A bladder diary records the urination time and is used for the diagnosis of patients with urination disorders. We have developed a non-contact uroflowmeter system to record urination time. In this ...study, we compared the urination time recorded by the uroflowmeter system, which is used as a standard, and that recorded manually in a bladder diary. Time differences between the two methods of recording urination time were evaluated in 645 urinations in healthy subjects (Subj group) and 102 urinations in hospitalized patients (P_Subj group). Individuals in the Subj group confirmed the urination time using a radio controlled clock, while those in the P_Subj group confirmed the time using their own clock according to standard medical care procedures. The differences in urination time recorded manually by participants in the P_Subj group were due to human error, and the time differences were significantly longer than those in the Subj group. These results suggest that the uroflowmeter system will be useful for monitoring urination time for the bladder diary.
Op weg naar een ‘animictielijst’? Schlatmann, Florine W. M.; Smeenk, Stella C.; van Balken, Michael R.
Tijdschrift voor urologie,
05/2024
Journal Article
Recenzirano
Samenvatting Introductie De mictielijst is een veelgebruikt diagnostisch instrument in de urologie. Voor het verkrijgen van een betrouwbaar klinisch beeld is het essentieel dat deze correct wordt ...ingevuld. Uit eerdere onderzoeken bleek dat dat niet altijd probleemloos verloopt. Dit kwalitatieve onderzoek ging na of een geanimeerde invulinstructie het begrip van de manier waarop de mictielijst moet worden ingevuld meer vergroot dan een tekstuele invulinstructie. Materiaal en methoden Volwassenen beoordeelden een mictielijst met de reguliere tekstuele invulinstructie (TML) of met een geanimeerde invulinstructie (AML). We maakten gebruik van de thinking-aloud -methode en interviews. Vooraf gedefinieerde items werden gescoord. Resultaten AML-participanten hadden een beter begrip van hoe de ML moet worden ingevuld dan de TML-participanten van de mictielijst, wat vooral gold voor deelnemers met een laag opleidingsniveau. Zij scoorden beter bij het benoemen van de mictie, vochtinname, incontinentie en aandrang. Anderstaligen waardeerden de visuele ondersteuning. Conclusie Tekstuele invulinstructies voor mictielijsten zijn moeilijk te begrijpen voor deelnemers van alle opleidingsniveaus vanwege de terminologie en lay-out. Een geanimeerde invulinstructie verbetert het begrip en de invulkwaliteit, waardoor betrouwbaardere informatie wordt verkregen.
Abstract Introduction The bladder diary (BD) is a widely used diagnostic instrument. Its correct completion is essential for obtaining a reliable clinical impression. Previous studies reported problems with correctly completing the BD. This qualitative study investigated whether an animated fill-in instruction improves comprehension compared with a textual fill-in instruction. Material and methods Adults assessed either a BD with the regular textual fill-in instruction (TBD) or a BD with an animated fill-in instruction (ABD). The thinking-aloud method and interviews were used. Predefined items were scored. Results ABD participants had a better understanding of the BD than the TBD participants, especially participants with low levels of education. They scored better in naming micturition, fluid intake, incontinence and urge. Non-native speakers appreciated the visual support. Conclusion Textual fill-in instructions for bladder diaries are difficult to understand for participants of all education levels because of terminology and layout. Animated fill-in instructions improve comprehension and completion quality and provide more reliable information.
Defining nocturnal polyuria in women Baines, Georgina; Da Silva, Ana Sofia; Cardozo, Linda ...
Neurourology and urodynamics,
January 2021, 2021-01-00, 20210101, Letnik:
40, Številka:
1
Journal Article
Recenzirano
Aims
Nocturnal polyuria (NP) is defined by the International Continence Society (ICS) as “excessive production of urine during the main sleep period” and is one of the main causes of nocturia. The ...ICS recognized that “excessive” is not clearly defined and that this needs to be highlighted in both clinical and research settings. The aim of this study was to identify different definitions of NP and apply them to a population of women attending the Urogynaecology clinic.
Methods
This was a retrospective study of complete bladder diaries collected from women attending a tertiary Urogynaecology Unit. Six different definitions were identified and were divided into “absolute,” “relative,” and “functional definitions.” Prevalence data were calculated and values generated for sensitivity, specificity, positive and negative predictive values when related to women voiding ≥ 2 times per night.
