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The Journal of urology
01, 2023;209 (1): 233-242.

Phenotyping of Urinary Urgency Patients Without Urgency Incontinence, and Their Comparison to Urgency Incontinence Patients: Findings From the LURN Study.

H Henry Lai, Jonathan B Wiseman, Margaret E Helmuth, Abigail R Smith, Cindy L Amundsen, Anne P Cameron, Alexander P Glaser, Whitney K Hendrickson, Ziya Kirkali, Kimberly Kenton
Author Information
  1. H Henry Lai: Division of Urologic Surgery, Departments of Surgery and Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
  2. Jonathan B Wiseman: Arbor Research Collaborative for Health, Ann Arbor, Michigan.
  3. Margaret E Helmuth: Arbor Research Collaborative for Health, Ann Arbor, Michigan.
  4. Abigail R Smith: Arbor Research Collaborative for Health, Ann Arbor, Michigan.
  5. Cindy L Amundsen: Department of Obstetrics and Gynecology, Division of Urogynecology, Duke University, Durham, North Carolina.
  6. Anne P Cameron: Department of Urology, University of Michigan, Ann Arbor, Michigan.
  7. Alexander P Glaser: NorthShore University HealthSystem, Evanston, Illinois.
  8. Whitney K Hendrickson: Department of Obstetrics and Gynecology, Division of Urogynecology, Duke University, Durham, North Carolina.
  9. Ziya Kirkali: National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
  10. Kimberly Kenton: Department of Obstetrics & Gynecology, Division of Female Pelvic Medicine & Reconstructive Surgery, Northwestern University, Chicago, Illinois.
PMID: 36067368 DOI: 10.1097/JU.0000000000002939

Abstract

PURPOSE: We characterize patients with urinary urgency with vs without urgency urinary incontinence who presented to clinics actively seeking treatment for their symptoms.
MATERIALS AND METHODS: Participants who enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network were categorized into urinary urgency with vs without urgency urinary incontinence. Participants were followed for 1 year; their urinary symptoms, urological pain, psychosocial factors, bowel function, sleep disturbance, physical activity levels, physical function, and quality of life were compared. Mixed effects linear regression models were used to examine the relationships between urgency urinary incontinence and these factors.
RESULTS: Among 683 participants with urinary urgency at baseline, two-thirds (n=453) also had urgency urinary incontinence; one-third (n=230) had urinary urgency-only without urgency urinary incontinence. No differences were detected in urological pain between urinary urgency-only and urgency urinary incontinence. Those with urgency urinary incontinence had more severe urgency and frequency symptoms, higher depression, anxiety, perceived stress scores, more severe bowel dysfunction and sleep disturbance, lower physical activity levels, lower physical function, and worse quality of life than those with urinary urgency-only. Among those with urinary urgency-only at baseline, 40% continued to have urinary urgency-only, 15% progressed to urgency urinary incontinence, and 45% had no urgency at 12 months. Fifty-eight percent with urgency urinary incontinence at baseline continued to report urgency urinary incontinence at 12 months, while 15% improved to urinary urgency-only, and 27% had no urgency.
CONCLUSIONS: Patients with urgency urinary incontinence have severe storage symptoms, more psychosocial symptoms, poorer physical functioning, and worse quality of life. Our data suggested urgency urinary incontinence may be a more severe manifestation of urinary urgency, rather than urinary urgency and urgency urinary incontinence being distinct entities.

Keywords

lower urinary tract symptoms overactive urgency urgency urinary incontinence urinary bladder

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Grants

  1. U01 DK100017/NIDDK NIH HHS
  2. U01 DK097780/NIDDK NIH HHS
  3. UL1 TR001422/NCATS NIH HHS
  4. U01 DK100011/NIDDK NIH HHS
  5. U01 DK097772/NIDDK NIH HHS
  6. U24 DK099879/NIDDK NIH HHS
  7. U01 DK099932/NIDDK NIH HHS
  8. U01 DK097779/NIDDK NIH HHS
  9. U01 DK099879/NIDDK NIH HHS

MeSH Term

Humans
Quality of Life
Surveys and Questionnaires
Urinary Incontinence
Urination Disorders
Sleep Wake Disorders
Pain
Urinary Incontinence, Urge
Journal Article
Article has an altmetric score of 4

Word Cloud

Created with Highcharts 10.0.0urinaryurgencyincontinencesymptomsurgency-onlyphysicalseverewithoutfunctionqualitylifebaselinelowerUrgencyvsParticipantsUrinaryurologicalpainpsychosocialfactorsbowelsleepdisturbanceactivitylevelsAmongworsecontinued15%12monthsPatientsIncontinencePURPOSE:characterizepatientspresentedclinicsactivelyseekingtreatmentMATERIALSANDMETHODS:enrolledSymptomsLowerTractDysfunctionResearchNetworkcategorizedfollowed1yearcomparedMixedeffectslinearregressionmodelsusedexaminerelationshipsRESULTS:683participantstwo-thirdsn=453alsoone-thirdn=230differencesdetectedfrequencyhigherdepressionanxietyperceivedstressscoresdysfunction40%progressed45%Fifty-eightpercentreportimproved27%CONCLUSIONS:storagepoorerfunctioningdatasuggestedmaymanifestationratherdistinctentitiesPhenotypingWithoutComparisonPatients:FindingsLURNStudytractoveractivebladder

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