Evaluation of female overactive bladder using urodynamics: relationship with female voiding dysfunction

Abstract

Purpose:To investigate the role of urodynamic study (UDS) in female patients with overactive bladder (OAB) analyzing the relationship between OAB symptoms and female voiding dysfunction (FVD).Materials and Methods:We analyzed the clinical and urodynamic data of 163 women with OAB symptoms. OAB symptoms were categorized as dry and wet. FVD was described as detrusor underactivity (DUA), which was defined as a maximum flow rate (Qmax) of ≤15mL/s associated with a detrusor pressure at Qmax (PdetQmax) of ≤20cmH2O, along with bladder outlet obstruction (BOO), which was defined as a Qmax of ≤15mL/s with a PdetQmax of >20cmH2O. Clinical and urodynamic results were compared between patients with dry and wet symptoms and between those with and without FVD.Results:78 (47.9%) had dry, and 85 (52.1%) had wet symptoms. The entire group had a relatively low Qmax (15.1±6.6mL/s) and relatively high number of BOO (42.9%, 70/163) and DUA (8.6%, 14/163). A significantly higher number of patients with wet symptoms had detrusor overactivity compared to those with dry, as detected by the UDS (p<0.05). No significant differences were found in BOO and DUA number between dry and wet groups. Further, the international prostate symptom score did not different significantly between patients with and without FVD.Conclusion:A significant number of women with OAB had voiding dysfunction. However, the OAB symptoms themselves were not useful for predicting the presence of FVD. Therefore, UDS may be necessary for accurate diagnosis in women with OAB symptoms.

Overactive Bladder Syndrome is Associated With Detrusor Overactivity and Abnormal Voiding Pattern in Nulliparous Women

“…Our ndings showed a high prevalence of DO (69.68%) and abnormal voiding patterns (65.16%) among NP women with OAB as compared with parous women. Our nding of VD with an abnormal voiding pattern corroborates the ndings of Cho et al, who reported that more than half the women in their study presented with OAB symptoms in conjunction with VD, as revealed by UDS 8 . In addition, Nitti et al reported the existence of very high overlapping storage (79%) and obstructive symptoms (76%) in 331 non-neurogenic VD women who underwent multichannel video-UDS for non-neurogenic VD 17 .…”

“…It is generally considered that detrusor overactivity (DO) plays a role in OAB, but not all OAB patients are diagnosed with DO after urodynamic study (UDS) 5,6 . In addition to DO, bladder outlet obstruction (BOO) may play a role in the development of OAB, because OAB and voiding dysfunction (VD) can coexist 7,8 . VD, which is de ned as abnormally slow and/or incomplete micturition, can be classi ed as BOO (mechanical and functional) and detrusor underactivity (DU) 9,10 .…”

The role of urodynamics in females with lower urinary tract symptoms

“…Digesu et al [39], in their study showed that only 27.5% of women with DO on UDS had OAB symptoms, whilst only 54% of women with OAB symptoms had DO on UDS, so they concluded that symptomatic diagnosis alone of OAB was not recommended for women with LUTS due to weak correlation between symptoms and UDS diagnosis. In another study, of the women with OAB symptoms, only 38.7% (63/163) had DO on UDS [38].…”

“…Cho et al [38] investigated the role of UDS in female patients with OAB. Clinical and urodynamic data of 163 women with OAB were analysed.…”

Urodynamic and Bladder Diary Factors Predict Overactive Bladder-wet in Women: A Comparison With Overactive Bladder-dry

“…Cho et al [29] reported similar Qmax (mean: 15.3 mL/sec vs. 15.0 mL/sec, P=0.759) and PdetQmax (mean: 31.0 cm H 2 O vs. 31.4 cm H 2 O, P=0.862) between the OAB-dry and OAB-wet patients. In our study, high Qmax (OR, 1.06) and high PdetQmax (OR, 1.01) were identified as novel predictors for OAB-wet (Table 3).…”