Objectives: Population-level data are lacking for urinary incontinence (UI) in Central and Eastern European countries. Therefore, the objective of this study was to estimate the prevalence, bother, and behavior regarding treatment for UI in a population-representative group of Polish adults aged ≥ 40 years. Methods: Data for this epidemiological study were derived from the larger LUTS POLAND project, in which a group of adults that typified the Polish population were surveyed, by telephone, about lower urinary tract symptoms. Respondents were classified by age, sex, and place of residence. UI was assessed with a standard protocol and established International Continence Society definitions. Results: The LUTS POLAND survey included 6005 completed interviews. The prevalence of UI was 14.6–25.4%; women reported a greater occurrence compared with men (p < 0.001). For both sexes, UI prevalence increased with age. Stress UI was the most common type of UI in women, and urgency UI was the most prevalent in men. We did not find a difference in prevalence between urban and rural areas. Individuals were greatly bothered by UI. For women, mixed UI was the most bothersome, whereas for men, leak for no reason was most annoying. More than half of respondents (51.4–62.3%) who reported UI expressed anxiety about the effect of UI on their quality of life. Nevertheless, only around one third (29.2–38.1%) of respondents with UI sought treatment, most of whom received treatment. Persons from urban and rural areas did not differ in the degrees of treatment seeking and treatment receiving. Conclusion: Urinary incontinence was prevalent and greatly bothersome among Polish adults aged ≥ 40 years. Consequently, UI had detrimental effects on quality of life. Nonetheless, most affected persons did not seek treatment. Therefore, we need to increase population awareness in Poland about UI and available treatment methods, and we need to ensure adequate allocation of government and healthcare system resources.
Background and Objectives: In the general population, sleep disorders are associated with lower urinary tract symptoms (LUTS) including urinary incontinence (UI). This connection has not been explored fully in specific patient groups. Thus, we investigated the association between sleep quality and LUTS for patients with depression. Materials and Methods: This study was prospective and cross-sectional. We analyzed questionnaire data on depression, sleep quality, LUTS, and UI from depressed patients treated in our department of adult psychiatry. We used the Hamilton Rating Scale for Depression, the Holland Sleep Disorders Questionnaire, the International Prostate Symptom Score, and the International Consultation on Incontinence Questionnaire-Short Form. Results: In total, 102 patients treated for depression were enrolled. We found a statistically significant correlation between depression severity and sleep quality. A significant correlation was also investigated for sleep quality and LUTS severity. The group of depressed patients with moderate or severe LUTS had greater sleep problems compared with patients who had mild urinary tract symptoms or no symptoms. With regression analysis, we further demonstrated that the relationships between LUTS and sleep quality as well as UI and sleep quality in depressed patients are independent from age and sex. Conclusions: In the cohort of patients treated for depression, sleep quality correlated with LUTS including UI. We suggest that the negative effect of LUTS and UI on sleep quality that we observed should lead to the re-evaluation of current recommendations for diagnosis and treatment of sleep problems among patients with depression.
Purpose To analyze and summarize the efficacy of immune checkpoint inhibitor (ICI) alone or in combination therapy for renal cell carcinoma (RCC) and urothelial carcinoma (UC) stratified by sex. Methods Three databases were queried in October 2022 for randomized controlled trials (RCTs) analyzing RCC and UC patients treated with ICIs. We analyzed the association between sex and the efficacy of ICIs in RCC and UC patients across several clinical settings. The outcomes of interest were overall survival (OS) and progression-free survival for the metastatic setting and disease-free survival (DFS) for the adjuvant setting. Results Overall, 16 RCTs were included for meta-analyses and network meta-analyses. In the first-line treatment of metastatic RCC (mRCC) and UC (mUC) patients, ICI-based combination therapies significantly improved OS compared to the current standard of care, regardless of sex. Adjuvant ICI monotherapy reduced the risk of disease recurrence in female patients with locally advanced RCC (pooled hazard ratio [HR]: 0.71, 95% confidence interval [CI] 0.55–0.93) but not in male patients, and, conversely, in male patients with muscle-invasive UC (pooled HR: 0.80, 95%CI 0.68–0.94) but not in female patients. Treatment ranking analyses in the first-line treatment of mRCC and mUC showed different results between sexes. Of note, regarding adjuvant treatment for RCC, pembrolizumab (99%) had the highest likelihood of improved DFS in males, whereas atezolizumab (84%) in females. Conclusions OS benefit of first-line ICI-based combination therapy was seen in mRCC and mUC patients regardless of sex. Sex-based recommendations for ICI-based regimens according to the clinical setting may help guide clinical decision-making.
Background: The aim of this study was to perform a cross-sectional study of Polish neurogenic patients to measure, at the population level, the prevalence, bother and behavior associated with treatment for lower urinary tract symptoms (LUTS) and overactive bladder (OAB). Methods: This epidemiological study was based on data from LUTS POLAND, a computer-assisted and population-representative telephone survey. Participants were classified by age, sex and place of residence. Results: LUTS POLAND includes 6005 completed interviews, of which 1166 (19.4%) were for individuals who had ever received any treatment by neurologists and/or neurosurgeons. Among these neurogenic participants, LUTS prevalence was 72.3%, statistically higher than for non-neurogenic respondents. At the population level, neurogenic patients had about a 20% higher risk for LUTS presence than non-neurogenic participants (relative risk: 1.17–1.21). LUTS prevalence did not differ between men and women. Frequency was the most common of the LUTS. Forty percent of neurogenic respondents described having more than one LUTS subtype (i.e., storage, voiding, and/or post-micturition symptom subtype), and more than 50% of respondents reported OAB symptoms. Both storage and voiding symptoms were bothersome, and many neurogenic individuals (42.3–51.0%) expressed anxiety about bladder function affecting quality of life. Only one-third (34.9–36.6%) of neurogenic participants had sought treatment for their LUTS, and the majority of such individuals received and maintained treatment. Conclusions: LUTS and OAB symptoms were highly prevalent and bothersome among Polish neurogenic patients at the population level. Because the scale of seeking treatment for LUTS was low, Polish neurogenic patients may not be adequately informed about multiple effects of LUTS and OAB.
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