Interrater Reliability of Pressure Flow Study Interpretation in the SISTEr Trial


Introduction and Objectives: It is generally recognized that OAB symptoms significantly affect patient’s quality of life and spread their negative impact to all aspects of human life: social, family, professional and sexual relationship. Therefore, assessment of patient’s quality of life is one of the main aspects in examination OAB patient. During last few years a lot of studies were dedicated to this subject but unfortunately their results are contradictory. There is no universally accepted conception about which of OAB symptoms affect more patient’s quality of life and characteristics of impairment patient’s quality of life according to gender and age. To clarify these questions was primary goal of our research.

Study Design, Materials, and Methods: Three hundred and forty-nine OAB patients, 218 (62, 5%) females and 131 (37, 5%) males were underwent quality of life assessment. 176 (50, 4%) patients experienced urge incontinence. Intensity of OAB symptom was assessed by a 72-hour voiding diary. Quality of life was estimated using King’s Health Questionnaire.

Results: Our study revealed that OAB symptoms affect all aspects of patient’s life and significantly impair his/her quality of life. According to patient’s self-assessment valuation of his/her health in general was decreased most all. Then role limitations, sleep disturbances, physical and social limitations, influence on emotional status and personal relationship were distributed in decreasing order. Correlation between quality of life of OAB patients and number of urgencies and frequency was revealed. This correlation was quiet accurate (_ < 0.001) that signifies as more number of urinations and urgencies patient has as worse he/she estimates his/her quality of life. Frequency and number of urgency correlated well with answers on all units of KHQ. Urge incontinence was of the less importance and affects patient’s emotional status and his/her daily activities. Correlation between patient’s age and his/her answers on questions about personal relationship and sleep quality was found. As younger a patient was as more urination disorders affected his/her sexual life (r = 0.22; p < 0.001). At the same time OAB symptoms had greater impact on family life and sleep quality in aged patients. Analysis of patients answers according to their gender revealed reliable differences in Q9 and Q21 (9th and 21st questions of KHQ) answers, moreover women showed greater impairment of their quality of life. In women OAB symptoms affect more their emotional status and increase level of anxiety and irritability (t = 2.44; p = 0.015) as well as disturb sleep (t = 2.35; p = 0.019). Together with differences, similar tendencies in men and women were observed analyzing influence of OAB symptoms on several aspects of patient’s quality of life. The most significant correlation was found between intensity of OAB symptoms and disturbances of emotional status and sleep quality and the less significant between them (OAB symptoms) and personal and family relationship in both women and men.

Interpretation of Results: Diagnose OAB considerably affects patients quality of life and degree of impairment correlates well with intensity of OAB symptoms. Analyzing role of each of OAB symptoms in deterioration several aspects of patients quality of life significant role of urgency and noticeably less important of urge incontinence was observed. This observation could be explained by: Patients suffering from urge incontinence manage their life the way to be near by the toilet most of the time and try to prevent leakage of urine during episode of urgency. This type of patients more determined to prevent urge incontinence as urgency occurred. At the same time probability of urge incontinence depends not only from the intensity of urgency but from availability of the toilet. As a result it might be number of urgency, not urge incontinence that affects patient’s quality of life most of all.

Concluding Message: OAB symptoms significantly affect patient’s quality of life. Degree of impairment patient’s quality of life depends on intensity of OAB symptoms as well as patient’s gender and age. Among OAB symptoms urgency and frequency play more significant role.

KEYWORDS: OAB, quality of life in OAB patients, urency, frequency of urination