Relationship between urodynamic patterns and lower urinary tract symptoms in Chinese women with a non-neurogenic bladder

Wang, Linhui; Wang, Cunzhou; Qu, Chao; Li, Yin; Xu, Danfeng; Cui, Xingang; Liu, Bing

doi:10.1016/j.ajur.2015.11.004

Cited by 6 publications

(5 citation statements)

References 32 publications

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“…Its prevalence rate is estimated to vary between 2.7% and 8% in women with LUTS[234]. Thus, it is difficult to find and select suitable cases for this intervention; so, one of our limitations was the small size of patients population and the second was the lack of UDS and VCUG in the follow-up which was due to UDS high expense and invasiveness, though repeated UDS performed only in patients with unsatisfactory results or in case of intervention-related complications.…”

Section: Discussionmentioning

confidence: 99%

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Internal Urethrotomy in Treatment of Female with Anatomical Bladder Outlet Obstruction

et al. 2019

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Background: Bladder outlet obstruction (BOO) is a relatively infrequent urologic condition in women, but can cause bothersome symptoms. In this article, transurethral incisions of the bladder neck (TUIBN) and urethra in the treatment of anatomical BOO were assessed. Materials and Methods: A total of 23 women who referred with chronic lower urinary tract symptoms, urinary retention, and difficulty in micturition were assessed. Diagnose was made on the basis of urethrocystoscopy, voiding cystourethrography, and urodynamic studies. All patients underwent transurethral incisions of bladder neck contracture or site of observed urethral stenosis at 3- and 9-o'clock positions. Clinical improvements and complications were assessed by follow-up examination and International Prostate Symptom Score (IPSS) and quality of life (QOL) scoring before and after intervention. Results: All patients were followed for at least 6 months after intervention. Follow-up data were available for 19 (90.5%), 13 (61.9%), and 7 (33.3%) of patients at 12, 24, and 48 months' follow-up, respectively. During the follow-up period, the mean IPSS and QOL significantly changed from 26.84 to 10.74 and 4.76 to 2.32, respectively ( P < 0.001). Approximately 66.7% had satisfactory outcomes, 47.7% patients after first, and 19.1% after second TUI. About9.5% patients developed new onset of stress urinary incontinence, one of them had indications of surgical intervention, and thus, symptoms were relieved by mid-urethral sling. Conclusion: Transurethral incision of bladder neck and urethra seems to be effective in relieving urinary symptoms of anatomical BOO in women. Complications may rarely occur and can be fully managed.

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Section: Discussionmentioning

confidence: 99%

“…[123] In patients with BOO, LUTS is confusing and has no pathognomonic diagnosis, indeed can be presented with storage, voiding, and postmicturition symptoms. [45] The causes of BOO can be divided into two main groups: anatomical and functional. Anatomical obstruction can be either extrinsic or luminal.…”

Section: Introductionmentioning

confidence: 99%

Internal Urethrotomy in Treatment of Female with Anatomical Bladder Outlet Obstruction

et al. 2019

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“…This has shown DU to be present in 12-45% of females with LUTS, distinctively more common in elderly nursing home residents who often have concomitant DOA, an entity described as "detrusor hyperactivity with impaired contractility" (DHIC) [1]. A recent study from China which analysed 3265 urodynamic traces of neurologically normal women, using the ICS definition of DU, found a prevalence of 19.9% [6]. Another recent large series from Taiwan including a total of 1914 women found a DU prevalence of 17.6% and detrusor hyperactivity with impaired contractility of 12.1%, the diagnosis was made on the basis of videourodynamics with no specific definition added [7].…”

Section: Epidemiologymentioning

confidence: 99%

Detrusor Underactivity and Underactive Bladder in Women: What Is New?

Osman

Pang

Martens

et al. 2019

Curr Bladder Dysfunct Rep

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Purpose of Review Detrusor underactivity (DU) and its symptom-based correlation, the underactive bladder (UAB), are common problems encountered in urological practice. Whilst DU has been defined for many years, only recently has UAB received a formal definition and there is now accumulating literature based on this condition. In this article, we reviewed the recent literature on the aetiology, pathogenesis, diagnosis and management of DU/UAB in women. Recent Findings Detrusor underactivity is diagnosed on urodynamic studies but there still remains a lack of widely recognised and accepted diagnostic criteria. Commencing treatment based on the diagnosis of UAB, with or without a PVR measurement, is perhaps feasible due to the lower occurrence of BOO in women and specific clinical features that may distinguish this group. Prospective studies attempting to correlate UAB with the underlying DU are needed before this approach could be considered. Summary Detrusor underactivity/UAB in women requires a separate consideration from men due to the anatomical and functional differences in the lower urinary tracts between both genders and consequent differences in pathologies affecting them. The aetiology of DU remains largely unknown, but is probably multifactorial, including myogenic, neurogenic and vasculogenic factors. There remains a lack of any simple effective drug treatments, whilst apart from sacral neuromodulation for the specific subgroup with non-obstructive urinary retention, no safe and effective surgical treatment is currently available. Often, permanent or intermittent bladder drainage with a catheter is the final solution.

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“…Wang et al identified DU in 19.9% of women with LUTS, with 4.0% of those women having demonstrable BOO. [ 20 ] In women for whom there is uncertainty as to the etiology of LUTS or who are unresponsive to first-line therapies, urodynamics may be beneficial to identify a subset of patients with combined DU and BOO. In particular, video urodynamics may allow for the identification of anatomic obstruction, which in many cases can be surgically addressed.…”

Section: Diagnosismentioning

confidence: 99%