Screening for depression and anxiety in patients with storage or voiding dysfunction: A retrospective cohort study predicting outcome of sacral neuromodulation

Neurourol Urodyn. 2016 Nov;35(8):1011-1016. doi: 10.1002/nau.22871. Epub 2015 Sep 9.

Abstract

Aims: It has been reported that somatic treatment in patients with affective symptoms has a higher risk of failure. The aim was to investigate whether affective symptoms could predict the outcome of sacral neuromodulation (SNM) for lower urinary tract symptoms (LUTS).

Methods: All patients that underwent a SNM evaluation between 2006 and 2013 and filled out a Hospital Anxiety and Depression Score (HADS) before treatment, were included. Chi-square analysis and bivariate logistic regression were used to assess associations and predictive value.

Results: Eighty-six patients were included, 65 females and 21 males. Most patients, 66, had overactive bladder syndrome (OAB). The remaining 20 patients suffered from non-obstructive urinary retention (NOR). Thirty-nine OAB patients and 17 NOR patients, had a normal total HADS score before treatment. Significantly more patients showed abnormal HADS-D (P = 0.047) and HADS-A (P = 0.015) scores in the OAB group compared to the NOR group. Success of SNM could not be predicted by the HADS score P = 0.464 (after 1 year P = 0.446). Subsequent analysis revealed that an abnormal HADS score was not related to the occurrence of SNM adverse events.

Conclusions: The present study did not reveal a significant relationship between an abnormal HADS score and failure of the SNM test period in a mixed group of OAB and NOR patients. However, differences between OAB and NOR patients concerning affective symptoms were present. It is known that psychological factors play a role in the severity of LUTS, but they may not predict SNM outcome. Neurourol. Urodynam. 35:1011-1016, 2016. © 2015 Wiley Periodicals, Inc.

Keywords: affective symptoms; anxiety; depression; non-obstructive urinary retention; overactive bladder syndrome; sacral neuromodulation; screening.

MeSH terms

  • Anxiety / psychology*
  • Cohort Studies
  • Depression / psychology*
  • Electric Stimulation Therapy / adverse effects
  • Electric Stimulation Therapy / methods*
  • Electrodes, Implanted
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Sacrococcygeal Region
  • Treatment Outcome
  • Urinary Bladder, Overactive / complications
  • Urinary Bladder, Overactive / psychology
  • Urinary Bladder, Overactive / therapy
  • Urinary Retention / complications
  • Urinary Retention / psychology
  • Urinary Retention / therapy
  • Urination Disorders / complications
  • Urination Disorders / psychology*
  • Urination Disorders / therapy*
  • Urodynamics