Symptoms of Lower Urinary Tract Dysfunction Phenotyping Study

NCT ID: NCT02485808

Last Updated: 2019-01-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1879 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-04-30

Study Completion Date

2018-05-31

Brief Summary

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The purpose of this study is to advance our understanding of people who experience urinary and bladder problems. We are interested in learning about people's experiences with urinary symptoms and how these symptoms will be managed. We want to understand the important differences among people and what factors affect urinary and bladder problems. After all of the information is collected, we will have a better understanding of how to improve the care and treatment for people who have urinary and bladder problems.

Detailed Description

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The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) was established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to advance our understanding of lower urinary tract dysfunction (LUTD) in women and men. LUTD is a term intended to be comprehensive and to challenge current paradigms about how symptomatic pelvic disorders are defined as 'diseases.' Lower urinary tract symptoms (LUTS) are likely caused and exacerbated by a variety of factors and thus do not represent the manifestation of a single disease. Clinical management of LUTD, including treatment outcomes, remains suboptimal since the biological and psychosocial factors that initiate, exacerbate, and modify this group of symptoms remain largely unknown. As an initial effort to better characterize the biological and psychosocial factors that initiate, exacerbate, and modify LUTS, the LURN investigators will establish a prospective Observational Cohort Study of men and women with LUTS presenting for the first time to LURN physicians.

Information to be obtained from study participants initially (at time of enrollment) includes a standardized clinical examination, medical history, select testing of the lower urinary tract, and participants' self-report of LUTS, pelvic floor symptoms including sexual function and bowel symptoms, depression, anxiety, sleep patterns, stress, metabolic risk factors, and health-related quality of life. We will also collect serum, urine, saliva, and perineal swabs from men and vaginal swabs from women for storage at the NIDDK Sample Repository for future study by the LURN investigators and the broader research community. This information will be used to construct subgroups of patients who have similar symptoms, clinical presentations, comorbidities, pelvic floor dysfunctions, and psychological profiles. These patient characteristics and behaviors likely affect the evaluation, diagnosis, and/or treatment of LUTS. Additional information will be collected 3 months and 12 months after enrollment or 3 and 12 months after surgery for patients receiving surgical treatment, and will include an interval clinical history, participants' self-report of LUTS, pelvic floor symptoms including sexual function and bowel symptoms, depression, anxiety, and health-related quality of life. We will also collect biological samples at 3 and 12 months after enrollment.

The LURN Neuroimaging and Sensory Testing component of the study will investigate abnormal sensation of the lower urinary tract at the level of the organism. Subjects and controls will have a one-time visit soon after their baseline visit, where they will undergo an fMRI scan of their brain and multimodal quantitative sensory testing assessing perceptual responses to physical stimuli (pain and sound).

The information to be collected from the prospective Observational Cohort Study will be limited and not sufficient to fully understand the pathophysiology and biology of LUTS. Therefore, the Observational Cohort Study will serve as the basis for further LURN studies. The long-term goal of the LURN is to better characterize patients with LUTD in order to advance future research on the pathophysiology of these

Conditions

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Lower Urinary Tract Symptoms

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Surgical

Men and women presenting for clinical care for whom surgical treatment of their lower urinary symptoms is planned.

There will be no interventions, as this is an observational cohort.

None-observational

Intervention Type OTHER

For surgical patients, follow-up assessments will occur 3 and 12 months after the surgery. For medical patients, follow-up assessments will occur 3 and 12 months after the baseline assessment.

Medical

Men and women presenting for clinical care for whom medical treatment of their lower urinary symptoms is planned.

There will be no interventions, as this is an observational cohort.

None-observational

Intervention Type OTHER

For surgical patients, follow-up assessments will occur 3 and 12 months after the surgery. For medical patients, follow-up assessments will occur 3 and 12 months after the baseline assessment.

Controls

Men and women who are not experiencing lower urinary tract symptoms.

This group will undergo MRI, pain and auditory sensitivity testing.

Magnetic Resonance Imaging (MRI)

Intervention Type PROCEDURE

One time MRI scanning session examining brain structure and function in a resting state and after water consumption.

Multimodal Automated Sensory Testing System

Intervention Type OTHER

Pressure pain thresholds will be assess using computer-controlled pressures delivered by a device called the Multimodal Automated Sensory Testing System (MAST) device on to the subjects thumbnail bed.

Auditory Sensitivity Test

Intervention Type OTHER

Subjects' sensitivity to sound will be evaluated using a series of sounds delivered by a standard audiometer device.

Neuroimaging & Sensory Testing

Subjects from the Medical and Surgical Cohorts who agree to additional testing in the form of neuroimaging (via fMRI) and multimodal sensory testing.

