title: Characterization of lower urinary tract symptoms in patients with idiopathic normal pressure hydrocephalus.
abstract: The purpose of this study was to evaluate lower urinary tract symptoms (LUTS) in idiopathic normal pressure hydrocephalus (iNPH).
  
  
  
  Patients with new-onset iNPH were prospectively evaluated for LUTS via detailed history and physical, and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), overactive bladder (ICIq-OAB), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale. All patients with moderate-to-severe LUTS were offered urodynamic testing. Sub-analysis was performed based on gender, medical comorbidities, and age.
  
  
  
  Fifty-five consecutive patients with iNPH completed the initial evaluation and surveys. Total urinary incontinence score was mild to moderate (8.71 ± 0.64: 0-21 scale) with 90.9% experiencing leakage and 74.5% reporting urge incontinence. The most common OAB symptom was nocturia (2.2 ± 0.14: 0-4 scale) with urge incontinence the most bothersome (3.71 ± 0.44: 0-10 scale). Quality-of-life impact was moderate (4.47 ± 0.4: 0-10 scale) and American Urological Association Symptom Score bother scale was 2.89 ± 0.22 (0-6 scale). Urodynamics testing revealed 100% detrusor overactivity and mean bladder capacity of 200 mL. Several differences were identified based on gender, medical comorbidities, and age.
  
  
  
  Patients with iNPH present with mild-moderate incontinence of which nocturia is the most common symptom, urge incontinence the most bothersome, with 100% of patients having detrusor overactivity. Younger patients experienced greater bother related to LUTS. To our knowledge, this is the only prospective evaluation of urinary symptoms in patients with new-onset iNPH.
authors.affiliation: Division of Urology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Krzastek
authors.affiliation: Division of Urology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: William M
authors.initials: WM
authors.lastname: Bruch
authors.affiliation: Division of Urology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: Samuel P
authors.initials: SP
authors.lastname: Robinson
authors.affiliation: Department of Neurosurgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: Harold F
authors.initials: HF
authors.lastname: Young
authors.affiliation: Division of Urology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Klausner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000150:complications*; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D053158:Nocturia / Q000175:diagnosis / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000209:etiology; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology; D053202:Urinary Incontinence, Urge / Q000175:diagnosis / Q000209:etiology; D014563:Urodynamics
keywords: NPH; hydrocephalus; lower urinary tract symptoms; urodynamics