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Prevalence of storage lower urinary tract symptoms in male patients attending Spanish urology office. Urinary urgency as predictor of quality of life
Prevalencia de síntomas del tracto urinario inferior de llenado en pacientes varones que acuden a consulta de urología en España. La urgencia urinaria como predictor de calidad de vida
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Urinary urgency as predictor of quality of life" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1566 "Ancho" => 2835 "Tamanyo" => 537615 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Resultados de la escala OABq-SF. A. Subescala de molestias por los síntomas urinarios. B. Subescala de calidad de vida en relación con los síntomas urinarios. 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Urinary urgency as predictor of quality of life" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "621" "paginaFinal" => "627" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Cambronero Santos, C. Errando Smet" "autores" => array:2 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Cambronero Santos" "email" => array:1 [ 0 => "javicambro@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Errando Smet" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Urología, Hospital Universitario Infanta Leonor, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Urología funcional y Femenina, Fundación Puigvert, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de síntomas del tracto urinario inferior de llenado en pacientes varones que acuden a consulta de urología en España. La urgencia urinaria como predictor de calidad de vida" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 950 "Ancho" => 1497 "Tamanyo" => 105542 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Actions or behaviors of patients with urgency LUTS to control their urinary symptoms. Patients could select more than one option.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">International Continence Society</span> proposed the term ‘lower urinary tract symptoms’ (LUTS) to describe symptoms associated with the phases of filling and emptying of the micturition cycle.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> The high prevalence of LUTS has changed the traditional concepts on their etiology. Traditionally, they were considered secondary to benign prostate growth in men,<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">2–4</span></a> but the current approach is multifactorial, with symptoms related to the prostate, the bladder or the kidney, as reflected in the latest update of the guidelines of the European Association of Urology.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a> Filling LUTS are the most common<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a>; their prevalence and severity in men increases with age, and up to 43% of men >60 years have their quality of life altered for it.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">2,6,7</span></a> Filling LUTS include frequency, nocturia, urgency, and urge urinary incontinence<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1,8</span></a> and, as defined by the <span class="elsevierStyleItalic">International Continence Society</span>, they correspond to the symptoms of overactive bladder.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> LUTS appear frequently in combination, thus increasing symptomatic patient discomfort. More than half of the men relate LUTS of more than one symptomatic group,<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">9,10</span></a> including symptoms of filling, emptying, and post void, although filling symptoms are the reason for consultation in 89% of cases in Spain<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> and urgency is the most prevalent.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a> The high frequency of presentation correlates with perception of worsening of quality of life, and it may involve a deterioration in activity and labor productivity of patients,<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a> and lead to stress, depression, and social isolation.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The relationship of filling LUTS with age and increasing life expectancy of the population has important implications at the level of care and health spending, so it is interesting to obtain information on their prevalence in men in our country. The main objective of this study was to describe the frequency of occurrence of filling LUTS among men patients attending the urology office for any reason. In addition, the symptom profile and comorbidities of these patients was investigated, as well as the impact of urinary urgency (the most representative symptom) in their quality of life.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">An epidemiological, multicenter, cross-sectional study was conducted involving 291 urology clinics throughout Spain between May and October 2013. The study lasted 5 consecutive days at each visit and consisted of 2 parts. In the first, the presence of filling LUTS was questioned to all adult males who attended for any reason. In the second part, the first patient of the day that met the inclusion criteria was invited to complete the questionnaires of data collection. It included up to 5 patients per center (one per day) and the inclusion criteria were: male ≥18 years old having filling LUTS, able to complete the questionnaires and that gives written informed consent.</p><p id="par0020" class="elsevierStylePara elsevierViewall">No intervention was performed and it was not interfered with the normal practice of the participating experts. All the procedures complied with the Organic Law 15/1999 of December 13, of Protection of personal data and the principles of the Declaration of Helsinki (2008). The study protocol was approved by the Ethics Committee of Clinical Research of the University Hospital Gregorio Marañón de Madrid and the Puigvert Foundation in Barcelona.