Hypothesis / aims of study
Storage symptoms include frequency, urgency, nocturia and incontinence. Based on bladder diaries, we could get the objective data of the above symptoms. To the best of our knowledge, there is lack of correlation of quality of life (QoL) with lower urinary tract symptoms (LUTS) based on bladder dairies. Thus, we aimed to perform the above correlation.
Study design, materials and methods
The bladder diaries and the King’s Health Questionnaires of all consecutive women with LUTS, who visited urogynecologic clinics in a tertiary referral center, were reviewed.
Base on bladder dairies, women with at least one episode of urgency and urinary incontinence were allocated to the overactive bladder syndrome (OAB) & urinary incontinence (UI) group. Women with at least one episode of urgency but without incontinence were allocated to the OAB group. Women with at least one episode of urinary incontinence but without urgency were allocated to the UI group. Women with ≥2 episodes of nocturia but without urgency and urinary incontinence were allocated to the nocturia group. Women with ≥8 episodes of daytime frequency but without urgency, urinary incontinence and ≥2 episodes of nocturia were allocated to the frequency group. Women without urgency, urinary incontinence, ≥2 episodes of nocturia and ≥8 episodes of daytime frequency were allocated to the normal group.
Analysis of variance with Bonferroni correction was used to perform statistical analysis for between-group comparisons.
Results
Between 2010 and 2019, medical records of 2,953 women were reviewed in this study. There was no case with isolated “≥8 episodes of daytime frequency” (i.e., the frequency group). All women with ≥8 episodes of daytime frequency also had at least one episode of urgency. Women in the OAB & UI and nocturia groups were older than the normal group (Table 1). In addition, higher parities were noted in the OAB & UI and nocturia groups, compared with the normal group (Table 1).
Compared with the normal group, the QoL scores were poorer in all groups (Table 2). In addition, the OAB & UI group had the poorest QoL scores, compared with the other groups. The OAB group had similar QoL scores with the UI group. The nocturia group had better QoL scores, compared with the OAB & UI and OAB groups (Table 2).
Interpretation of results
Based on bladder diaries, we can classify women with LUTS into five groups (i.e., the OAB & UI, OAB, UI, nocturia and normal groups). In general, after correlation with the scores of King’ Health Questionnaire, the OAB & UI group had a poorest QoL score, followed by the OAB group and the UI group. The nocturia group had a better QoL score than the OAB & UI, OAB and UI groups.
Concluding message
Based on bladder diaries, we can classify women with LUTS into five groups (i.e., the OAB & UI, OAB, UI, nocturia and normal groups), and this classification is closely related to the severity in the impairment of QoL. Thus this novel classification based on bladder dairy might be used a reference of disease severity for physicians in treating women with LUTS.