Chris C. Sexton

The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study

To estimate and compare the prevalence and associated bother of lower urinary tract symptoms (LUTS) in the general populations of the USA, UK and Sweden using current International Continence Society (ICS) definitions, as no previous population‐based studies evaluating the prevalence of LUTS in the USA, using the 2002 ICS definitions, have been conducted.

The impact of overactive bladder on mental health, work productivity and health-related quality of life in the UK and Sweden: results from EpiLUTS

Study Type – Symptom prevalence (prospective cohort)

The overlap of storage, voiding and postmicturition symptoms and implications for treatment seeking in the USA, UK and Sweden: EpiLUTS.

To assess the (i) the overlap between voiding, storage, and postmicturition symptoms; and (ii) the relative effect of bother and implications for treatment seeking within these symptom groups, using data from the EpiLUTS study.

The prevalence of lower urinary tract symptoms (LUTS) and overactive bladder (OAB) by racial/ethnic group and age: results from OAB-POLL.

To estimate the prevalence of LUTS and OAB in a large, ethnically diverse US study.

Prevalence and Effect on Health-Related Quality of Life of Overactive Bladder in Older Americans:: Results from the Epidemiology of Lower Urinary Tract Symptoms Study

OBJECTIVE: To evaluate the prevalence and effect of overactive bladder (OAB) on healthcare‐seeking behavior, mental health, and generic and condition‐specific health‐related quality of life (HRQL) in older adults.

Risk factors and comorbid conditions associated with lower urinary tract symptoms: EpiLUTS.

To explore the risk factors and comorbid conditions associated with subgroups of lower urinary tract symptoms (LUTS) in men and women aged ≥40 years in three countries, using data from the EpiLUTS study, as LUTS are common amongst men and women and increase in prevalence with age.

The Co-occurrence of Reading Disorder and ADHD Epidemiology, Treatment, Psychosocial Impact, and Economic Burden

The co-occurrence of reading disorder (RD) and attention-deficit/hyperactivity disorder (ADHD) has received increasing attention. This review summarizes the epidemiology, treatment strategies, psychosocial impact, and economic burden associated with the co-occurrence of these conditions. Common genetic and neuropsychological deficits may partially explain the high degree of overlap between RD and ADHD. Children who face the additive problems of both disorders are at greater risk for academic failure, psychosocial consequences, and poor long-term outcomes that persist into adulthood. However, few studies have evaluated interventions targeted to this patient population, underscoring the importance of identifying effective multimodal treatments that address the neuropsychological deficits of RD and ADHD through carefully planned clinical research.

Opioid-induced constipation in patients with chronic noncancer pain in the Usa, Canada, germany, and the UK: descriptive analysis of baseline patient-reported outcomes and retrospective chart review

Background The characteristics of patients who suffer from noncancer pain and opioid-induced constipation are not well understood. Methods Cross-sectional patient survey and chart review data from the baseline assessment of an ongoing longitudinal study in the USA, Canada, Germany, and the UK were evaluated via descriptive statistics. Participants had confirmation of daily opioid therapy ≥30 mg for ≥4 weeks and self-reported opioid-induced constipation. Response to laxatives was defined by classifying participants into categories of laxative use and evaluating the prevalence of inadequate response to one laxative agent and two or more agents from at least two different laxative classes. Outcomes included the Patient Assessment of Constipation-Symptoms, Work Productivity and Activity Impairment Questionnaire-Specific Health Problem, EuroQOL 5 Dimensions, and Global Assessment of Treatment Benefit, Satisfaction, and Willingness to Continue. Results Patients reported a mean of 1.4 bowel movements not preceded by laxatives and 3.7 bowel movements with laxative use per week; 83% wanted at least one bowel movement per day. Most commonly reported on Patient Assessment of Constipation-Symptoms were straining/squeezing to pass bowel movements (83%), bowel movements too hard (75%), flatulence (69%), and bloating (69%). Eighty-four percent were taking natural or behavioral therapies; 60% were taking at least one over-the-counter laxative; and 19% were taking at least one prescription laxative. Prevalence of inadequate response to one laxative agent was 94%; inadequate response to two or more agents from at least two different laxative classes was 27%. Mean Work Productivity and Activity Impairment Questionnaire-Specific Health Problem values for percent work time missed, percent impairment while working, and percent activity impairment were 9%, 32% (equivalent of 14 hours of lost productivity per week), and 38%. Mean EuroQOL 5 Dimensions index and visual analog scale scores were 0.49 and 50.6, respectively. Forty-four percent reported being satisfied with their treatment for constipation. Conclusion Patients treated with opioids for noncancer pain commonly endure constipation symptoms that limit their work productivity and overall health-related quality of life while adhering to treatments that provide little relief. Further research is needed to identify more efficacious constipation therapies for this patient population.

The Impact of OAB on Sexual Health in Men and Women: Results from EpiLUTS

INTRODUCTION Prior research suggests that overactive bladder (OAB) is common and adversely affects sexuality in both men and women. However, more data are needed from population-based studies to evaluate the impact OAB on sexual health. AIM To describe sexual health outcomes in men and women with continent and incontinent OAB (C-OAB, I-OAB) compared to those with no/minimal urinary symptoms (NMS) and to evaluate correlates of decreased sexual activity and enjoyment in men and women, and correlates of erectile dysfunction (ED), ejaculatory dysfunction (EjD), and premature ejaculation (PE) in men. METHODS A cross-sectional, population-representative survey was conducted via the Internet in the United Kingdom, Sweden, and United States. OAB was assessed via a questionnaire based on current International Continence Society definitions. Descriptive statistics were used to compare outcomes for those with I-OAB, C-OAB and NMS, and logistic regressions were used to evaluate predictors of sexual functioning. MAIN OUTCOME MEASURES Participants responding to the sexual health portion of the survey were asked questions about sexual activity and satisfaction. Other outcomes included two domains from the Abbreviated Sexual Function Questionnaire, the erectile function domain of the International Index of Erectile Function, and questions assessing EjD and PE. RESULTS Survey response was 59.2%; 6,326 men and 8,085 women participated in the sexual health portion of the survey. Across outcomes, I-OAB and C-OAB were associated with worse sexual health as compared to those with NMS. Logistic regressions showed that those with I-OAB and C-OAB were significantly (P<0.0001) more likely to report diminished sexual activity and enjoyment of sex. I-OAB and C-OAB were also significant predictors of ED and EjD in men, but not PE. CONCLUSIONS The impact of OAB is evident across domains of sexual health in both men and women. Sexual health should be assessed in men and women presenting with OAB.

The relationship between BMI and urinary incontinence subgroups: Results from EpiLUTS

To evaluate the relationship between body mass index (BMI) and urinary incontinence (UI) in adults ≥40 from the United States, United Kingdom, and Sweden.