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Variables and definitions</span><p id="par0025" class="elsevierStylePara elsevierViewall">All patients were asked whether they experienced filling LUTS, defined as ≥6 episodes of frequency and ≥1 episode of urgency and/or ≥2 nocturia episodes and/or ≥1 incontinence episodes. The data were classified according to 3 age ranges of patients (18–49 years, 50–64 years, and ≥65 years). For the second part, the selected patient filled the <span class="elsevierStyleItalic">International Prostate Symptom Score</span> (IPSS) in its version in Spanish<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> to quantify urinary symptoms. The discomfort caused by overactive bladder and quality of life of patients in this connection were quantified with the <span class="elsevierStyleItalic">Overactive Bladder symptom and health-related quality of life questionnaire</span> in its short version (OABq-SF), also in its version validated in Spanish.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> Finally, the <span class="elsevierStyleItalic">Patient Perception of Bladder Condition</span><a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a> was used, adapted to Spanish, to assess the patient's perception about their urinary problems and discomfort. From the group that completed the questionnaires, sociodemographic and lifestyle data were collected (age, consumption of caffeinated beverages, fluid intake), and clinical data (comorbidities, reason for consultation in urology, reported symptoms and time of evolution, prostate volume determined by DRE and ultrasound and flowmetry).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Statistical procedures</span><p id="par0030" class="elsevierStylePara elsevierViewall">To detect cases of filling LUTS with a prevalence of 51.3% (prevalence according to the EPIC study<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a>) with accuracy of 0.01 and a confidence interval of 95% (95% CI), a sample of 7275 patients was necessary. The planned population of 30,000 patients, according to the number of centers involved and recruitment procedures, was sufficiently representative. For the second part, it was found that the prevalence of urinary urgency was ≈10%, so 1464 patients were required to detect a prevalence of 10% with an accuracy of 1.5% and 95%. The selection bias was controlled including only the first patient of each of the 5 consecutive days of study.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The prevalences are given as percentages or frequencies. The prevalence of filling LUTS was calculated as the ratio between the number of patients who reported filling LUTS and the total of patients attending urology consultations. All other analyses were performed on the sample of patients who completed the data collection of the second phase. Clinical and demographic data are given as frequencies for qualitative variables and as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation for quantitative ones. The results of the questionnaires were analyzed according to their respective manuals. A multivariate analysis was performed to determine the factors that made it possible to correctly classify patients according to the severity of their urgency LUTS, according to their quality of life and symptoms. All analyses were performed with SAS 9.2. All tests were bilateral and the level of statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 25,482 patients were seen in 5 days at the participating centers (95.7% Caucasian). Of these, 10,446 (41.0%) had filling LUTS as defined by this study, and the prevalence increased with age: 14.1% in men aged 18–49 years, 41.5% in those aged 50–64 years, and 60.8% in ≥65 years old.</p><p id="par0045" class="elsevierStylePara elsevierViewall">In the collection of data on quality of life, 1015 patients with urgency LUTS took part, whose clinical and demographic data are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> and as supplementary material. Of these, only 2.6% had only filling symptoms, while 6.5% had filling and emptying LUTS, 2.6% filling and postvoid LUTS, and 88.5% the 3 types of LUTS. The most frequent comorbidities among patients with urgency were hypertension (59.6%), diabetes (28.7%), lung diseases (12.9%), and depression (7.7%). The results of the IPSS questionnaire (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>769) on nuisance caused by symptoms are summarized in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A. The responses indicate that the frequency, urgency/incontinence, and weak urinary stream were the symptoms experienced more often by patients. According to the overall score of this questionnaire, 41.5% had moderate symptoms and 58.4% severe, with only 0.1% with mild symptoms, and progressive worsening was observed with age (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). 60.3% of patients with coexistence of filling, emptying and postvoid LUTS were in the category severe IPSS, while most of those with only filling LUTS or only 2 types of LUTS were classified as moderate severity according to the IPSS score (60% filling, 66.7% filling and emptying, and 72.7% filling and postvoid).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The scores in the subscale of discomfort OABq-SF (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A) indicate that participants considered the degree of their discomfort moderate (somewhat/quite annoying), with the worst ratings for urgency and nocturia. The discomfort leads them to a series of control behaviors, among which 51.7% say that they limit their fluid intake (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The impact on the quality of life of filling LUTS was explored first with item 8 of the IPSS (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A), which revealed that participants would generally feel dissatisfied if their symptoms were maintained as at the time of the survey. Meanwhile, the OABq-SF subscale on quality of life (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B) shows an impact of filling LUTS from moderately to quite negative. The worst rated aspects were the items related to lower quality of nighttime sleep due to nocturia. In the OABq-SF, we observed an inverse correlation between the score in the subscale of discomfort and the one achieved in the quality of life subscale (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>A; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.773, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0001): the greater the inconvenience, the lower the quality of life. In addition, the overall score for discomfort increased and quality of life decreased as the severity of the urgency LUTS increased (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>B). 