Study Type – Symptom prevalence (non‐consecutive cohort) Level of Evidence 4 What’s known on the subject? and What does the study add? There have been no previous studies examining the overlap of chronic constipation and overactive bladder in the US population. Limited research to date based on samples of elderly, Asian and pediatric populations suggests that there is substantial overlap. The results of this study suggest that the prevalence of chronic constipation is increased in people with overactive bladder who are ≥40 years and should be considered by healthcare providers treating these patients. OBJECTIVE To estimate the prevalence and overlap of overactive bladder (OAB), chronic constipation (CC) and faecal incontinence (FI) among a general population sample of adults in the USA. PATIENTS AND METHODS A cross‐sectional internet‐based survey of randomly selected panel members who were ≥40 years of age was conducted. Participants reported how often they experienced symptoms of OAB, CC and FI using Likert scales and modified Rome III criteria. Analyses were conducted to examine the overall prevalence of OAB, CC and FI in men and women separately and to characterize the extent of overlap between these conditions in participants with OAB vs those without OAB, and those participants with continent vs incontinent OAB. RESULTS The response rate for the survey was 62.2% and the final sample (N= 2000) included 927 men and 1073 women. The overall prevalence of OAB [defined as a response of ≥‘sometimes’ to urinary urgency (i.e. ‘sometimes’ or more often) or ‘yes’ to urinary urgency incontinence (UUI)] was 26.1% in men and 41.2% in women. The overall prevalence of CC was significantly lower in men than in women (15.3 vs 26.3%), but both men and women with OAB were significantly more likely to report CC (22.3 and 35.9% vs 5.7 and 6.7%, respectively, P < 0.0001). The overall prevalence of FI reported ‘rarely’ or more was 16.7% of men and 21.9% of women. Men and women with OAB were significantly more likely to report FI than those without OAB. FI was also more common in participants with incontinent OAB than in those with continent OAB. Logistic regressions controlling for demographic factors and comorbid conditions suggest that OAB status is a very strong predictor of CC, FI and overlapping CC and FI (odds ratios, range 3.55–7.96). CONCLUSIONS Chronic constipation, FI and overlapping CC and faecal incontinence occur more frequently in patients with OAB and should be considered when evaluating and treating patients with OAB. These findings suggest a shared pathophysiology among these conditions. Additional study is needed to determine if successful treatment of one or more of these conditions is accompanied by commensurate improvement in symptoms referable to the other organ system.
The USS is a valid and highly responsive measure of urinary urgency in men with OAB-LUTS and women with OAB.
Introduction Sexual dysfunction (SD) and lower urinary tract symptoms (LUTS) are highly prevalent in men and increase with age. Previous studies have shown that LUTS and SD are highly associated in men, but most have not distinguished between voiding and storage LUTS. Aims Assess impact of voiding and storage LUTS on recorded diagnosis of SD in men in U.K. general practice. Methods Identified records of patients with SD and storage (e.g., overactive bladder) and voiding LUTS (e.g., benign prostatic hyperplasia) from a population-based study using The Health Improvement Network database with records from 333 general practices. Study period was 2000–2007; study population was men aged ≥ 18 years. Main Outcome Measures Prevalence rates of SD, and storage and voiding LUTS on January 1 of each year from 2000 to 2007. Results Overall prevalence of recorded SD rose from 1.7% in 2000 to 4.9% in 2007. The prevalence of storage and voiding LUTS also increased. Median age at diagnosis was 60 years for erectile dysfunction (ED), 62 years for other SD, 62 years for storage LUTS, and 61 years for voiding LUTS. Compared to men with no LUTS, odds ratios (95% CI) for ED were as follows: storage LUTS, 3.0 (2.6–3.4); voiding LUTS, 2.6 (2.4–2.7); and both voiding and storage LUTS, 4.0 (3.4–4.8). Among the 11,327 men with any recorded LUTS and ED at the beginning of 2007, LUTS diagnosis preceded SD in 63.1% of patients by a mean of 4.8 years. Conclusions Prevalence of SD was significantly higher in the presence of either storage or voiding LUTS compared to men with no recorded LUTS. The diagnosis of LUTS preceded SD in the majority of cases. Further research into the interrelationships between functional problems of the genitourinary tract may have implications for current treatment approaches and future therapeutic developments.
The translated instruments in this study demonstrated a high level of overall linguistic validity.
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