The impact of lower urinary tract symptomatology on urine volumes in stone formers

  • Nathan Y. Hoy Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
  • Nick S. Dean Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
  • Jeremy Wu Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
  • Timothy A. Wollin Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
  • Shubha K. De Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
Keywords: LUTS, stones, urine volume

Abstract

Introduction: We aimed to determine if there is a correlation between International Prostate Symptom scores (IPSS) and 24-hour urine collection volumes, as patients experiencing lower urinary tract symptoms (LUTS) may have impaired ability to increase fluid intake for stone prevention.

Methods: A single-center, retrospective review was performed of stone formers presenting from 2014‒2016. Inclusion criteria were completion of an IPSS questionnaire and a 24-hour urine collection. Exclusion criteria included symptomatic stone or urinary tract infection at time of IPSS completion, inadequate 24-hour collection, or incomplete IPSS questionnaire.

Results: A total of 131 patients met inclusion criteria. Stratification by IPSS severity into mild (0‒7), moderate (8‒19), and severe (20‒35) yielded groups of n=96, 28, and 7, respectively. Linear regression modelling did not reveal a correlation between IPSS score and volume (p=0.10). When compared to those with adequate urine volumes (>2 L/day, n=65), low-volume patients (<1 L/day, n=10) had a significantly higher total IPSS (11.7 vs. 6.1; p=0.036). These groups showed significant differences in their responses to questions about incomplete emptying (p=0.031), intermittency (p=0.011), and stranguria (p=0.0020), with higher scores noted in the low urine output group.

Conclusions: This study is the first to examine the correlation between IPSS and 24-hour urine volume. Though our data does not show a linear relationship between urine output and IPSS, those with lower urine volumes appear to have worse self-reported voiding symptoms when compared to those with adequate volumes (>2 L/day) for stone prevention. The overall number of patients in our study is relatively small, which may account for the lack of a relationship between IPSS and 24-hour urine volumes.

Author Biographies

Nathan Y. Hoy, Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
MD
Nick S. Dean, Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
MD
Jeremy Wu, Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
MD
Timothy A. Wollin, Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
MD, FRCSC
Shubha K. De, Division of Urology, University of Alberta Northern Alberta Urology Centre 11400 University Ave, 7th Floor Edmonton, AB, T6G 1Z1
MD, FRCSC
Published
2018-12-03
How to Cite
Hoy, N. Y., Dean, N. S., Wu, J., Wollin, T. A., & De, S. K. (2018). The impact of lower urinary tract symptomatology on urine volumes in stone formers. Canadian Urological Association Journal, 13(8). https://doi.org/10.5489/cuaj.5530
Section
Original Research