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Bothersome urinary symptoms and disease-specific quality of life in patients with benign prostatic obstruction: High prevalence of urinary incontinence before and after intervention
Linköping University, Department of Clinical and Experimental Medicine, Urology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Urology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
2007 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, Vol. 41, no 1, 32-41 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Firstly, to describe self-reported urinary symptoms and bothersomeness, including disease-specific quality of life (QOL), in patients with symptomatic benign prostatic obstruction (BPO) before and 6 months after intervention. Secondly, to identify factors which predict disease-specific QOL. Thirdly, to develop and test the reliability of an instrument to evaluate incontinence, the Linköping Incontinence Questionnaire (LIQ). Finally, to translate and test the reliability of Swedish versions of the International Prostate Symptom Score, including the bother question, the American Urological Association Symptom Problem Index (SPI) and the Benign Prostatic Hyperplasia Impact Index.

Material and methods: Disease-specific QOL was studied in 572/720 consecutively treated patients using structured questionnaires. The reliability of the instruments was tested in 122 patients with lower urinary tract symptoms (LUTS) or BPO.

Results: The frequency and weak stream items of the SPI were among those that best explained the patients' disease-specific QOL both before and after intervention. Before and after intervention the prevalence of urinary incontinence, assessed using the LIQ instrument, was 46% and 16%, respectively. Symptoms and disease-specific QOL improved most in the surgery group, intermediately in the transurethral incision of the prostate/transurethral microwave thermotherapy group and least in the drug therapy group.

Conclusions: The frequency and weak stream items of the SPI were the factors that best explained disease-specific QOL. The prevalence of incontinence before and after intervention was higher than that previously

Place, publisher, year, edition, pages
Taylor & Francis , 2007. Vol. 41, no 1, 32-41 p.
Keyword [en]
Benign prostatic obstruction, benign prostatic hyperplasia, disease-specific quality of life, interventions, lower urinary tract symptoms, predicting factors, treatment, urinary incontinence, urinary symptoms
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:liu:diva-15942DOI: 10.1080/00365590601068926OAI: oai:DiVA.org:liu-15942DiVA: diva2:128422
Available from: 2008-12-17 Created: 2008-12-17 Last updated: 2009-08-19Bibliographically approved
In thesis
1. Sleep and quality of life in men with lower urinary tract symptoms: and their partners
Open this publication in new window or tab >>Sleep and quality of life in men with lower urinary tract symptoms: and their partners
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims: The overall aim was to determine how lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction (BPO) affect sleep, health related quality of life and disease specific quality of life, and how the men’s urinary symptoms affect their partners.

Subjects and methods: In papers I–II, a descriptive design with a pre-test and post-test was used and in papers III-IV the design was descriptive and comparative. The method was self-administered questionnaires. In papers I- II: The questionnaires were translated in the ethnographic mode. In paper I the reliability of the questionnaire was tested in 122 patients with LUTS/ BPO. The disease specific quality of life was studied before and after intervention in 572 consecutive patients with BPO, aged 45-94 yrs. In paper II, the partner specific quality of life was studied in partners to men with BPO before and after TURP. The reliability and the responsiveness of the questionnaire were tested in two groups with 51 partners each. Papers III-IV: A study of 239 men with LUTS, aged 45-80 yrs, and their partners (n=126) who were compared to randomly selected men from the population (n=213) and their partners (n=131). The men had an extra control group, men with inguinal hernia (n=200). Sleep and health related quality of life was studied in both men and their partners. The partners’ specific quality of life was also studied and the men with LUTS answered questions about urinary symptoms and disease specific quality of life.

Results: Papers I-II: All the tested questionnaires showed an acceptable reliability and responsiveness. I: Before and after intervention the prevalence of urinary incontinence was 46 % and 16 % respectively. II: Partners were affected by the patients’ BPO symptoms before and improved after the patients TURPs. III: Most sleep variables were significantly impaired in men with LUTS compared to one or both of the control groups. The men with LUTS had a significantly higher prevalence of insomnia (40 %) than both control groups and significantly lower sleep efficiency (49 %) than men with hernia. The men with LUTS were significantly impaired in most domains of the health related quality of life compared to men in the population. IV: There were no significant differences between the two partner groups regarding the quantity and quality of sleep or the health related quality of life.

Conclusions: All tested questionnaires showed an acceptable reliability and responsiveness.

The prevalence of urinary incontinence before and after intervention was higher than earlier reported.

Men with LUTS had significantly poorer sleep quality, reduced sleep efficiency and a higher prevalence of insomnia than men in the population and men with inguinal hernia.

The HRQOL is impaired in men with LUTS compared to men in the population and men with inguinal hernia.

Partners are affected by the patients’ symptoms, and it is emotional rather than practical aspects that affect them most.

Partners of men with LUTS did not differ significantly from partners in the population with regard to sleep and health related quality of life.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 80 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1092
Keyword
Benign prostatic hyperplasia, Benign prostatic obstruction, Disease specific quality of life, Health related quality of life, Inguinal hernia, Insomnia, Lower urinary tract symptoms, Population, Sleep disorders, Sleep quality
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:liu:diva-15946 (URN)978-91-7393-724-5 (ISBN)
Public defence
2009-01-30, Berzeliussalen, Campus US, Hälsouniversitetet, Linköpings Universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2008-12-17 Created: 2008-12-17 Last updated: 2009-08-21Bibliographically approved

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Marklund-Bau, HelénEdéll-Gustafsson, UllaSpångberg, Anders

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Urology Faculty of Health SciencesDepartment of Urology in ÖstergötlandNursing Science
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