Page 1. 117 13 Treatment of interstitial cystitis: does anything work? Ann Oldendorf and J. Quent... more Page 1. 117 13 Treatment of interstitial cystitis: does anything work? Ann Oldendorf and J. Quentin Clemens Department of Urology, University of Michigan, Ann Arbor, MI, USA Introduction ...Perez-Marrero [13] DMSO cross-over 32 Pain relieved Odds ratio 0.22 (1.10 to 1.55) ...
We examine symptom variability in men and women with urological chronic pelvic pain syndrome (UCP... more We examine symptom variability in men and women with urological chronic pelvic pain syndrome (UCPPS). We describe symptom fluctuations as related to early symptom regression and its effect on estimated one-year symptom change. We then describe a method to quantify patient-specific symptom variability. Symptoms were assessed biweekly in 424 UCPPS subjects over one year. Subjects were classified as 'improved', 'no change', or 'worse' according to their rate of change using 1) all data, 2) excluding week 0, and 3) excluding weeks 0 and 2 to evaluate the impact of early symptom regression. Patient-specific time-varying variability was calculated at each interval using a sliding window approach. Patients were classified as high, medium, or low variability at each time and ultimately as high or low variability overall based on their variability for the majority of contacts. Prior to excluding early weeks to adjust for early symptom regression 25-38% and 5-6% of pat...
Hypothesis / aims of study The primary aim of this study is to determine the effectiveness of per... more Hypothesis / aims of study The primary aim of this study is to determine the effectiveness of percutaneous tibial nerve stimulation (PTNS) in patients with overactive bladder (OAB) symptoms in a real-world setting. We will also determine the rate of patient adherence to the recommended 12 weeks of therapy. Our secondary objective is to determine the rate of conversion to maintenance PTNS therapy as a surrogate for treatment success, and to identify interval treatments offered to those patients who have not derived improvement in their symptoms.
To describe and evaluate the use of urodynamics (UDS) studies for all indications in an academic ... more To describe and evaluate the use of urodynamics (UDS) studies for all indications in an academic specialty referral urology practice. This is a prospective questionnaire-based study wherein clinicians completed a pre- and post-UDS questionnaire on each UDS that they ordered for all clinical indications between May 2013 and August 2014. Questions pertained to patient demographics and history, the clinical indication for the UDS, the clinician's pre- and post-UDS clinical impressions, and changes in post-UDS management plans. Pre- and post-UDS diagnoses were compared using the McNemar test. Clinicians evaluated a total of 285 UDS studies during the study period. The average age of study participants was 56.0 (±16.4) years, 59.5% were female, and 29.3% had a neurologic diagnosis. The most common indication for performing UDS was to discern the predominant type of urinary incontinence (stress vs urgency) in patients with mixed incontinence symptoms (38.5%) and to assess the safety o...
To determine predictors of physical and emotional discomfort associated with urodynamic testing i... more To determine predictors of physical and emotional discomfort associated with urodynamic testing in men and women both with and without neurologic conditions. An anonymous questionnaire-based study was completed by patients immediately after undergoing fluoroscopic urodynamic testing. Participants were asked questions pertaining to their perceptions of physical and emotional discomfort related to the study, their urologic and general health history, and demographics. Logistic regression was performed to determine predictors of physical and emotional discomfort. A total of 314 patients completed the questionnaire representing a response rate of 60%. Half of the respondents (50.7%) felt that the examination was neither physically nor emotionally uncomfortable, whereas 29.0% and 12.4% of respondents felt that the physical and emotional components of the examination were most uncomfortable, respectively. Placement of the urethral catheter was the most commonly reported component of physical discomfort (42.9%), whereas anxiety (27.7%) was the most commonly reported component of emotional discomfort. Presence of a neurologic problem (odds ratio, 0.273; 95% confidence interval, 0.121-0.617) and older age (odds ratio, 0.585; 95% confidence interval, 0.405-0.847) were factors associated with less physical discomfort. There were no significant predictors of emotional discomfort based on our model. Urodynamic studies were well tolerated regardless of gender. Presence of a neurologic condition and older age were predictors of less physical discomfort. These findings are useful in counseling patients regarding what to expect when having urodynamic procedures.