22.2% indicated in the questionnaire Patient Perception of Bladder Condition (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1015) that urinary symptoms caused them minor problems, which were moderate for 42.6% and severe for 24.2%. Only 7.1% considered their problems negligible or nonexistent. Univariate analysis indicated that the scores of the questionnaires, the blood PSA, and concomitant pulmonary disease were factors independently associated with the severity of urinary urgency (defined in 2 levels or 1–2 episodes<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>2 episodes daily). In the multivariate analysis, factors associated with urinary urgency were IPSS and OABq-SF scores of discomfort (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">The results of this study show that the prevalence of filling LUTS, among patients attending Urology Consultations in Spain for various reasons, is 41%. This figure is lower than the 51.3% observed in population epidemiological study (EPIC) conducted in 5 countries (Canada, Germany, Italy, Sweden and the United Kingdom).<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> However, the estimation model of overall prevalence of LUTS calculated in 2011 established the estimate between 31.8% and 32.5% for males over 20 years.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Patients with filling LUTS attending the consultation of Urology in this study were mostly over 65, as inferred from the sample of patients who completed the second part of the study. Caffeine consumption was practically universal in this group, and its association with LUTS, particularly filling, has been extensively tested.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">18</span></a> Logically, since one of the inclusion criteria for this second part was the presence of filling LUTS, most of these patients in this subgroup (63%) had come for this reason. All of them indicated that they experienced most filling LUTS and with a significant number of episodes per day, exceeding the previous observations in a sample of patients with a mean age 65<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 years.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> It has been previously observed that the symptoms that most often encourage consultation between patients who come for LUTS are urinary frequency and nocturia.<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">9,10</span></a> These two aspects were those which received the worst scores in the IPSS and OABq-SF questionnaires of this study, in addition to the urgency. Filling symptoms, particularly these three symptoms, are those that most affect the quality of life of the patient.<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">9,11,15</span></a> On the other hand, most patients surveyed (88.5%) had filling, emptying and postvoid LUTS, and only 2.6% exclusively filling LUTS. This is consistent with the results of the EpiLUTS study<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> and the previous results in a sample of Spanish elderly patients, in which 69% had combination of symptoms and only 8.4% had filling symptoms.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> The data on the impact of urinary symptoms on quality of life are consistent with other studies.<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">10,15,19</span></a> Men with LUTS require a differential diagnosis, and the primary objective is to improve their quality of life by improving their symptoms with an appropriate therapeutic approach. Patients clearly manifest in the IPSS their dissatisfaction with their situation, and the prospect of continuing the rest of their life with the symptoms they experience is valued very negatively. Unfortunately, the perspective is not that either, but that of a possible worsening with age, if not treated properly, as observed in this study according to the IPSS severity scores with age. Patients perceive limitations in daily life arising from their symptoms, as evidenced by the large percentage of patients who reported taking particular actions to control their symptoms. We must keep in mind that these actions can also be detrimental to their health, such as limiting intake of liquids, social outings, or sporting activities.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Finally, in this study, we intended to establish factors that made it possible to predict the severity of urgency LUTS of patients, a subjective symptom, according to other tools. Both the total IPSS score and the subscale of of discomfort of the OABq-SF proved to be predictors, again demonstrating the association between urinary urgency and quality of life.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The limitations of this study are inherent to the method of data collection, since the questionnaires on experienced discomfort and quality of life refer to a period of the last 30 days, and their response depends on the perception and memory of the patient. However, these questionnaires have been validated and the patient sample that completed them was representative of patients with filling LUTS. In this regard, the possible selection bias was minimized by limiting the recruitment to the first patient of each day. On the other hand, urinary urgency is a subjective symptom and in this study an assessment of its intensity was not performed with specific tools, such as the <span class="elsevierStyleItalic">Patient Perception of Intensity of Urgency Scale.</span><a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">In conclusion, in this study, a high prevalence of filling LUTS is observed in urological consultation in Spain. The severity of urgency, measured as the number of episodes of urgency, predicted a worse quality of life of the patient, although there are many symptomatic profiles of men with LUTS attending the urology clinic.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0085" class="elsevierStylePara elsevierViewall">This study was funded by Astellas Pharma, Spain.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">J. Cambronero is main investigator in clinical trials and speaker at symposia of Astellas Pharma.</p><p id="par0095" class="elsevierStylePara elsevierViewall">C. Errando Smet has participated in courses and symposia sponsored by Astellas Pharma, Gebro and AMS.