Results
Complete bladder diaries were obtained from 1398 women, over 6 years, with a mean age of 57 years. Prevalence varied across the definitions from 21.5% (absolute definition) to 77% (relative definition). Sensitivity ranged from 43% (absolute) to 87% (relative). The definitions that showed the highest combined sensitivity and specificity were the functional definitions.
Conclusion
From this study it is clear that more work needs to be done to arrive at a consensus for defining NP to enable accurate diagnosis and development of treatment pathways. We propose that a relative definition may provide a more clinically relevant method of defining NP.
Lower urinary tract symptoms (LUTS) are a common presenting complaint for both men and women, affecting >60% of men and women aged >40 years. They encompass a wide range of aetiologies and can be an ...indicator of covert underlying pathologies such as obesity and metabolic syndrome. The initial assessment should focus on identifying the underlying cause and assessing the impact on quality of life aided by validated objective questionnaires. Risk factors have been identified that can predict the likelihood of progression of LUTS (e.g. urinary retention), such as age, moderately elevated prostate-specific antigen and prostate size. Initial management includes conservative and medical management, and not all patients require surgery. Identifying those at high risk of acute urinary retention helps in counselling and subsequent management decisions. Aside from lifestyle modification, medications include selective α-adrenoceptor blockers, 5α-reductase inhibitors, antimuscarinics, β3-agonists and phosphodiesterase-5 inhibitors, either as monotherapy or combination therapy.
Abstract Background Despite the common use of urinary diaries to assess lower urinary tract symptoms (LUTS), a standardised validated diary does not exist. Objective To develop a validated urinary ...diary, using the psychometric validation protocol used in previous International Consultation on Incontinence Questionnaire (ICIQ) modules. Design, setting, and participants We invited 400 consecutive patients attending the urology department for assessment of LUTS to complete a urinary diary (developed and validated for content in a previous study), and the ICIQ Male or Female LUTS questionnaire. Outcome measurements and statistical analysis To establish construct validity, the urinary diary was compared with known theories from published literature; to establish criterion validity, the diary was compared with questionnaire responses and/or urodynamic observations. Optimal diary duration was tested by comparing the 4-d diary against shorter durations. Patients completed a second diary after 2–3 wk for test-retest analysis, and a subset receiving sacral nerve stimulation completed the diary before and after treatment for analysis of responsiveness. A variety of statistical tests were used for different stages of the study. Results and limitations The urinary diaries and ICIQ LUTS questionnaires were completed by 264 patients. Construct validity was established for two of three tested hypotheses. Criterion testing showed good agreement between questionnaire and diary recordings of nocturia (κ = 0.653; p < 0.001; 92.2%) and incontinence (κ = 0.351; p < 0.001; 64.5%), whereas good agreement (κ = 0.378; p < 0.001; 69.2%) was observed between urodynamically proven incontinence and diary reports ( n = 104). Diary recordings of urgency showed weak agreement with questionnaire responses (κ = −0.215; p < 0.001; 36%) and urodynamic observations (κ = −0.105; p = 0.256; 43.7%). The 3-d diary explained at least 94% of the total variance of the 4-d diary. A second diary for test-retest analysis was returned by 59 patients, demonstrating fair to excellent agreement (Spearman correlations: 0.49–0.88). Pre- and post-treatment analysis, on pilot testing, showed that the diary is responsive to change. Conclusions Using the ICIQ psychometric validation methodology, a bladder diary was developed for the assessment of LUTS and shown to be valid, reliable, and responsive to change. The 3-d diary has been accepted as the ICIQ bladder diary. Patient summary In this study, patients and clinicians developed and tested a diary in which patients can record their urinary symptoms. The resulting 3-d diary is called the ICIQ bladder diary and is available for adult men and women with urinary symptoms.
Introduction and hypothesis
Urethrovaginal reflux (UVR) secondary to vaginal urine entrapment is an unnoticed cause of daytime urinary leakage in toilet-trained girls. Our aim is to emphasize the ...diagnosis of UVR as a cause of urinary incontinence, its predisposing factors, early detection, and treatment.
