TY - JOUR
T1 - Prevalence of preoperative lower urinary tract symptoms in patients undergoing elective lumbar spine surgery
AU - Lieberman, Elizabeth G.
AU - Boone, Ryan M.
AU - Radoslovich, Stephanie
AU - Haj, Valentina
AU - Hiratzka, Jayme
AU - Marshall, Lynn M.
AU - Yoo, Jung U.
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Study Design. Cross-sectional cohort study. Objective. To determine the prevalence of moderate-to-severe lower urinary tract symptoms (LUTS) in patients undergoing elective lumbar spine surgery, and to describe associations between prevalence, severity of symptoms, demographic variables, and spine pathology. Summary of Background Data. The prevalence of LUTS is unknown in patients with lumbar spine disease. Furthermore, the extent of LUTS severity and the relationship between spine pathology and LUTS is not well documented. Methods. We used the validated International Prostate Symptom Score (IPSS) to assess LUTS severity among elective lumbar spine surgery patients from October 2015 to April 2017 at a single academic institution. Moderate-to-severe LUTS was defined as IPSS score of 8 or more. The IPSS also includes a question to assess urinary bother, for which a score of 4 or more indicates clinically significant bother. Prevalence estimates and 95% confidence intervals were computed in the sample overall, and according to sex, age, and lumbar spine diagnosis. Results. IPSS data were obtained from 373 patients (97% of those eligible) undergoing elective lumbar spine surgery. Moderate- to-severe urinary symptoms were reported by 46% of these patients, and by 51% of women and 42% of men. Prevalence of moderate-to-severe urinary symptoms increased with age, rising from 38% in patients younger than 40 years to 57% in patients 70 years or older. LUTS prevalence according to spondylolisthesis, stenosis, scoliosis, and herniated nucleus pulposus diagnostic groups were 51%, 50%, 50%, and 31%, respectively. Clinically significant urinary bother was reported by 14% overall, 10% of men, and 18% of women, and prevalence also increased with age. Conclusion. Moderate-to-severe LUTS were highly prevalent in this sample. Urinary symptoms are more prevalent with increasing age, in women, and in patients with stenosis, spondylolisthesis, and scoliosis. Proportionally, fewer patients reported clinically significant urinary bother, which may impact patient reporting and physician identification of urinary symptoms.
AB - Study Design. Cross-sectional cohort study. Objective. To determine the prevalence of moderate-to-severe lower urinary tract symptoms (LUTS) in patients undergoing elective lumbar spine surgery, and to describe associations between prevalence, severity of symptoms, demographic variables, and spine pathology. Summary of Background Data. The prevalence of LUTS is unknown in patients with lumbar spine disease. Furthermore, the extent of LUTS severity and the relationship between spine pathology and LUTS is not well documented. Methods. We used the validated International Prostate Symptom Score (IPSS) to assess LUTS severity among elective lumbar spine surgery patients from October 2015 to April 2017 at a single academic institution. Moderate-to-severe LUTS was defined as IPSS score of 8 or more. The IPSS also includes a question to assess urinary bother, for which a score of 4 or more indicates clinically significant bother. Prevalence estimates and 95% confidence intervals were computed in the sample overall, and according to sex, age, and lumbar spine diagnosis. Results. IPSS data were obtained from 373 patients (97% of those eligible) undergoing elective lumbar spine surgery. Moderate- to-severe urinary symptoms were reported by 46% of these patients, and by 51% of women and 42% of men. Prevalence of moderate-to-severe urinary symptoms increased with age, rising from 38% in patients younger than 40 years to 57% in patients 70 years or older. LUTS prevalence according to spondylolisthesis, stenosis, scoliosis, and herniated nucleus pulposus diagnostic groups were 51%, 50%, 50%, and 31%, respectively. Clinically significant urinary bother was reported by 14% overall, 10% of men, and 18% of women, and prevalence also increased with age. Conclusion. Moderate-to-severe LUTS were highly prevalent in this sample. Urinary symptoms are more prevalent with increasing age, in women, and in patients with stenosis, spondylolisthesis, and scoliosis. Proportionally, fewer patients reported clinically significant urinary bother, which may impact patient reporting and physician identification of urinary symptoms.
KW - Lower urinary tract symptoms
KW - Lumbar spine
KW - Urinary bother
UR - http://www.scopus.com/inward/record.url?scp=85055181720&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055181720&partnerID=8YFLogxK
U2 - 10.1097/BRS.0000000000002649
DO - 10.1097/BRS.0000000000002649
M3 - Review article
C2 - 29561297
AN - SCOPUS:85055181720
SN - 0362-2436
VL - 43
SP - E1152-E1156
JO - Spine
JF - Spine
IS - 19
ER -