Voiding dysfunction in patients with nasal congestion treated with pseudoephedrine: a prospective study

Figures & data

Table 1 IPSS questionnaire

Questions	Not at all	Less than 1 in 5 times	Less than half the time	Approximately half the time	More than half the time	Almost always
1. Incomplete emptying: How often have you had the sensation of not emptying your bladder?	0	1	2	3	4	5
2. Frequency: How often have you had to urinate less than every 2 hours?	0	1	2	3	4	5
3. Intermittency: How often have you found you stopped and started again several times when you urinated?	0	1	2	3	4	5
4. Urgency: How often have you found it difficult to postpone urination?	0	1	2	3	4	5
5. Weak stream: How often have you had a weak urinary stream?	0	1	2	3	4	5
6. Straining: How often have you had to strain to start urination?	0	1	2	3	4	5
	None	1 time	2 times	3 times	4 times	5 times
7. Nocturia: How many times did you typically get up at night to urinate?	0	1	2	3	4	5
Quality of life due to urinary symptoms	Delighted	Pleased	Mostly satisfied	Mixed	Mostly dissatisfied	Unhappy	Terrible
8. If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?	0	1	2	3	4	5	6

Notes: The questions refer to the following urinary symptoms: 1) incomplete emptying, 2) frequency, 3) intermittency, 4) urgency, 5) weak stream, 6) straining, and 7) nocturia. IPSS-T = Score 1+2+3+4+5+6+7. IPSS-V = Score 1+3+5+6. IPSS-S = Score 2+4+7. QoL-US = Score 8.

Abbreviations: IPSS, International Prostate Symptom Score; IPSS-T, IPSS total; IPSS-V, IPSS voiding; IPSS-S, IPSS storage; QoL-US, quality of life due to urinary symptoms.

Table 2 Demographic and clinical data of patients with nasal congestion treated with pseudoephedrine

Total number of patients	131
	Mean ± SD	Range
Mean patient age – years	42.0±14.3	15–71
IPSS total (IPSS-T) score
Premedication	6.49±7.4	0–31
Postmedication	6.77±8.1	0–28
IPSS voiding (IPSS-V) score
Premedication	3.33±4.4	0–16
Postmedication	3.53±5.2	0–17
IPSS storage (IPSS-S) score
Premedication	3.17±3.6	0–15
Postmedication	3.24±3.4	0–11
QoL-US
Premedication	2.02±1.5	0–5
Postmedication	1.87±1.3	0–4
	Number	Percentage
IPSS-T score change pre- and postmedication
Decreased	52	39.7
Unchanged	37	28.2
Increased	42	32.1
IPSS-V score change pre- and postmedication
Decreased	35	26.7
Unchanged	56	42.7
Increased	40	30.5
IPSS-S score change pre- and postmedication
Decreased	44	33.6
Unchanged	46	35.1
Increased	41	31.3
QoL-US score change pre- and postmedication
Decreased	33	25.2
Unchanged	75	57.3
Increased	23	17.6

Abbreviations: IPSS, International Prostate Symptom Score; IPSS-T, IPSS total; IPSS-V, IPSS voiding; IPSS-S, IPSS storage; QoL-US, quality of life due to urinary symptoms; SD, standard deviation.

Table 3 Differences between the subclinical voiding dysfunction and the unchanged voiding function groups

Age/respective score	Subclinical voiding dysfunction group	Unchanged voiding function group	P-value
Mean age – years	49.6±13.2	38.4±13.5	0.000
Premedication IPSS-T score	7.71±6.43	5.91±7.79	0.165
Premedication IPSS-V score	4.57±4.23	2.74±4.42	0.025
Premedication IPSS-S score	3.05±2.85	3.22±3.85	0.769
Premedication QoL-US score	2.14±1.35	1.96±1.54	0.480

Notes: Subclinical voiding dysfunction group: patients with a higher total IPSS score after taking the medication. Unchanged voiding function group: patients who had an unchanged or lower total IPSS score after taking the medication. Data presented as mean ± standard deviation.

Abbreviations: IPSS, International Prostate Symptom Score; IPSS-T, IPSS total; IPSS-V, IPSS voiding; IPSS-S, IPSS storage; QoL-US, quality of life due to urinary symptoms.

Table 4 Pre- and postmedication comparison of IPSS scores in patients treated with pseudoephedrine for nasal congestion

Respective score	Overall (n=131)		Age ≥50 years (n=56)		Age <50 years (n=75)
	Premedication	Postmedication	Premedication	Postmedication	Premedication	Postmedication
IPSS-T score	6.49±7.4	6.77±8.1	9.95±8.83	11.45±8.95*	3.91±4.75	3.28±5.17
IPSS-V score	3.33±4.4	3.53±5.2	5.38±5.02	6.07±2.98*	1.80±3.19	1.64±3.52
IPSS-S score	3.17±3.6	3.24±3.4	4.57±4.41	5.38±3.69*	2.12±2.25	1.64±2.13*
QoL-US score	2.02±1.5	1.87±1.3	2.71±1.44	2.48±1.14	1.49±1.29	1.41±1.25
Patients with elevated postmedication IPSS-T score	42/131, 32.1%		29/56, 51.8%		13/75, 17.3%

Notes:

* P<0.05. Data presented as mean ± standard deviation.

Abbreviations: IPSS, International Prostate Symptom Score; IPSS-T, IPSS total; IPSS-V, IPSS voiding; IPSS-S, IPSS storage; QoL-US, quality of life due to urinary symptoms.

Figure 1 Changes in IPSS scores after treatment with pseudoephedrine for nasal congestion stratified by age.

Notes: The specific postmedication scores significantly increased in the age group of >50 years. *P<0.05.
Abbreviations: IPSS, International Prostate Symptom Score; IPSS-T, IPSS total; IPSS-V, IPSS voiding; IPSS-S, IPSS storage; LUTS, lower urinary tract symptoms; QoL, quality of life.

Figure 2 Generalized additive model plot for changes in the IPSS-T score after receiving pseudoephedrine versus age.

Note: It clearly shows that postmedication IPSS-T scores dramatically increased in patients aged >52.819 years.
Abbreviation: IPSS-T, International Prostate Symptom Score total.