Methods
A total of 25 girls aged between 9 and 14 years presented with mixed daytime urinary incontinence from 2019 to 2021. They were evaluated by detailed history, vaginal examination, focused neurological examination, bladder diaries, urine analysis, uroflowmetry, and residual urine assessment. Micturating cystourethrography was also performed in those girls who did not show improvement with a conservative line of management.
Results
The parents of these girls were educated about the cause of leakage. They were treated with behavioral modifications, urotherapy, correcting toilet postures, and reverse sitting on the commode. Urethrovaginal reflux was found in 6 of the 25 girls (24%). Their ages were 9, 10, 10, 11, 12, and 14 years respectively. Two girls (10 and 14 years old) had a body mass index more than 25. They all had a typical history of a small quantity of urine leakage 5–10 min (post-micturition dribble) after every void. At follow-up after 12 months, all of them were free from urinary incontinence.
Conclusions
Urethrovaginal reflux should be considered in the differential diagnoses of girls with day-time incontinence. The key to diagnosis is an appropriate and detailed history as it is common for parents or girls to ignore symptoms or fail to report them. Proper voiding instructions and behavioral therapy often resolve the problem.
Introduction and hypothesis
The objectives of this study are (1) to assess practice patterns among urogynecology/female pelvic medicine and reconstructive surgery (FPMRS) providers regarding the use ...of bladder diaries (BD) and (2) to review the literature regarding BD.
Methods
For the first objective, a survey was emailed to United States-based urogynecology providers in 2019 querying frequency of use of bladder diaries (F
BD
), indications, problems, patient education methods, and perception of utility. Chi-square tests and multiple logistic regression were performed. For the second objective, we reviewed literature published in English by searching the terms “voiding,” “bladder,” or “incontinence,” in combination with “diary,” “log,” or “questionnaire.”
Results
A total of 371 of 851 (43.5%) contacted providers responded. Nearly 80% were attending physicians, 75.5% of whom completed the FPMRS fellowship; 20.8% of all respondents and nearly 25% of fellowship-trained attendings reported F
BD
<20% in the last year. FPMRS providers were more likely to report F
BD
>80%. A total of 97.5% of respondents cited difficulty in using BD. Most (71.6%) taught patients to use BD themselves or shared responsibility with a nonphysician staff member (53.4%). BD is a validated and valuable instrument; however, there are obstacles to its use. Despite recent innovations including electronic and automated BD, there is a paucity of data regarding the provider-viewed challenges in implementing BD.
Conclusions
The literature supports the use of BD; however, many survey respondents, including fellowship-trained attendings, never or rarely use BD. Most respondents reported difficulty in using BD. More research is needed to improve the ease, accuracy, and widespread adaptation of BD use in clinical practice.
Introduction and hypotheses
The International Continence Society recommends the International Consultation on Incontinence Questionnaire-Bladder Diary (ICIQ-BD) for the assessment, management, and ...monitoring of lower urinary tract symptoms (LUTS). Translation, cross-cultural adaptation and validation will establish a valid and reliable tool for Brazilian women with LUTS.
Methods
A cross-sectional study involving 101 women was carried out at the Urogynecology Outpatient Clinic in Belo Horizonte, Brazil, between August 2020 and April 2022. The process of cross-cultural adaptation and validation was executed following the ICIQ Group's protocol. Reviewed by an expert committee, the first pre-test was followed by subsequent adaptations, resulting in a second adapted version that underwent expert revisions. A second pretest was conducted, followed by cross-cultural adaptation and construct validation. Finally, the International Consultation on Incontinence Questionnaire-Bladder Diary-Brazilian Portuguese Version (ICIQ-BD-Br) underwent a validation process.
Results
Construct validity (IVC >0.78) and internal consistency were satisfactory (α-Cronbach coefficient 0.87–0.94). The following adjustments were made: a specific field was created to document sleep and wake times, and a printed score ranging from 0 to 4 was included in the bladder sensation column. Test–retest reliability ranged from fair to excellent for all analyzed items (Spearman correlation: 0.64–0.95). Criterion validity analysis indicated slight agreement for one of the four symptoms analyzed (nocturia k=0.32). The final version was approved by the ICIQ Group.
Conclusions
The ICIQ-BD-Br has been adapted for use in Brazilian Portuguese and has exhibited robust construct validity and reliability for Brazilian women with LUTS.
