Year: 2023
Type: article
Abstract: IMPORTANCE: Physical health and psychological health represent modifiable factors in the causal pathway of lower urinary tract symptoms (LUTS). OBJECTIVES: Understand the relationship between physical and psychological factors and LUTS over time. STUDY DESIGN: Adult women enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network observational cohort study completed the LUTS Tool and Pelvic Floor Distress Inventory, including urinary (Urinary Distress Inventory), prolapse (Pelvic Organ Prolapse Distress Inventory), and colorectal anal (Colorectal-Anal Distress Inventory) subscales at baseline, 3 months, and 12 months. Physical functioning, depression, and sleep disturbance were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires; relationships were assessed using multivariable linear mixed models. RESULTS: Of 545 women enrolled, 472 had follow-up. Median age was 57 years; 61% and 78% reported stress urinary incontinence and overactive bladder, respectively; and 81% reported obstructive symptoms. The PROMIS depression scores were positively associated with all urinary outcomes (range, 2.5- to 4.8-unit increase per 10-unit increase in depression score; P < 0.01 for all). Higher sleep disturbance scores were associated with higher urgency, obstruction, LUTS Total Severity, Urinary Distress Inventory, and Pelvic Floor Distress Inventory (1.9- to 3.4-point increase per 10-unit increase, all P < 0.02). Better physical functioning was associated with less severe urinary symptoms except stress urinary incontinence (2.3- to 5.2-point decrease per 10-unit increase, all P < 0.01). All symptoms decreased over time; however, no association was detected between baseline PROMIS scores and trajectories of LUTS over time. CONCLUSIONS: Nonurologic factors demonstrated small to medium cross-sectional associations with urinary symptom domains, but no significant association was detected with changes in LUTS. Further work is needed to determine whether interventions targeting nonurologic factors reduce LUTS in women.
Source: Urogynecology
Authors: Abigail R. Smith, Sarah A. Mansfield, Catherine S. Bradley, Kimberly S. Kenton, Margaret E. Helmuth, Anne P. Cameron, Ziya Kirkali, C. Emi Bretschneider, Victor Andreev, Aruna Sarma, Giulia Lane, Sarah A. Collins, David Cella, H. Henry Lai, Steven E. Harte, James W. Griffith, the LURN Study Group
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1031717111, G1407459761, G1723544043, G1926036958, G2084387148, G2373717018, G2801418238, G33670165, G3408161643, G3730033447, G3852170316, LURN II: Enhanced Characterization of Patients with LUTS Using Biopsychosocial Approaches, Northwestern University Clinical and Translational Science Institute (NUCATS), G5438081026, G5689344653, G5709465739, G7097112096, G7707125228, G7758172473, G8204409728, G825392080, Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)Data Coordinat
OpenAlex ID: W4383753502