This group will undergo MRI, pain and auditory sensitivity testing.

Magnetic Resonance Imaging (MRI)

Intervention Type PROCEDURE

One time MRI scanning session examining brain structure and function in a resting state and after water consumption.

Multimodal Automated Sensory Testing System

Intervention Type OTHER

Pressure pain thresholds will be assess using computer-controlled pressures delivered by a device called the Multimodal Automated Sensory Testing System (MAST) device on to the subjects thumbnail bed.

Auditory Sensitivity Test

Intervention Type OTHER

Subjects' sensitivity to sound will be evaluated using a series of sounds delivered by a standard audiometer device.

Interventions

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None-observational

For surgical patients, follow-up assessments will occur 3 and 12 months after the surgery. For medical patients, follow-up assessments will occur 3 and 12 months after the baseline assessment.

Intervention Type OTHER

Magnetic Resonance Imaging (MRI)

One time MRI scanning session examining brain structure and function in a resting state and after water consumption.

Intervention Type PROCEDURE

Multimodal Automated Sensory Testing System

Pressure pain thresholds will be assess using computer-controlled pressures delivered by a device called the Multimodal Automated Sensory Testing System (MAST) device on to the subjects thumbnail bed.

Intervention Type OTHER

Auditory Sensitivity Test

Subjects' sensitivity to sound will be evaluated using a series of sounds delivered by a standard audiometer device.

Intervention Type OTHER

Other Intervention Names

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MRI Pain Sensitivity

Eligibility Criteria

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Inclusion Criteria

1. Men and women presenting for new patient visits for evaluation or treatment of LUTS to one of the LURN physicians.
2. Age ≥ 18 years.
3. The presence of any of the symptoms reported in Table 1, based on responses to the LUTS Tool with a one month recall period.
4. The ability to give informed consent and complete self-reported questionnaires electronically.

Table 1: LUTS Appropriate for Study Inclusion

* Daytime frequency
* Nocturia
* Urgency
* Incontinence/leakage (various types)
* Poor or absent sensation of bladder filling
* Slow/weak stream
* Splitting or spraying
* Intermittent stream/Double voiding
* Hesitancy
* Straining
* Dribbling at the end of flow
* Paruesis (shy bladder syndrome)
* Poor or absent sensation of urethra during void
* Feeling of incomplete emptying
* Post-micturition dribble (delayed)
* Abnormal bladder or urethral sensations

Exclusion Criteria

1. Gross hematuria.
2. Significant neurologic disease or injury, including but not limited to: cerebral vascular accident with residual defect, Alzheimer's dementia, Parkinson's disease, traumatic brain injury, spinal cord injury, complicated spinal surgery, multiple sclerosis.
3. Primary complaint is pelvic pain.
4. Diagnosis of interstitial cystitis, chronic prostatitis, or chronic orchialgia.
5. Pelvic or endoscopic GU surgery within the preceding 6 months (not including diagnostic cystoscopy).
6. Current sexually transmitted infection. (deferral; subject can enroll after negative culture)
7. Ongoing symptomatic urethral stricture.
8. History of lower urinary tract or pelvic malignancy.
9. Current chemotherapy or other cancer therapy.
10. Pelvic device or implant complication (e.g., sling or mesh complications).
11. Current functioning neurostimulator.
12. Botox injection to the bladder or pelvic structures within the preceding 12 months.
13. In men, prostate biopsy in the previous 3 months.
14. In women, pregnancy.
15. History of cystitis caused by tuberculosis, radiation therapy, or Cytoxan/cyclophosphamide therapy.
16. Augmentation cystoplasty or cystectomy.
17. Presence of urinary tract fistula.
18. Current major psychiatric disorder or other psychiatric or medical issues that would interfere with study participation (e.g., dementia, psychosis, etc.).
19. Inability to relay valid information, actively participate in the study, or provide informed consent (includes uncontrolled psychiatric disease).
20. Difficulty reading or communicating in English.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role collaborator

Northwestern University

OTHER

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role collaborator

University of Iowa

OTHER

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role collaborator

Washington University School of Medicine

OTHER

Sponsor Role collaborator

Arbor Research Collaborative for Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kevin P Weinfurt, PhD

Role: STUDY_CHAIR

Duke University

Claire Yang, MD

Role: STUDY_CHAIR

University of Washington

Robert M Merion, MD, FACS

Role: PRINCIPAL_INVESTIGATOR

Arbor Research Collaborative for Health - DCC

Locations

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Northwestern University

Chicago, Illinois, United States

Site Status

University of Iowa

Iowa City, Iowa, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

Washington University

St Louis, Missouri, United States

Site Status

Duke University

Durham, North Carolina, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Coyne KS, Matza LS, Kopp ZS, Thompson C, Henry D, Irwin DE, Artibani W, Herschorn S, Milsom I. Examining lower urinary tract symptom constellations using cluster analysis. BJU Int. 2008 May;101(10):1267-73. doi: 10.1111/j.1464-410X.2008.07598.x. Epub 2008 Mar 11.

