ABSTRACT
Objective: To report the current clinical features, treatment patterns and outcomes of female patients who were seen at a tertiary referral centre with a primary diagnosis of nocturia, and to assess the predictive factors of therapeutic management failure. Patients and methods: A retrospective chart review of all new female patients seen in a single-centre functional urology practice with the diagnosis of nocturia was performed. Up to three visits within a 12-month period from the time of presenting were reviewed. The primary endpoint was patient-reported improvement assessed at each follow-up visit and the change in the number of nocturia episodes. Results: In all, 239 female patients were included for analysis. The prevalence of nocturnal polyuria, reduced bladder capacity, and global polyuria were 75%, 40.2%, and 18.1%, respectively. Within the first two visits, 72.7% of patients had started a treatment beyond behavioural therapies. Anticholinergics were the most commonly initiated treatment (47.2% of patients). At the latest considered visit, 80 patients reported improvement in nocturia (45.5%) and there was a mean - 0.8 decrease in the number of nocturia episodes from 4 to 3.2, which was statistically significant (P < 0.001). There was no statistically significant association between any of the bladder diary findings and treatment outcomes. A smaller number of nocturia episodes was the only predictive factor of therapeutic management failure in multivariate analysis (odds ratio 0.10; P = 0.01). Conclusions: Whilst the prevalence of nocturnal polyuria in women with nocturia is high, the therapeutic management until 2016 seemed to rely mostly upon overactive bladder medications with a relatively low success rate. Abbreviations: BD: bladder diary; BPS: bladder pain syndrome; ICD(-9)-(10): International Classifications of Disease (ninth revision) (10th revision); NPI: Nocturnal Polyuria Index; OAB: overactive bladder; OR: odd ratio; POP: pelvic organ prolapse.
ABSTRACT
PURPOSE OF REVIEW: Radical prostatectomy (RP) is the standard surgical treatment for localized prostate cancer. One of the side effects after RP impacting quality of life is urinary incontinence. Because of the impact in quality of life, more patients are seeking treatment for post-prostatectomy incontinence. Urodynamics are an important tool to help understand how prostate surgery changes bladder and urethral function. We reviewed the current literature in order to determine the role of urodynamics in post-prostatectomy incontinence. RECENT FINDINGS: Studies have been done to demonstrate the anatomical and functional changes in incontinent men after radical prostatectomy compared to continent men, as well as to evaluate the use of urodynamics in the work-up for post-prostatectomy incontinence prior to treatment. However, there is not a consensus about the indications of urodynamics in this population and new studies have questioned the real role of urodynamics in this setting. Because of the impact in quality of life, more patients are seeking treatment for post-prostatectomy incontinence. Urodynamics have been used to have a better understanding of the anatomical and functional changes in incontinent men after radical prostatectomy; however, the role of urodynamic testing to assess these patients and offer treatment is still to be determined.