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres762902" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec764378" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres762901" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec764377" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Variables and definitions" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Statistical procedures" ] ] ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0035" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interest" ] 10 => array:2 [ "identificador" => "xack253803" "titulo" => "Acknowledgements" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-01-20" "fechaAceptado" => "2016-04-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec764378" "palabras" => array:4 [ 0 => "Lower urinary tract symptoms" 1 => "Filling-type LUTS" 2 => "Urinary urgency" 3 => "Quality of life" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec764377" "palabras" => array:3 [ 0 => "Síntomas del tracto urinario inferior de llenado" 1 => "Urgencia urinaria" 2 => "Calidad de vida" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The study sought to determine the symptomatic profile of men with lower urinary tract symptoms (LUTS) who visited a urology clinic in Spain and its impact on their health-related quality of life (HRQL).</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A national, epidemiological cross-sectional study was conducted and included 291 urology clinics. The prevalence of storage LUTS was investigated in 25,482 men. The study collected sociodemographic and clinical data from a subgroup of 1015 patients with storage LUTS who filled out the International Prostate Symptom Score (IPSS), Overactive Bladder Questionnaire Short Form (OABq-SF) and Patient Perception of Bladder Condition (PPBC) questionnaires. The impact of urinary urgency on HRQL was analyzed.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The prevalence of storage LUTS was 41%, increasing with age: 14.1%, 41.5% and 60.8% for patients aged 18–49, 50–64 and ≥65 years, respectively. Of the 1015 selected patients, only 2.6% had storage symptoms exclusively. Symptom severity (IPSS) increased with age. Nocturia, frequency and urgency were the most common symptoms and had the most impact on HRQL (IPSS and OABq-SF). The number of urgency episodes was inversely correlated with the HRQL (<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0.773; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.0001). In the multivariate analysis, only the IPSS and OABq-SF bother scores were significant predictors of HRQL (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Storage LUTS are highly prevalent among patients attending urology clinics in Spain. The severity of the urgency (number of urgency episodes) predicted a poorer quality of life for the patient.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Materials and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se buscó conocer el perfil sintomático de pacientes varones con síntomas del tracto urinario inferior (STUI) que acuden a consulta de urología en España, y el impacto en la calidad de vida relacionada con la salud (CVRS).</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio nacional, epidemiológico, transversal. Incluyó 291 consultas de urología. La prevalencia de STUI de llenado se investigó en 25.482 varones. Se recogieron datos sociodemográficos y clínicos de un subgrupo de 1.015 pacientes con STUI de llenado que completó los cuestionarios IPSS, OABq-SF y PPBC. Se analizó el impacto de la urgencia urinaria en la CVRS.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de STUI de llenado fue 41%, aumentando con la edad: 14,1%, 41,5% y 60,8% de los pacientes con 18-49, 50-64 y ≥<span class="elsevierStyleHsp" style=""></span>65 años, respectivamente. De los 1.015 pacientes seleccionados solo el 2,6% presentaba exclusivamente síntomas de llenado. La gravedad de los síntomas (IPSS) aumentó con la edad. La nocturia, la frecuencia y la urgencia fueron los síntomas más frecuentes y con más impacto en la CVRS (IPSS y OABq-SF). El número de episodios de urgencia se correlacionó inversamente con la CVRS (r<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−0,773; p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,0001). En el análisis multivariado solo el IPSS y el OABq-SF de molestias fueron predictores significativos de CVRS (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Existe una alta prevalencia de STUI de llenado entre los pacientes que acuden a consulta de urología en España. La gravedad de la urgencia (número de episodios de urgencia) predijo una peor calidad de vida del paciente.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Santos J, Errando Smet C. Prevalencia de síntomas del tracto urinario inferior de llenado en pacientes varones que acuden a consulta de urología en España. La urgencia urinaria como predictor de calidad de vida. Actas Urol Esp. 2016;40:621–627.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0110" class="elsevierStylePara elsevierViewall">The following is the supplementary data to this article:</p> <p id="par0115" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0050" ] ] ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1233 "Ancho" => 3301 "Tamanyo" => 338929 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Results of the IPSS questionnaire of urinary symptoms. (A) The first 7 items refer to the discomfort and 8 to the quality of life in relation to urinary symptoms. Likert responses have 6 levels: 0, none; 1, ≤1 of every 5 times; 2, < half of the times; 3, half of the times; 4, > half of the times; 5, nearly always. To consider the scale assessable, it was necessary to have information on all items. The data are mean and standard deviation. (B) Severity of symptoms with age according to overall IPSS score.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1566 "Ancho" => 2836 "Tamanyo" => 523725 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Results of the OABq-SF scale. (A) Subscale of discomfort due to urinary symptoms. (B) Subscale of quality of life in relation to urinary symptoms. Likert responses have 6 levels: 1, nothing; 2, a little; 3, some; 4, quite; 5, a lot; 6, way too much. The data are mean and standard deviation.