Should we routinely assess psychological morbidities in idiopathic lower urinary tract dysfunction: ICI-RS 2019?

Psychological morbidities play a major role in idiopathic lower urinary tract dysfunction (iLUTD). The aim of the Think Tank (TT) was to discuss the relevance of psychological morbidities in idiopathic LUTD over the life span, including overactive bladder (OAB) or dysfunctional voiding (DV) and methods of assessment.

The paper is based on a selective review of the literature and in-depth discussions, leading to research recommendations regarding the assessment of psychological morbidities in iLUTD on children and adults held during the TT of the International Consultation on Incontinence Research Society in 2019.

Psychological comorbidities affect the health behaviors and treatment outcomes in patients with iLUTD. Both clinically relevant comorbid mental disorders, as well as subclinical psychological symptoms have a major impact and negatively influence incontinence treatment. Research is needed to elucidate mechanisms underlying iLUTD and psychological comorbidities. Clinical studies are needed to determine how perception generation and cognition impacts on the relationship of urinary perceptions, symptoms, and objective urodynamic function. Due to high psychological comorbidity rates, screening with validated, generic questionnaires for emotional and behavioral disorders in children with nocturnal enuresis, daytime urinary incontinence, and fecal incontinence is recommended. Brief screening is recommended for all adults with iLUTD, especially with OAB and DV, who are refractory to treatment.

Due to the high rate and relevance in clinical practice, screening for psychological comorbidities is recommended for all age groups. The research recommendations of this TT may be followed to improve the assessment of psychological morbidities in iLUTD.

Neurourology and urodynamics. 2020 Jul [Epub]

Tufan Tarcan, Caroline Selai, Fran├žois Herve, Desiree Vrijens, Phillip P Smith, Apostolos Apostolidis, Jalesh N Panicker, Ruth Kirschner-Hermanns, Salvador Arlandis, Giovanni Mosiello, Roger Dmochowski, Linda Cardozo, Alexander von Gontard

Department of Urology, Marmara University School of Medicine, Istanbul, Turkey., Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK., Department of Urology, Cliniques Universitaires Saint Luc, Brussels, Belgium., Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands., Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut., 2nd Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece., Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, UK., Department of Urology, Pediatric Urology, and Neurourology, University Hospital of Bonn, Bonn, Germany., Department of Urology, La Fe University and Polytechnic Hospital, Valencia University, Spain., Department of Surgery, Neuro-Urology Unit, Bambino Gesu Pediatric Hospital, Rome, Italy., Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Department of Urogynaecology, King's College Hospital, London, UK., Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg, Germany.

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