Racial and Ethnic Differences in Urodynamic Parameters in Women With Overactive Bladder Symptoms

Abstract

Objectives This study aimed to identify differences in severity of overactive bladder (OAB) symptoms in women of different races and ethnicities using urodynamic study (UDS) parameters. Methods We performed a 5-year retrospective chart review from January 2014 to January 2019 of women 18 years and older who endorsed OAB symptoms and underwent UDS at a racially and ethnically diverse academic urban medical center. Logistic and linear regressions were used to examine the associations of various UDS parameters between racial/ethnic groups, after adjusting for age, diabetes, and parity. Results A total of 161 women with an average age of 59 years were included in the study. The racial/ethnic composition of the group was Hispanic (62%), black (24%), and white (11%). Symptoms on presentation included urgency and/or frequency (11.8%), urge incontinence (23.0%), or mixed urinary symptoms (65.2%). Black and Hispanic women presented with differing symptoms (urgency/frequency vs mixed urinary symptoms). Half of the patients (n = 82) had detrusor overactivity. Compared with whites, blacks were 3.4-fold more likely to have detrusor overactivity (95% confidence interval, 0.99–11.40) and had lower volumes at time of “strong desire” (−102.6 mL, P = 0.003). Hispanics had on average 75.88 mL less volume at sensation of “strong desire” (P = 0.016) than did whites. Conclusions Our study suggests that minority race and ethnicity may be associated with worse performance on certain UDS parameters. Future studies should aim to understand if these differences are due to genetic, disease-related, behavioral, and/or socioeconomic factors and whether these differences are associated with worse subjective OAB.

Health disparities and access to advanced therapy for overactive bladder

“…Additionally, compared with White women, Black women were 3.4‐fold more likely to have detrusor overactivity (95% confidence interval [CI]: 0.99–11.40) and had lower volumes at time of “strong desire” (−102.6 ml, p = 0.003) on urodynamic testing. Similarly, Hispanic women had on average 75.88 ml less volume at sensation of “strong desire” ( p = 0.016) than did White women 18 . Although the physiologic mechanism remains unclear, this study suggests that race and epigenetic influences contribute to the experience of OAB pathology, and that race is a proxy for an unmeasured determinant of OAB severity.…”

“…Similarly, Hispanic women had on average 75.88 ml less volume at sensation of "strong desire" (p = 0.016) than did White women. 18 Although the physiologic mechanism remains unclear, this study suggests that race and epigenetic influences contribute to the experience of OAB pathology, and that race is a proxy for an unmeasured determinant of OAB severity.…”

“…In addition to differences in diagnosed OAB prevalence based on race and ethnicity, there is also an association between symptom severity and race. Zuo et al 18 examined urodynamic parameters of women presenting for urogynecology care at a high‐volume urban center and found several distinctions amongst different races. Namely, Black and Hispanic women were more likely to present with urgency/frequency symptoms while White women more often presented with mixed urinary symptoms.…”

Health inequities within the field of urogynecology

“…Questionnaire studies have found that race/ethnicity is associated with OAB symptoms, with African American and Hispanic women 3-4 times more likely to have OAB than White or Asian women [11,12]. In a more recent study examining differences in urodynamic parameters in women with OAB, African American women were more likely to endorse OAB symptoms and have detrusor overactivity on urodynamics than Hispanic women, and Hispanic women were more likely to report mixed urinary incontinence (MUI) than African American women [13]. However, the authors admit the limitations of this study include its small sample size, retrospective nature and inclusion of patients at a single institution.…”

Advances in Assistive Electronic Device Solutions for Urology

“…A few research groups have studied racial and ethnic differences in the prevalence of urological disorders. Zuo et al [16] conducted a study to identify differences in severity of overactive bladder (OAB) in women of different races, and Van Den Eeden et al [17] sought to examine if there are racial or ethnic differences in lower urinary tract symptoms (LUTS) in men. A recent study showed more than 70% of urinary incontinence is associated with bother regardless of race or ethnicity [18].…”