Short-term retrospective analysis of voiding diary of patients with non-urological cancer referred to urologist for new-onset nocturia after surgery

Kim S H1, Joung J Y1, Ho Kyung Seo H K1

Research Type

Clinical

Abstract Category

Nocturia

Abstract 116
Open Discussion ePosters
Scientific Open Discussion Session 7
Wednesday 29th August 2018
12:50 - 12:55 (ePoster Station 5)
Exhibition Hall
Questionnaire Quality of Life (QoL) Voiding Diary Nocturia Urodynamics Techniques
1. Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
Presenter
S

Sung Han Kim

Links

Abstract

Hypothesis / aims of study
Patients with non-urological cancer frequently complain of de novo voiding problems after surgery and are referred to urologists. Postoperative nocturia is one of the most troublesome voiding complaints for patients visiting the urology department during the postoperative follow-up period.This study aimed to describe the nocturia-related baseline characteristics of patients with non-urological cancer suffering from postoperative nocturia and analyze the characteristics of voiding diaries by patient age. All patients had no further planned cancer therapies except regular follow-up.
Study design, materials and methods
Between 2013 and 2017, the medical records of 297 patients with new-onset postoperative nocturia were selected for analysis of an International Prostate Symptom Score (IPSS) questionnaire, uroflowmetry, urodynamic study, and voiding diary. Among the 297 patients, the 3-day voiding diary and urodynamic study were completed for only 97 (32.7%). The patients were divided by age (<65 years versus ≥65 years) and their baseline clinical laboratory work-ups were compared using Student’s t-test, the Wilcoxon rank-sum test, Pearson’s chi-square test, and Fischer’s test. Values of p < 0.05 were considered statistically significant.
Results
The overall median age, IPSS total score, and IPSS quality of life score were 68 years, 21, and 5, respectively. The median peak uroflowmetry, voided volume, and post-voided residual urine were 11.6 (1.2–40.8) cm/sec, 141.3 (8.5–497.4) cc, and 25 (0–498) cc, respectively. The underlying diseases were hypertension (37.1%), diabetes (216%), cardiovascular disease (12.4%), cerebrovascular disease (3.1%), hepatic disease (4.1%), chronic pulmonary disease (4.1%), and benign prostatic hyperplasia (8.2%). The underlying cancers included colorectal (6.2%), lung (11.3%), stomach (12.4%), hepatobiliary (14.1%), gynecologic (14.4%), thyroid (9.3%), hematologic (11.3%), breast (6.2%), neurologic (4.1%), and other (10.7%) cancers. The comparison of baseline characteristics between young (<65 years) and old (≥65 years) groups showed that only quality of life score (5.4 ± 0.8 vs 4.9 ± 1.4) and peak flow rate (17.2 ± 9.1 vs 12.0 ± 7.6) were significantly different (p < 0.05). In the 3-day voiding diary, the old group had significantly fewer nocturia episodes (old, 3.6 ± 2.2 times vs young, 4.5 ± 2.1 times) with smaller voided volume (57.6 ± 88.9 mL vs 207.8 ± 347.8 mL) and smaller total voided volume (1834.8 ± 1024 mL vs 2043 ± 12380 mL) (p < 0.05). However, the urodynamic study parameters did not differ significantly between the groups (p > 0.05).
Interpretation of results
Frequently asking problem about the management of de novo postoperative nocturia after surgery from other surgical oncologists are one of the main theme for morbidity and quality of life. It is important to discriminate the etiology of de novo nocturia and suggest therapeutic plans after completing several work-ups of voiding dysfunction. The study showed that the 3-day voiding diary with uroflowmetry gave significant information to differentiate young from old patients with non-urological cancer complaining of new-onset nocturia after surgery. Further evaluations of the differential diagnosis of nocturia and decision-making for therapeutic plans along with voiding diary and uroflowmetry will be helpful.
Concluding message
The 3-day voiding diary and uroflowmetry provided significantly different information in the domains of voiding pattern and quality of life between patients < 65 years of age and those ≥65 years of age with non-urological cancer complaining of postoperative nocturia.
References
  1. The short-term prevalence of de novo urinary symptoms after different modes of hysterectomy.Int Urogynecol J Pelvic Floor Dysfunct. 2004 Jan-Feb;15(1):14-9; discussion 19.
  2. Urinary and sexual dysfunction after rectal cancer treatment. Nat Rev Urol. 2011 Jan;8(1):51-7.
  3. Urinary dysfunction after rectal cancer treatment is mainly caused by surgery.Br J Surg. 2008 Aug;95(8):1020-8.
Disclosures
Funding Nonw Clinical Trial No Subjects Human Ethics Committee IRB of National Cancer Center, Korea Helsinki Yes Informed Consent No
28/03/2024 10:33:31