoms in community based versus referral urological practices and examined the various pathophysiological mechanisms of these symptoms. Materials and Methods: We reviewed a multicenter urodynamics database of 963 consecutive men referred for the evaluation of persistent lower urinary tract symptoms at 2 community based and 1 urological referral center. Of the 963 patients in the database 422 (44%) were excluded from study due to neurological disorder in 41%, previous urinary or pelvic surgery in 27% and the use of medications known to affect voiding in 24%. A total of 541 patients with a mean age plus or minus standard deviation of 64.4 ± 13.8 years met study inclusion criteria and were analyzed further. We compared the clinical and urodynamic characteristics of patients at the community and referral centers. Results: Lower urinary tract symptoms were equally common in men presenting to community and referral centers. The most common symptom was difficult voiding, followed by frequency, urgency and nocturia in 58%, 54%, 43% and 40% of the study population, respectively. Urodynamic diagnoses were also similar in the 2 groups. Although bladder outlet obstruction was diagnosed in 69% of patients, it was the only urodynamic finding in a third of the patients with obstruction. The main concomitant urodynamic diagnoses were detrusor overactivity, bladder hyposensitivity, impaired detrusor contractility, low bladder compliance and bladder hypersensitivity in 47%, 10%, 10%, 9% and 3% of obstructed cases, respectively. Conclusions: The pathophysiology of lower urinary tract symptoms in men is multifactorial, and similar at community practice and tertiary referral centers. The disparity in urodynamic findings and subjective symptoms emphasizes the need for a thorough and early clinical and urodynamic evaluation.

AB - Purpose: We compared the clinical and urodynamic characteristics of men referred for evaluation of lower urinary tract symptoms in community based versus referral urological practices and examined the various pathophysiological mechanisms of these symptoms. Materials and Methods: We reviewed a multicenter urodynamics database of 963 consecutive men referred for the evaluation of persistent lower urinary tract symptoms at 2 community based and 1 urological referral center. Of the 963 patients in the database 422 (44%) were excluded from study due to neurological disorder in 41%, previous urinary or pelvic surgery in 27% and the use of medications known to affect voiding in 24%. A total of 541 patients with a mean age plus or minus standard deviation of 64.4 ± 13.8 years met study inclusion criteria and were analyzed further. We compared the clinical and urodynamic characteristics of patients at the community and referral centers. Results: Lower urinary tract symptoms were equally common in men presenting to community and referral centers. The most common symptom was difficult voiding, followed by frequency, urgency and nocturia in 58%, 54%, 43% and 40% of the study population, respectively. Urodynamic diagnoses were also similar in the 2 groups. Although bladder outlet obstruction was diagnosed in 69% of patients, it was the only urodynamic finding in a third of the patients with obstruction. The main concomitant urodynamic diagnoses were detrusor overactivity, bladder hyposensitivity, impaired detrusor contractility, low bladder compliance and bladder hypersensitivity in 47%, 10%, 10%, 9% and 3% of obstructed cases, respectively. Conclusions: The pathophysiology of lower urinary tract symptoms in men is multifactorial, and similar at community practice and tertiary referral centers. The disparity in urodynamic findings and subjective symptoms emphasizes the need for a thorough and early clinical and urodynamic evaluation.

UR - http://www.scopus.com/inward/record.url?scp=0034889626&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034889626&partnerID=8YFLogxK

U2 - 10.1016/S0022-5347(05)65862-4

DO - 10.1016/S0022-5347(05)65862-4

M3 - Article

VL - 166

SP - 910

EP - 913

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 3

ER -