Lower urinary tract symptoms; an undetected cause for morbidity in adults.

INTRODUCTION: Lower urinary tract symptoms (LUTS) have been recognised as a cause of distress among adult men and women. In view of the increasing elderly population in Sri Lanka, the number of individuals with LUTS is likely to increase. OBJECTIVES: To determine the prevalence and severity of LUTS in a community sample of older men and women residing in an urban area. DESIGN: Cross-sectional descriptive study. SETTING: Field practice area of National Institute of Health Sciences, Kalutara. METHODS: Households were selected using probability proportionate to the size (PPS) method. 985 adult men and women (above 40 years of age) were interviewed by Public Health Midwives regarding LUTS using an interviewer-administered questionnaire. The questions were adapted from ICSmale questionnaire and the Bristol Female Lower Urinary Tract questionnaire. RESULTS: 209 (47%) men and 338 (62.6%) women reported at least one urinary symptom. In men, urgency, nocturia, dysuria and frequency were the most prevalent symptoms with stress incontinence being the least prevalent. Majority of the symptoms showed an increase in prevalence with age. In women, dysuria, stress incontinence, urgency and frequency were the most prevalent symptoms. Hesitancy, intermittency, and stress and urge incontinence were the most bothersome symptoms among men, and urge and stress incontinence among women. CONCLUSIONS: Prevalence of LUTS was high in our study population.

Banding of oesophageal varices using locally improvised materials.

Bleeding from oesophageal varices is the commonest cause of significant upper gastrointestinal bleeding in Sri Lanka. Endoscopic band ligation is an effective method in the management of varices. But the cost of banding equipment is high, unaffordable for a majority of our patients. We have devised a cheap method to carry out banding of varices. Banding of varices using this technique was carried out in 235 patients. In the patients who were followed up, there was a reduction in the size of varices across all grades of varices. No complications due to banding were noted, and only 10 patients developed re-bleeding. Since the initial experience on efficacy and safety of this technique is encouraging, we believe that its widespread adoption in Sri Lanka would be cost effective and life-saving.