European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence

Arjun K. Nambiar; Salvador Arlandis; Kari Bø; Hanny Cobussen-Boekhorst; Elisabetta Costantini; Monica de Heide; Fawzy Farag; Jan Groen; Markos Karavitakis; Marie Carmela Lapitan; Margarida Manso; Serenella Monagas Arteaga; Aisling Nic An Riogh; Eabhann O'Connor; Muhammad Imran Omar; Benoit Peyronnet; Veronique Phé; Vasileios I. Sakalis; Néha Sihra; Lazaros Tzelves; Mary Lynne van Poelgeest-Pomfret; Tine W.L. van den Bos; Huub van der Vaart; Christopher K. Harding

doi:10.1016/j.eururo.2022.01.045

European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence

Arjun K. Nambiar^*, Salvador Arlandis, Kari Bø, Hanny Cobussen-Boekhorst, Elisabetta Costantini, Monica de Heide, Fawzy Farag, Jan Groen, Markos Karavitakis, Marie Carmela Lapitan, Margarida Manso, Serenella Monagas Arteaga, Aisling Nic An Riogh, Eabhann O'Connor, Muhammad Imran Omar, Benoit Peyronnet, Veronique Phé, Vasileios I. Sakalis, Néha Sihra, Lazaros TzelvesMary Lynne van Poelgeest-Pomfret, Tine W.L. van den Bos, Huub van der Vaart, Christopher K. Harding

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

83 Citations (Scopus)

3 Downloads (Pure)

Abstract

Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guideline expands the remit to include these symptoms and conditions.

Objective: To summarise the diagnostic section of the non-neurogenic female LUTS guideline and the management of female overactive bladder (OAB), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI).

Evidence acquisition: New literature searches were carried out in September 2021 and evidence synthesis was conducted using the modified GRADE criteria as outlined for all EAU guidelines. A new systematic review (SR) on OAB was carried out by the panel for the purposes of this guideline.

Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations.

Conclusions: Non-neurogenic female LUTS are an important cause of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion based on the best available evidence. This guideline serves to present this evidence to health care providers in an easily accessible and digestible format.

Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to diagnosis of these conditions, as well as the treatment of overactive bladder, stress urinary incontinence, and mixed urinary incontinence.

Original language	English
Pages (from-to)	49-59
Number of pages	11
Journal	European Urology
Volume	82
Issue number	1
Early online date	23 Feb 2022
DOIs	https://doi.org/10.1016/j.eururo.2022.01.045
Publication status	Published - Jul 2022

Bibliographical note

Funding Information:
Financial disclosures: Arjun K. Nambiar certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Christopher K. Harding is a company consultant for Teleflex Medical; has received speaker honoraria from Astellas, Allergan, and Medtronic; has participated in clinical trials by Medtronic; has received fellowship and travel grants from Medtronic; and has received research support from the National Institute for Health Research and The Urological Foundation. Marie Carmela Lapitan has received speaker honoraria from Astellas, AstraZeneca, and GSK. Salvador Arlandis has received company speaker honoraria from Astellas Pharma S.A., Bayer Hispania S.L., and Lacer-Holliste; has received honoraria for consultation from Presurgy S.L., Boston Scientific Europe, and Coloplast Productos Medicos; has participated in clinical trials by GlaxoSmithKline, Astellas, Ipsen, and Urovant; has received travel grants from Astellas Pharma S.A., WellSpect, Lacer, and Rovi; and was a company consultant for Lacer Laboratories. Elisabetta Costantini has received research support from S&R Farmaceutici. Jan Groen has participated in clinical trials by Neuspera Medical Inc. Veronique Phé has received speaker honoraria from Medtronic and Viatris and is a company consultant for Allergan and Coloplast. Huub van der Vaart has ownership of a patent with Ligalli B.V., is a director of Berman Clinics, receives royalties from NVOG, is participating in clinical trials by UroGyn, and receives research support from ZonMw and NWO-TTW. Benoit Peyronnet is a company consultant for Boston Scientific. Lazaros Tzelves receives research support from the National and Kapodistrian University of Athens and the ASCAPE Project and is participating in a clinical trial by the ASCAPE Project and received. The remaining authors have nothing to disclose.

Keywords

Female lower urinary tracts symptoms
diagnostics
overactive bladder
urinary incontinence
stress urinary incontinence
mixed urinary incontinence
conservative management
pharmacologic management
surgical management
EAU Guidelines

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Nambiar, A. K., Arlandis, S., Bø, K., Cobussen-Boekhorst, H., Costantini, E., de Heide, M., Farag, F., Groen, J., Karavitakis, M., Lapitan, M. C., Manso, M., Arteaga, S. M., Riogh, A. N. A., O'Connor, E., Omar, M. I., Peyronnet, B., Phé, V., Sakalis, V. I., Sihra, N., ... Harding, C. K. (2022). European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence. European Urology, 82(1), 49-59. https://doi.org/10.1016/j.eururo.2022.01.045

European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence. / Nambiar, Arjun K.; Arlandis, Salvador; Bø, Kari et al.
In: European Urology, Vol. 82, No. 1, 07.2022, p. 49-59.