Page 1. 117 13 Treatment of interstitial cystitis: does anything work? Ann Oldendorf and J. Quent... more Page 1. 117 13 Treatment of interstitial cystitis: does anything work? Ann Oldendorf and J. Quentin Clemens Department of Urology, University of Michigan, Ann Arbor, MI, USA Introduction ...Perez-Marrero [13] DMSO cross-over 32 Pain relieved Odds ratio 0.22 (1.10 to 1.55) ...
We examine symptom variability in men and women with urological chronic pelvic pain syndrome (UCP... more We examine symptom variability in men and women with urological chronic pelvic pain syndrome (UCPPS). We describe symptom fluctuations as related to early symptom regression and its effect on estimated one-year symptom change. We then describe a method to quantify patient-specific symptom variability. Symptoms were assessed biweekly in 424 UCPPS subjects over one year. Subjects were classified as 'improved', 'no change', or 'worse' according to their rate of change using 1) all data, 2) excluding week 0, and 3) excluding weeks 0 and 2 to evaluate the impact of early symptom regression. Patient-specific time-varying variability was calculated at each interval using a sliding window approach. Patients were classified as high, medium, or low variability at each time and ultimately as high or low variability overall based on their variability for the majority of contacts. Prior to excluding early weeks to adjust for early symptom regression 25-38% and 5-6% of pat...
Hypothesis / aims of study The primary aim of this study is to determine the effectiveness of per... more Hypothesis / aims of study The primary aim of this study is to determine the effectiveness of percutaneous tibial nerve stimulation (PTNS) in patients with overactive bladder (OAB) symptoms in a real-world setting. We will also determine the rate of patient adherence to the recommended 12 weeks of therapy. Our secondary objective is to determine the rate of conversion to maintenance PTNS therapy as a surrogate for treatment success, and to identify interval treatments offered to those patients who have not derived improvement in their symptoms.
To describe and evaluate the use of urodynamics (UDS) studies for all indications in an academic ... more To describe and evaluate the use of urodynamics (UDS) studies for all indications in an academic specialty referral urology practice. This is a prospective questionnaire-based study wherein clinicians completed a pre- and post-UDS questionnaire on each UDS that they ordered for all clinical indications between May 2013 and August 2014. Questions pertained to patient demographics and history, the clinical indication for the UDS, the clinician's pre- and post-UDS clinical impressions, and changes in post-UDS management plans. Pre- and post-UDS diagnoses were compared using the McNemar test. Clinicians evaluated a total of 285 UDS studies during the study period. The average age of study participants was 56.0 (±16.4) years, 59.5% were female, and 29.3% had a neurologic diagnosis. The most common indication for performing UDS was to discern the predominant type of urinary incontinence (stress vs urgency) in patients with mixed incontinence symptoms (38.5%) and to assess the safety o...
To determine predictors of physical and emotional discomfort associated with urodynamic testing i... more To determine predictors of physical and emotional discomfort associated with urodynamic testing in men and women both with and without neurologic conditions. An anonymous questionnaire-based study was completed by patients immediately after undergoing fluoroscopic urodynamic testing. Participants were asked questions pertaining to their perceptions of physical and emotional discomfort related to the study, their urologic and general health history, and demographics. Logistic regression was performed to determine predictors of physical and emotional discomfort. A total of 314 patients completed the questionnaire representing a response rate of 60%. Half of the respondents (50.7%) felt that the examination was neither physically nor emotionally uncomfortable, whereas 29.0% and 12.4% of respondents felt that the physical and emotional components of the examination were most uncomfortable, respectively. Placement of the urethral catheter was the most commonly reported component of physical discomfort (42.9%), whereas anxiety (27.7%) was the most commonly reported component of emotional discomfort. Presence of a neurologic problem (odds ratio, 0.273; 95% confidence interval, 0.121-0.617) and older age (odds ratio, 0.585; 95% confidence interval, 0.405-0.847) were factors associated with less physical discomfort. There were no significant predictors of emotional discomfort based on our model. Urodynamic studies were well tolerated regardless of gender. Presence of a neurologic condition and older age were predictors of less physical discomfort. These findings are useful in counseling patients regarding what to expect when having urodynamic procedures.
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