Yun Jeong

Generic and disease-specific health-related quality of life in women with coital incontinence: a prospective, multicenter study.

Objective: This study was carried out to evaluate the impact of coital incontinence on health-related quality of life (HRQOL) in women with lower urinary tract symptoms. Methods: A total of 180 women with sexual activity were evaluated. To obtain HRQOL assessments, patients were asked to fill out the Bristol Female Lower Urinary Tract Symptoms and the Medical Outcomes Study Short Form (SF-36) questionnaires. Results: The coital incontinence group had more frequently symptoms including urgency, urge incontinence, bladder pain, stress incontinence, unpredictable incontinence, nocturnal incontinence, reduced stream, and stopping flow than the no coital incontinence group. The frequency of incontinence and volume of leakage were also higher in the coital incontinence group than the no coital incontinence group. All symptom questions regarding sexual matters and quality of life except cutting down on fluid were more frequent in patients with coital incontinence than those without coital incontinence. Of the eight domains in the SF-36 questionnaire, five domains, namely, Physical functioning, Role-physical functioning, Social functioning, Role-emotional functioning, and Mental health were significantly different between the two groups. When comparing the Bristol Female Lower Urinary Tract Symptoms scores in the two groups, the scores in all domains except Voiding symptoms in the coital incontinence group were significantly higher than those in the no coital incontinence group. Patients with coital incontinence had more HRQOL impairment than those without coital incontinence. Conclusions: Our study reveals that more emphasis should be placed on coital incontinence in the terminology of urinary incontinence.

Patients' experience with ambulatory urodynamics. A prospective study.

Objective. To assess emotional variables in patients who underwent ambulatory urodynamic monitoring (AUM). Material and methods. A total of 33 females and 7 males aged 23–72 years with an overactive bladder who had undergone three consecutive AUM sessions were included in the study on a prospective basis. Patients completed a self-administered questionnaire before and immediately after each procedure. Answers were given using a visual analog scale. Results. The pre-procedural level of anxiety did not differ significantly with respect to sex, age, education level or income. The degree of bother experienced by patients aged ≥ 50 years was higher than for those aged < 50 years: 5 vs 2.5 (p=0.030). As income increased, the degrees of pain (p=0.016), bother (p=0.013) and boredom (p=0.010) decreased. Other emotional aspects did not differ significantly according to age or income (p>0.05). Only the subjective bother score influenced the examiner-rated degree of intolerance during AUM (p=0.007). A total of 34 patients (85.0%) indicated that they would be willing to return for a further session of AUM. The degree of intolerance decreased at the second (p=0.006) and third (p=0.049) AUM sessions, whereas other parameters were not significantly different. Conclusion. Our results demonstrate that AUM is acceptable and well tolerated by patients with bladder dysfunction.

A comparative study of patient experiences of conventional fluoroscopic and four-hour ambulatory urodynamic studies

We assessed several emotional variables in patients experiencing conventional urodynamic and ambulatory urodynamic monitoring (AUM) to verify the hypothesis that AUM is tolerated as well as conventional urodynamics. A total of 33 women and 7 men from 23 to 72 years of age who were undergoing both procedures were prospectively included in this study. Prior to and immediately after the procedures, each patient completed a self-administered questionnaire. Answers were given on a visual analogue scale. The degree of anxiety was higher for conventional urodynamics than for AUM (p = 0.045), while the degree of boredom experienced during AUM was higher than that during conventional urodynamics (p = 0.013). There was no significant difference in the degree of shame or bother experienced by the patients during the two procedures. In general, patients tolerated both examinations extremely well. The examiner-rated degree of intolerance during conventional urodynamics was influenced by the subjective pain score (p = 0.001), while all other emotional variables except bother were not significantly related with the degree of intolerance during AUM (p = 0.007). A total of 74.4% and 84.6% responded that they were willing to repeat conventional urodynamics and AUM, respectively, which were not significantly different. Although AUM produced a significantly higher level of boredom than conventional urodynamics, our data demonstrates that patients are as tolerant of AUM as they are of conventional urodynamic procedures.