The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society - 26/08/11

Doi : 10.1016/S0090-4295(02)02243-4

Paul Abrams ^a, Linda Cardozo ^b, Magnus Fall ^c, Derek Griffiths ^d, Peter Rosier ^e, Ulf Ulmsten ^f, Philip Van Kerrebroeck ^g, Arne Victor ^h, Alan Wein ^i,^⁎
^a Bristol Urological Institute, Bristol, United Kingdom
^b Kings College Hospital, London, United Kingdom
^c Sahlgrensja University Hospital, Göteborg, Sweden
^d University of Pittsburgh, Pittsburgh, Pennsylvania, USA
^e Dutch Institute for Healthcare Improvement, Utrecht, The Netherlands
^f Uppsala University Hospital, Uppsala, Sweden
^g University Hospital Maastricht, Maastricht, The Netherlands
^h Medical Products Agency, Uppsala, Sweden
ⁱ University of Philadelphia, Philadelphia, Pennsylvania, USA

^*Correspondence to: International Continence Society Office, Southmead Hospital, Bristol BSIO 5NB United Kingdom.

Plan

Lower urinary tract symptoms (LUTS)

Signs suggestive of lower urinary tract dysfunction (LUTD)

Urodynamic observations

Conditions

Treatment

Lower urinary tract symptoms (LUTS)

Storage symptoms are experienced during the storage phase of the bladder and include daytime frequency and nocturia. (new)

Voiding symptoms are experienced during the voiding phase. (new)

Post micturition symptoms are experienced immediately after micturition. (new)

Symptoms associated with sexual intercourse

Symptoms associated with pelvic organ prolapse

Genital and lower urinary tract pain ^{The terms “strangury”, “bladder spasm”, and “dysuria” are difficult to define and of uncertain meaning and should not be used in relation to lower urinary tract dysfunction, unless a precise meaning is stated. Dysuria literally means ‘abnormal urination’ and is used correctly in some European countries. However, it is often used to describe the stinging/burning sensation characteristic of urinary infection. It is suggested that the descriptive words such as stinging and burning should be used in future.}

Genito-urinary pain syndromes and symptom syndromes suggestive of LUTD

Signs suggestive of lower urinary tract dysfunction (LUTD)

Measuring the frequency, severity and impact of lower urinary tract symptoms

Physical examination is essential in the assessment of all patients with lower urinary tract dysfunction. It should include abdominal, pelvic, perineal and a focussed neurological examination. For patients with possible neurogenic lower urinary tract dysfunction, a more extensive neurological examination is needed

Vaginal examination allows the description of observed and palpable anatomical abnormalities and the assessment of pelvic floor muscle function, as described in the ICS report on pelvic organ prolapse. The definitions given are simplified versions of the definitions in that report

Pelvic floor muscle function can be qualitatively defined by the tone at rest and the strength of a voluntary or reflex contraction as strong, weak or absent or by a validated grading system (e.g. Oxford 1-5). A pelvic muscle contraction may be assessed by visual inspection, by palpation, electromyography or perineometry. Factors to be assessed include strength, duration, displacement and repeatability. (new)

Pad testing may be used to quantify the amount of urine lost during incontinence episodes and methods range from a short provocative test to a 24-hour pad test

Filling cystometry

Pressure flow studies

Conditions

Treatment

Lower urinary tract rehabilitation is defined as non-surgical, non-pharmacological treatment for lower urinary tract function and includes

Electrical stimulation is the application of electrical current to stimulate the pelvic viscera or their nerve supply

Catheterisation is a technique for bladder emptying employing a catheter to drain the bladder or a urinary reservoir

Acknowledgements

Addendum

This article originally appeared in Neurourology and Urodynamics (Abrams P, Cardozo L, Fall M, et al: The Standardisation of Terminology of Lower Urinary Tract Function: Report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21: 167-178, 2002), copyright © 2002, Wiley-Liss, Inc. This material is used by permission of Wiley-Liss, Inc., a subsidiary of John Wiley & Sons, Inc.

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Vol 61 - N° 1

P. 37-49 - janvier 2003 Retour au numéro

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The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society - 26/08/11

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