It’s About Time: The Temporal Burden of Lower Urinary Tract Symptoms Among Women

Newman D1, Williams B2, Burgio K2, Connett J3, Mueller E4, LaCoursiere Y5, James A6, Low L7, Weinfurt K8, Vargo K3, Bavendam T9

Research Type

Clinical

Abstract Category

Prevention and Public Health

Abstract 610
Quality of Life and Health Delivery
Scientific Podium Short Oral Session 39
Saturday 21st November 2020
16:07 - 16:15
Brasilia 1
Female Quality of Life (QoL) Incontinence Urgency/Frequency
1. University of Pennsylvania, 2. University of Alabama at Birmingham, 3. University of Minnesota, 4. Loyola University, 5. University of California at San Diego, 6. Washington University at St Louis, 7. University of Michigan, 8. Duke University, 9. National Institute of Health
Presenter
D

Diane Newman

Links

Abstract

Hypothesis / aims of study
Lower urinary tract symptoms (LUTS) are associated with substantial economic, social, and emotional costs, with negative impact on overall health and quality of life. The experience of LUTS impacts the day-to-day physical, emotional, and social wellbeing of women. While efforts have been made to improve the quality of life of women with LUTS, there remains a need for a contextual understanding of bladder symptoms and how LUTS affect the daily life of sufferers.  An aim of the Prevention of Lower Urinary Tract Symptoms Research Consortium (PLUS) (1) is to understand better the lived experiences of women with LUTS, including psychological, social, and institutional processes. The aim of this study was to explore the lived experiences of U.S. adult women who experienced LUTS and to identify salient features of living with LUTS.
Study design, materials and methods
This is a secondary analysis of qualitative interviews conducted with 50 women from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) (2) (Table 1).  
The purpose of this analysis was to explore the temporal burden of LUTS. All participants reported one or more LUTS, such as storage, voiding, and post-micturition symptoms (Table 1). Seventy-six percent of participants had sought treatment for LUTS.  
Using directed content analysis, pairs of PLUS investigators (specialists in urology, gynecology, nursing, medical sociology, behavioral science and public health) coded the interview transcripts and identified themes related to living with LUTS. Data interpretation involved an inductive process guided by team science and informed by a transdisciplinary perspective.
Results
Accounts of living with LUTS have a prominent place in the biographies of symptomatic women, taking the form of illness narratives recounting the emergence and progression of LUTS.  Descriptions of the onset and temporal progression of LUTS reveal the increasing burden of symptoms and their pervasive and all-encompassing impact on daily life. Managing LUTS can become the driving organizational principle of daily life, leading to a loss of spontaneity and reduction of valued activities. Feelings of shame and embarrassment are engendered by untimely manifestations of LUTS during interpersonal encounters and in public settings. Descriptive accounts of living with LUTS emphasize the need for constant vigilance and time-consuming self-management strategies. Women with LUTS articulate a dissatisfaction with stopgap measures for relieving symptoms, underscoring a pressing need for an increased focus on prevention. (Table 2).
Interpretation of results
Articulating the temporal burden of LUTS demonstrates how constraints imposed by the interaction of time with LUTS can dictate the organization of daily life. Stories of the temporal burdens incurred by women living with LUTS can provide direction for research efforts and serve as cautionary tales in public health messages about risk and protective factors for bladder health and function.
Concluding message
Further research is needed to develop interventions to minimize the impact and prevent the development of LUTS.  Nurses have a key role in conducting routine screening, symptom assessment, and symptom management providing bladder health education
Figure 1
Figure 2
References
  1. Harlow BL, Bavendam TG, Palmer MH, Brubaker L, Burgio KL, Lukacz ES, Miller JM, Mueller ER, Newman DK, Rickey LM, Sutcliffe S, Simons-Morton D. The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium: A transdisciplinary approach toward promoting bladder health and preventing lower urinary tract symptoms in women across the life course. J Womens Health (Larchmt). 2018 Mar;27(3):283-289.
  2. Griffith JW, Messersmith EE, Gillespie BW, Wiseman JB, Flynn KE, Kirkali Z, Kusek JW, Bavendam T, Cella D, Kreder KJ, Nero JJ, Corona ME, Bradley CS, Kenton KS, Helfand BT, Merion RM, Weinfurt KP; LURN Study Group. Reasons for Seeking Clinical Care for Lower Urinary Tract Symptoms: A Mixed Methods Study. J Urol. 2018;199(2):528-535.
Disclosures
Funding Data provided by the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). LURN supported by NIDDK (grants DK097780, DK097772, DK097779, DK099932, DK100011, DK100017, DK099879).The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium supported by NIH—NIDDK by cooperative agreements (grants U01DK106786, U01DK106853, U01DK106858, U01DK106898, U01DK106893, U01DK106827, U01DK106908, U01DK106892). Clinical Trial No Subjects Human Ethics Committee The study was approved by Ethical & Independent Review Services for the DCC, and by local university IRBs at the four enrolling sites. Helsinki Yes Informed Consent Yes