Research output: Contribution to journal › Article › peer-review

Nambiar, AK, Arlandis, S, Bø, K, Cobussen-Boekhorst, H, Costantini, E, de Heide, M, Farag, F, Groen, J, Karavitakis, M, Lapitan, MC, Manso, M, Arteaga, SM, Riogh, ANA, O'Connor, E, Omar, MI, Peyronnet, B, Phé, V, Sakalis, VI, Sihra, N, Tzelves, L, van Poelgeest-Pomfret, ML, van den Bos, TWL, van der Vaart, H & Harding, CK 2022, 'European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence', European Urology, vol. 82, no. 1, pp. 49-59. https://doi.org/10.1016/j.eururo.2022.01.045

Nambiar AK, Arlandis S, Bø K, Cobussen-Boekhorst H, Costantini E, de Heide M et al. European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence. European Urology. 2022 Jul;82(1):49-59. Epub 2022 Feb 23. doi: 10.1016/j.eururo.2022.01.045

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title = "European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence",

abstract = "Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guideline expands the remit to include these symptoms and conditions. Objective: To summarise the diagnostic section of the non-neurogenic female LUTS guideline and the management of female overactive bladder (OAB), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI). Evidence acquisition: New literature searches were carried out in September 2021 and evidence synthesis was conducted using the modified GRADE criteria as outlined for all EAU guidelines. A new systematic review (SR) on OAB was carried out by the panel for the purposes of this guideline. Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations. Conclusions: Non-neurogenic female LUTS are an important cause of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion based on the best available evidence. This guideline serves to present this evidence to health care providers in an easily accessible and digestible format. Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to diagnosis of these conditions, as well as the treatment of overactive bladder, stress urinary incontinence, and mixed urinary incontinence.",

keywords = "Female lower urinary tracts symptoms, diagnostics, overactive bladder, urinary incontinence, stress urinary incontinence, mixed urinary incontinence, conservative management, pharmacologic management, surgical management, EAU Guidelines",

author = "Nambiar, {Arjun K.} and Salvador Arlandis and Kari B{\o} and Hanny Cobussen-Boekhorst and Elisabetta Costantini and {de Heide}, Monica and Fawzy Farag and Jan Groen and Markos Karavitakis and Lapitan, {Marie Carmela} and Margarida Manso and Arteaga, {Serenella Monagas} and Riogh, {Aisling Nic An} and Eabhann O'Connor and Omar, {Muhammad Imran} and Benoit Peyronnet and Veronique Ph{\'e} and Sakalis, {Vasileios I.} and N{\'e}ha Sihra and Lazaros Tzelves and {van Poelgeest-Pomfret}, {Mary Lynne} and {van den Bos}, {Tine W.L.} and {van der Vaart}, Huub and Harding, {Christopher K.}",

note = "Funding Information: Financial disclosures: Arjun K. Nambiar certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Christopher K. Harding is a company consultant for Teleflex Medical; has received speaker honoraria from Astellas, Allergan, and Medtronic; has participated in clinical trials by Medtronic; has received fellowship and travel grants from Medtronic; and has received research support from the National Institute for Health Research and The Urological Foundation. Marie Carmela Lapitan has received speaker honoraria from Astellas, AstraZeneca, and GSK. Salvador Arlandis has received company speaker honoraria from Astellas Pharma S.A., Bayer Hispania S.L., and Lacer-Holliste; has received honoraria for consultation from Presurgy S.L., Boston Scientific Europe, and Coloplast Productos Medicos; has participated in clinical trials by GlaxoSmithKline, Astellas, Ipsen, and Urovant; has received travel grants from Astellas Pharma S.A., WellSpect, Lacer, and Rovi; and was a company consultant for Lacer Laboratories. Elisabetta Costantini has received research support from S&R Farmaceutici. Jan Groen has participated in clinical trials by Neuspera Medical Inc. Veronique Ph{\'e} has received speaker honoraria from Medtronic and Viatris and is a company consultant for Allergan and Coloplast. Huub van der Vaart has ownership of a patent with Ligalli B.V., is a director of Berman Clinics, receives royalties from NVOG, is participating in clinical trials by UroGyn, and receives research support from ZonMw and NWO-TTW. Benoit Peyronnet is a company consultant for Boston Scientific. Lazaros Tzelves receives research support from the National and Kapodistrian University of Athens and the ASCAPE Project and is participating in a clinical trial by the ASCAPE Project and received. The remaining authors have nothing to disclose. ",

year = "2022",

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doi = "10.1016/j.eururo.2022.01.045",

language = "English",

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pages = "49--59",

journal = "European Urology",

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T1 - European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1

T2 - Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence

AU - Nambiar, Arjun K.

