Voiding dysfunction in young, nulliparous women: symptoms and urodynamic findings

Abstract

The objective was to determine urodynamic findings in young, premenopausal, nulliparous women with bothersome lower urinary tract symptoms and assess whether or not symptoms are predictive of specific urodynamic abnormalities. The records of 57 women were reviewed. Those with neurological disease or a primary complaint of stress incontinence were excluded. All completed the American Urological Association Symptom Index (AUASI) and underwent videourodynamics. Symptoms were compared in patients with and without bladder dysfunction and/or voiding phase dysfunction. Bladder dysfunction was diagnosed in 86% of patients with urge incontinence vs. 17% of those without (p<0.0001). Patients with voiding phase dysfunction had higher total and voiding AUASI scores. Occult neurological disease was later diagnosed in 4 women (24%) with urge incontinence and bladder dysfunction. Urge incontinence and voiding symptoms are frequently associated with urodynamically demonstrable abnormalities. Urge incontinence and bladder dysfunction may be a sign of occult neurological disease in this population. The presenting symptoms are useful in determining the utility of urodynamics in this population.

Links between lower urinary tract symptoms, intermittent hypoxia and diabetes: Causes or cures?

“…Further, and importantly, neither drug nor surgical interventions that target the prostate eliminate LUTS in all patients (Gravas et al, 2015). Of particular note, women suffer from and seek treatment for bothersome LUTS just as men do, in spite of the fact that women lack a prostate (Coyne et al, 2012; Milsom et al, 2012; Rosenblum et al, 2004; Scarpero et al, 2003).…”

Diagnostic Tests for Female Bladder Outlet Obstruction: A Systematic Review from the European Association of Urology Non-neurogenic Female LUTS Guidelines Panel

“…The characteristics of the 28 included studies are detailed in Table 1 and Supplementary Table 2. Of these, 25 evaluated the use of UDS AE fluoroscopy [4,[10][11][12][13][14][15][16][17][18][19][20][21][22][26][27][28][29][30][31][32][33][34][35][36], two of which evaluated pre-existing nomograms [35,36], one evaluated the use of transvaginal ultrasound scan (TVUS) and voiding UDS [23], and two looked at transperineal Doppler ultrasound scan (TPUS) [24,25]. Five studies defined cut-offs for UDS parameters [17,26,29,31,32], one study described fluoroscopic characteristics for fBOO [20], one study evaluated the area under the curve (AUC) of detrusor pressure [18], and three studies derived a nomogram to diagnose fBOO [10,14,19].…”

“…Klijer et al [30] used a Q max of <15 ml/s and a P det.Qmax of >40 cmH 2 O, and diagnosed BOO in 18.9% of 53 women with "chronic bladder symptoms". Choi et al [11] analysed 792 women with a range of LUTS and diagnosed BOO in 11.2%, using Q max <15 ml/s and P det.Qmax >20 cmH 2 O. Rosenblum et al [28] evaluated voiding dysfunction in 57 nulliparous womenwith a range of LUTS, and female BNO (fBNO) was diagnosed in 3.5% using Nitti et al's [20] radiological criteria.…”

Long‐term urogenital assessment after elective laparoscopic sigmoid resection for diverticulitis: a comparison between central and peripheral vascular resection

“…Urinary function was assessed using the American Urological Association Symptom Index (AUASI). This index was originally created for benign prostatic hyperplasia, but due to a lack of specificity the questionnaire evolved to a broader application for men and women [13][14][15][16][17][18][19]. The AUASI contains seven questions that investigate filling and voiding symptoms.…”