Reference Type BACKGROUND
PMID: 18336611 (View on PubMed)

Coyne KS, Barsdorf AI, Thompson C, Ireland A, Milsom I, Chapple C, Kopp ZS, Bavendam T. Moving towards a comprehensive assessment of lower urinary tract symptoms (LUTS). Neurourol Urodyn. 2012 Apr;31(4):448-54. doi: 10.1002/nau.21202. Epub 2012 Mar 6.

Reference Type BACKGROUND
PMID: 22396308 (View on PubMed)

Bower WF, Yip SK, Yeung CK. Dysfunctional elimination symptoms in childhood and adulthood. J Urol. 2005 Oct;174(4 Pt 2):1623-7; discussion 1627-8. doi: 10.1097/01.ju.0000176599.91836.12. Erratum In: J Urol. 2005 Dec;174(6):2428.

Reference Type BACKGROUND
PMID: 16148668 (View on PubMed)

Helmuth ME, Smith AR, Glaser AP, Yang CC, Cameron AP, Henry Lai H, Griffith JW, Eric Jelovsek J, Quentin Clemens J, Helfand BT, Merion RM, Andreev VP; and the LURN Study Group. Phenotyping Men With Lower Urinary Tract Symptoms: Results From the Symptoms of Lower Urinary Tract Dysfunction Research Network. Neurourol Urodyn. 2025 Jan;44(1):178-193. doi: 10.1002/nau.25596. Epub 2024 Oct 7.

Reference Type DERIVED
PMID: 39370868 (View on PubMed)

Lai HH, Rutlin J, Smith AR, Helmuth ME, Hokanson JA, Yang CC, Clemens JQ, Magnotta VA, Bretschneider CE, Kenton K, DeLancey JOL, John K, Kirkali Z, Shimony JS. Structural Changes in Brain White Matter Tracts Associated With Overactive Bladder Revealed by Diffusion Tensor Magnetic Resonance Imaging: Findings From a Symptoms of Lower Urinary Tract Dysfunction Research Network Cross-Sectional Case-Control Study. J Urol. 2024 Aug;212(2):351-361. doi: 10.1097/JU.0000000000004022. Epub 2024 May 8.

Reference Type DERIVED
PMID: 38717915 (View on PubMed)

Mawla I, Schrepf A, Kutch JJ, Helmuth ME, Smith AR, Ichesco E, Yang CC, Andreev VP, Kreder KJ, Bradley CS, Magnotta VA, Kirkali Z, Harris RE, Lai HH, Harte SE. Naturalistic Bladder Filling Reveals Subtypes in Overactive Bladder Syndrome That Differentially Engages Urinary Urgency-Related Brain Circuits: Results From the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN). J Urol. 2024 Jan;211(1):111-123. doi: 10.1097/JU.0000000000003699. Epub 2023 Oct 5.

Reference Type DERIVED
PMID: 37796776 (View on PubMed)

Harte SE, Wiseman J, Wang Y, Smith AR, Yang CC, Helmuth M, Kreder K, Kruger GH, Gillespie BW, Amundsen C, Kirkali Z, Lai HH; LURN Study Group. Experimental Pain and Auditory Sensitivity in Overactive Bladder Syndrome: A Symptoms of the Lower Urinary Tract Dysfunction Research Network (LURN) Study. J Urol. 2022 Jan;207(1):161-171. doi: 10.1097/JU.0000000000002147. Epub 2022 Aug 25.

Reference Type DERIVED
PMID: 34428922 (View on PubMed)

Helmuth ME, Smith AR, Andreev VP, Liu G; LURN Study Group; Lai HH, Cameron AP, Siddiqui NY. Use of Euclidean length to measure urinary incontinence severity based on the lower urinary tract symptoms tool. Am J Obstet Gynecol. 2018 Mar;218(3):357-359. doi: 10.1016/j.ajog.2017.12.219. Epub 2017 Dec 26. No abstract available.

Reference Type DERIVED
PMID: 29288065 (View on PubMed)

Related Links

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Other Identifiers

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U01DK100017

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK100011

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK099932

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK099879

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK097780

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK097779

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK097776

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U01DK097772

Identifier Type: NIH

Identifier Source: secondary_id

View Link

LURN Phenotyping Study V8.0

Identifier Type: -

Identifier Source: org_study_id

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