AU - Arlandis, Salvador

AU - Bø, Kari

AU - Cobussen-Boekhorst, Hanny

AU - Costantini, Elisabetta

AU - de Heide, Monica

AU - Farag, Fawzy

AU - Groen, Jan

AU - Karavitakis, Markos

AU - Lapitan, Marie Carmela

AU - Manso, Margarida

AU - Arteaga, Serenella Monagas

AU - Riogh, Aisling Nic An

AU - O'Connor, Eabhann

AU - Omar, Muhammad Imran

AU - Peyronnet, Benoit

AU - Phé, Veronique

AU - Sakalis, Vasileios I.

AU - Sihra, Néha

AU - Tzelves, Lazaros

AU - van Poelgeest-Pomfret, Mary Lynne

AU - van den Bos, Tine W.L.

AU - van der Vaart, Huub

AU - Harding, Christopher K.

N1 - Funding Information: Financial disclosures: Arjun K. Nambiar certifies that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (eg, employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: Christopher K. Harding is a company consultant for Teleflex Medical; has received speaker honoraria from Astellas, Allergan, and Medtronic; has participated in clinical trials by Medtronic; has received fellowship and travel grants from Medtronic; and has received research support from the National Institute for Health Research and The Urological Foundation. Marie Carmela Lapitan has received speaker honoraria from Astellas, AstraZeneca, and GSK. Salvador Arlandis has received company speaker honoraria from Astellas Pharma S.A., Bayer Hispania S.L., and Lacer-Holliste; has received honoraria for consultation from Presurgy S.L., Boston Scientific Europe, and Coloplast Productos Medicos; has participated in clinical trials by GlaxoSmithKline, Astellas, Ipsen, and Urovant; has received travel grants from Astellas Pharma S.A., WellSpect, Lacer, and Rovi; and was a company consultant for Lacer Laboratories. Elisabetta Costantini has received research support from S&R Farmaceutici. Jan Groen has participated in clinical trials by Neuspera Medical Inc. Veronique Phé has received speaker honoraria from Medtronic and Viatris and is a company consultant for Allergan and Coloplast. Huub van der Vaart has ownership of a patent with Ligalli B.V., is a director of Berman Clinics, receives royalties from NVOG, is participating in clinical trials by UroGyn, and receives research support from ZonMw and NWO-TTW. Benoit Peyronnet is a company consultant for Boston Scientific. Lazaros Tzelves receives research support from the National and Kapodistrian University of Athens and the ASCAPE Project and is participating in a clinical trial by the ASCAPE Project and received. The remaining authors have nothing to disclose.

PY - 2022/7

Y1 - 2022/7

N2 - Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guideline expands the remit to include these symptoms and conditions. Objective: To summarise the diagnostic section of the non-neurogenic female LUTS guideline and the management of female overactive bladder (OAB), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI). Evidence acquisition: New literature searches were carried out in September 2021 and evidence synthesis was conducted using the modified GRADE criteria as outlined for all EAU guidelines. A new systematic review (SR) on OAB was carried out by the panel for the purposes of this guideline. Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations. Conclusions: Non-neurogenic female LUTS are an important cause of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion based on the best available evidence. This guideline serves to present this evidence to health care providers in an easily accessible and digestible format. Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to diagnosis of these conditions, as well as the treatment of overactive bladder, stress urinary incontinence, and mixed urinary incontinence.

AB - Context: Female lower urinary tract symptoms (LUTS) are a common presentation in urological practice. Thus far, only a limited number of female LUTS conditions have been included in the European Association of Urology (EAU) guidelines compendium. The new non-neurogenic female LUTS guideline expands the remit to include these symptoms and conditions. Objective: To summarise the diagnostic section of the non-neurogenic female LUTS guideline and the management of female overactive bladder (OAB), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI). Evidence acquisition: New literature searches were carried out in September 2021 and evidence synthesis was conducted using the modified GRADE criteria as outlined for all EAU guidelines. A new systematic review (SR) on OAB was carried out by the panel for the purposes of this guideline. Evidence synthesis: The important considerations for informing guideline recommendations are presented, along with a summary of all the guideline recommendations. Conclusions: Non-neurogenic female LUTS are an important cause of urological dysfunction. Initial evaluation, diagnosis, and management should be carried out in a structured and logical fashion based on the best available evidence. This guideline serves to present this evidence to health care providers in an easily accessible and digestible format. Patient summary: This report summarises the main recommendations from the European Association of Urology guideline on symptoms and diseases of the female lower urinary tract (bladder and urethra) not associated with neurological disease. We cover recommendations related to diagnosis of these conditions, as well as the treatment of overactive bladder, stress urinary incontinence, and mixed urinary incontinence.

KW - Female lower urinary tracts symptoms

KW - diagnostics

KW - overactive bladder

KW - urinary incontinence

KW - stress urinary incontinence

KW - mixed urinary incontinence

KW - conservative management

KW - pharmacologic management

KW - surgical management

KW - EAU Guidelines

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European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence

Abstract

Bibliographical note

Keywords

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