Lack of association between the ICIQ-SF questionnaire and the urodynamic diagnosis in men with post radical prostatectomy incontinence

Abstract

PURPOSE:To analyze the correlation between the "International Consultation on Incontinence Questionnaire-Short Form" (ICIQ-UISF) survey and the urodynamic findings in men with urinary incontinence (UI) following radical prostatectomy (RP). METHODS:88 men who presented post-RP UI for a minimum of 1 year were enrolled prospectively. All answered the ICIQ-UISF survey and underwent urodynamic testing. Patients were divided in 3 Groups according to their urodynamic diagnosis: Group 1, patients with sphincteric incontinence (SI) alone; Group 2, patients with mixed UI (SI + Bladder Dysfunction (BD)); and Group 3, patients with BD alone. Data were analyzed using SPSS v16.0 software. RESULTS:There were 51 men in Group 1 (57.9%); 30 in Group 2 (34%); and 7 (7.9%) in Group 3. BD was found in 37/88 patients (42%), but it was the main cause of UI in only 14 patients (15.9%). There was no statistically significant difference among the mean ICIQ-UISFs values from groups 1, 2, or 3 (p>0.05). The symptoms of stress incontinence correlated with the urodynamic finding of SI (r = 0.59), and complaints of urinary urgency correlated with the presence of detrusor overactivity (DO) (r = 0.37), but these complaints did not predict the main cause of UI. CONCLUSION:The etiology of UI following RP cannot be predicted by the ICIQ-UISF survey. Symptoms of stress and urge incontinence predict the findings of SI and DO on urodynamic tests, but they cannot ascertain the main cause of UI. Short Form" (ICIQ-UISF) e os achados urodinâmicos em homens com incontinência urinária (IU) após a prostatectomia radical (PR). RESULTADOS: Dos 88 pacientes avaliados, após a avaliação urodinâmica, 51 homens (57,9%) apresentaram IE isolada (Grupo 1); 30 homens (34%) apresentaram IE associada a DV (Grupo 2) e 7 homens (7,9%) tinham somente DV (Grupo 3). A DV foi encontrada em 37/88 pacientes (42%), mas foi a principal causa de IU em apenas 14 pacientes (15,9%). Não houve diferença estatisticamente significativa entre os valores das médias do "ICIQ-UISFs" entre os grupos 1, 2 ou 3 (p> 0,05). Os sintomas de incontinência de esforço se correlacionaram com o diagnóstico urodinâmico de IE (r = 0,59), e as queixas de urgência miccional se correlacionaram com a presença de hiperactividade do detrusor na avaliação urodinâmica (r = 0,37), entretanto apesar da correlação encontrada, os sintomas não foram capazes de identificar a principal causa da UI . MÉTODOS CONCLUSÃO:A etiologia da UI após a PR não pode ser previsto pelo escore de sintomas obtidos através do "ICIQ-UISF". Os sintomas de perda urinária as manobras de estresse e de urgência miccional estão relacionados a presença de IE e hiperatividade detrusora na avaliação urodinâmica, entretanto estes sintomas não conseguem identificar com segurança qual é o principal fator da IU após a PR.O teste urodinâmico continua sendo o padrão ouro para avaliar a etiologia da IU após a PR.

Guideline of guidelines: urinary incontinence in women

“…The EAU gives a ‘Strong’ recommendation for the use of a validated and appropriate questionnaire in standardised assessments, i.e., to monitor a change after an intervention. In their literature review, they found that some questionnaires (Questionnaire for Urinary Incontinence Diagnosis [QUID], Three Incontinence Questions Questionnaire [3IQ]) have the potential to discriminate UI types in women , whereas in men the ICIQ Urinary Incontinence Short Form (ICIQ‐UI‐SF) has been found not to differentiate UI types . The EAU acknowledged that many studies looking at the validity and reliability of urinary symptom questionnaires were done in patients without UI, and there was no evidence to show that these questionnaires have an impact on treatment outcomes for UI.…”

Regenerative potential of human dental pulp stem cells in the treatment of stress urinary incontinence: In vitro and in vivo study

“…The evaluation of the presence and degree of incontinence must be done through an accurate diagnostic procedure. It may be necessary to collect the patient's medical history, perform a thorough physical examination, use specific and validated questionnaires differentiated for male and female, [29][30][31] obtain completed voiding diaries, 32 exclude urinary infections, 33 evaluate post-void residual volume, 34 perform urodynamic testing, 35 pad testing 36 In the category of non-surgical treatments, there are also pharmacological managements. Pharmacological treatments are more effective in the treatment of urge incontinence; however, in selected cases of SUI, duloxetine, oestrogens and desmopressin can find their application.…”

Pelvic symptoms after radiotherapy in prostate cancer: a cross-sectional study

“…Other studies have also utilized the same questionnaire in men [17 -19]. A Brazilian study [20] recently analyzed the correlation between the ICIQ-SF and urodynamic findings in men with UI after RP, representing the first study to address this correlation in men. Despite the correlations found in women, the total ICIQ-SF score could not differentiate whether sphincter incontinence or bladder dysfunction was the main cause of UI in that study.…”

“…This finding confirms the hypothesis that it is not possible to determine the main cause of post-RP UI based on subjective assessment alone. The authors suggest, therefore, that the ICIQ-SF was designed to generally assess UI symptoms, LUTS and its impact on the QoL of men and women [20]. This was the purpose of our study, where ICIQ-SF was chosen as an easily applied and understood questionnaire to assess the presence, severity and impact of urinary loss in DLA.…”