Yuuka Sugizaki1,2, Ryuji Sakakibara3,4, Fuyuki Tateno5,2, Tsuyoshi Ogata5,2, Yosuke Aiba5,2, Hiroyoshi Suzuki1,2, Masashi Yano1,2. 1. Department of Urology, Sakura Medical Center, Toho University, Sakura, Japan. 2. Undergraduate Course for Original Medical Manuscript, Toho University, Sakura, Japan. 3. Department of Neurology, Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura, 285-8741, Japan. sakakibara@sakura.med.toho-u.ac.jp. 4. Undergraduate Course for Original Medical Manuscript, Toho University, Sakura, Japan. sakakibara@sakura.med.toho-u.ac.jp. 5. Department of Neurology, Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura, 285-8741, Japan.
Abstract
OBJECTIVE: Older individuals often have multiple etiologies for their lower urinary tract symptoms (LUTS); i.e., both urologic (U) and neurologic (N) etiologies. Few studies have investigated 'triple disease' (typically one U and two N components) in the LUTS of older adults. Herein, we had specialists from both urology and neurology address triple- and quadruple-etiology disease. PATIENTS AND METHODS: This was a retrospective study with a 12-month recruiting period. We ascertained LUTS by standard questionnaires and bladder diaries. Urodynamics, sphincter EMG, prostate echography, and a neurologic examination were conducted for each patient as well as neuroimaging and neurophysiology examinations when appropriate. The diagnoses of the etiologies were based on published criteria. RESULTS: We analyzed the cases of 141 older (age > 65 years) adults with LUTS referred from both urology (27%) and neurology departments (73%). The final etiologies were U (n = 69, 49%), N (n = 136, 96%), and a combination (U and N) (n = 77, 55%, overlap counted). The majority of U diagnoses were benign prostatic hyperplasia. The majority of N diagnoses were dementia with Lewy bodies, white matter disease (brain); lumbar spondylosis, and diabetes (peripheral disease). We noted triple-disease etiology in 25% (n = 35), increasing with each decade of age (18.2% of sexagenarians, 23.5% of septuagenarians, 39.1% of octogenarians). However, the differences were not significant. CONCLUSION: Our results demonstrate that triple disease for LUTS is the most common in octogenarians, and clinicians thus need to untangle LUTS etiologies to provide appropriate care and management of older adults.
OBJECTIVE: Older individuals often have multiple etiologies for their lower urinary tract symptoms (LUTS); i.e., both urologic (U) and neurologic (N) etiologies. Few studies have investigated 'triple disease' (typically one U and two N components) in the LUTS of older adults. Herein, we had specialists from both urology and neurology address triple- and quadruple-etiology disease. PATIENTS AND METHODS: This was a retrospective study with a 12-month recruiting period. We ascertained LUTS by standard questionnaires and bladder diaries. Urodynamics, sphincter EMG, prostate echography, and a neurologic examination were conducted for each patient as well as neuroimaging and neurophysiology examinations when appropriate. The diagnoses of the etiologies were based on published criteria. RESULTS: We analyzed the cases of 141 older (age > 65 years) adults with LUTS referred from both urology (27%) and neurology departments (73%). The final etiologies were U (n = 69, 49%), N (n = 136, 96%), and a combination (U and N) (n = 77, 55%, overlap counted). The majority of U diagnoses were benign prostatic hyperplasia. The majority of N diagnoses were dementia with Lewy bodies, white matter disease (brain); lumbar spondylosis, and diabetes (peripheral disease). We noted triple-disease etiology in 25% (n = 35), increasing with each decade of age (18.2% of sexagenarians, 23.5% of septuagenarians, 39.1% of octogenarians). However, the differences were not significant. CONCLUSION: Our results demonstrate that triple disease for LUTS is the most common in octogenarians, and clinicians thus need to untangle LUTS etiologies to provide appropriate care and management of older adults.
Authors: Holly A Roy; Jeremy Nettleton; Camilla Blain; Catherine Dalton; Bilal Farhan; Ailton Fernandes; Petros Georgopoulos; Sabine Klepsch; John Lavelle; Evangelista Martinelli; Jalesh N Panicker; Ivan Radoja; Christina-Anastasia Rapidi; Ricardo Pereira E Silva; Katarina Tudor; Adrian S Wagg; Marcus J Drake Journal: Neurourol Urodyn Date: 2020-08-04 Impact factor: 2.696