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 950 "Ancho" => 1497 "Tamanyo" => 105542 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Actions or behaviors of patients with urgency LUTS to control their urinary symptoms. Patients could select more than one option.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1151 "Ancho" => 2966 "Tamanyo" => 311093 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Correlation between the score on the subscale of discomfort and the subscale of quality of life of the OABq-SF questionnaire in patients with urgency LUTS. (A) Scatter plot representing the discomfort score versus score in HRQOL. (B) The data are mean and standard deviation.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Proportion of patients \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age (years)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.62<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>18–49 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>50–64 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≥65 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleItalic">Reason for urology consultation</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>LUTS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">63.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Prostate health check-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sexual functional condition \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hematuria \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Filling symptoms reported by the patient (n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">=</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">1.015)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urinary frequency \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8.89<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nocturia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.96<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">99.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urgency \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.08<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Urgency urinary incontinence \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.84<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Evolution time<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>12 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.85% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Voiding symptoms reported by the patient (n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">=</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">963)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Weak/slow stream \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Intermittent stream \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Delayed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Abdominal press \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Post-micturition symptoms reported by the patient (n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">=</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">924)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">91.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span> Feeling of incomplete emptying \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Postvoid dripping \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68.8% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Urinary flow (ml/s)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.54<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><10<span class="elsevierStyleHsp" style=""></span>ml/s \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.7% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>10–15<span class="elsevierStyleHsp" style=""></span>ml/s \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≥15<span class="elsevierStyleHsp" style=""></span>ml/s \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.0% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Receives drug treatment for urinary symptoms (yes)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1260331.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Patients may have indicated more than one reason for consultation.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Demographic and clinical characteristics of patients with urgency LUTS (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1015).</p>" ] ] 5 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Specificity: 65.9%; sensitivity: 60.5%. The model enables to correctly classify 63.3% of patients. Higher score in discomfort OABq-SF and/or the IPSS scale is associated with an increased risk of having greater severity of the urgency.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Standard error \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Wald \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">gl \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sig. \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Odds ratio \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Total IPSS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.046 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.015 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.047 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.018–1.078 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">OABq-SF discomfort \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.024 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.005 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26.971 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.024 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.015–1.034 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Constant \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−2.158 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.248 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">75.608 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.116 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1260332.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Multivariate analysis of the relationship between the severity of the urgency LUTS and the scales of symptoms and quality of life.</p>" ] ] 6 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.zip" "ficheroTamanyo" => 9616 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. 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