Utilizing Bladder Diaries to Prevent Unnecessary Treatment in Patients With Storage Dysfunction: A Retrospective Study

Abstract

Introduction A frequency volume chart (FVC) or bladder diary (BD) is used to diagnose lower urinary tract symptoms and to determine the effectiveness of treatment. In outpatient practice, patients who use an FVC or BD may experience improvement in storage symptoms and not desire further treatment. The aim of this study was to determine the characteristics of patients who did not desire treatment after BD recording and to assess the changes in storage symptoms after BD recording. Methods This was a retrospective study. Patients who completed a three-day BD record were included. The patients were divided into two groups: those whose symptoms improved after using a BD and no longer desired treatment, and those who desired treatment. We compared endpoints including patient background, BD, Overactive Bladder Symptom Score (OABSS), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score. Results We recruited 79 patients. Four patients were excluded (two were minors and two due to cognitive impairment). Thus, 75 patients were included in the analysis. Of these, 27 (36.0%) did not desire treatment for storage symptoms after BD recording. Compared with the group of patients who desired treatment, those who did not desire treatment had significantly lower daytime and nighttime frequency and number of leaks recorded in their BD, and there were fewer patients with nocturia and habitual caffeine consumption. Baseline OABSS and ICIQ-UI SF scores were lower and there were no significant changes in storage symptoms after BD recording. The cut-off value for the baseline total score of OABSS that did not desire treatment for storage symptoms after BD recording was 6 points. Conclusion In this study, 36.0% of patients no longer desired treatment for storage symptoms after using a BD. These patients initially exhibited a normal daily urinary frequency and mild storage symptoms. These findings suggest that among patients presenting to the outpatient clinic with storage symptoms, those with mild symptom severity and a total OABSS of 6 points or less may be able to avoid unnecessary treatment through BD recording.

Keywords: bladder diary; iciq-ui sf; oabss; overactive bladder symptom score; storage symptoms.

Figure 1. Changes in OABSS and ICIQ-UI SF after recording BD

Group A: patients who no longer desired treatment; Group B: patients who desired treatment; OABSS: overactive bladder symptom score; ICIQ-UI SF: International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form; BD: bladder diary Wilcoxon signed-rank test was performed to examine the significance of the changes in OABSS and ICIQ-UI SF scores between the baseline and after BD recording in each of the two groups. *P < 0.05, **P < 0.01 versus baseline

Figure 2. ROC curve generated from the baseline OABSS total score in the two groups

The black curve: ROC curve; the yellow curve: the tangent line of ROC curve; ROC: receiver operating characteristic; OABSS: overactive bladder symptom score The area under the curve was 0.73.