Coexistent Detrusor Overactivity-Underactivity in Patients with Pelvic Floor Disorders

Abstract

Introduction and Hypothesis: Pelvic floor disorders represent a series of conditions that share, in part, the same etiological mechanisms, so they tend to be concomitant. Recently, awareness of a new lower urinary tract clinical syndrome has risen, namely the coexisting overactive–underactive bladder (COUB). The etiopathogenetic process, prevalence, and related instrumental findings of COUB are not well-established. We aimed to evaluate the prevalence, clinical features, and urodynamic findings of patients with COUB in a large cohort of patients with pelvic floor disorders. Methods: A cohort of 2092 women was retrospectively analyzed. A clinical interview, urogenital examination, and urodynamic assessment were performed by a trained urogynecologist. Based on baseline symptoms, patients were divided into COUB and non-COUB groups, and the degree of concordance between COUB and urodynamic findings, and other parameters related to the clinical aspects of these patients were measured and analyzed. Results: 18.8% of patients were classified as COUB. The association between COUB and patients with coexisting detrusor overactivity–underactivity (DOU) was statistically significant and there were substantial similarities in terms of population characteristics, symptoms, and urodynamic findings. Conclusions: Our study showed a high prevalence of COUB, and a link between this clinical syndrome and DOU was demonstrated. They showed substantial similarities in terms of clinical and urodynamics correlates. Based on these findings, we do think that urodynamic tests can be useful to improve knowledge on COUB and may be of help in the management of this condition.

Changes in Pelvic Floor Ultrasonographic Features after Flat Magnetic Stimulation in Women with Chronic Pelvic Pain and Levator Ani Muscle Hypertonicity

“…From an instrumental point of view, patients underwent TPU to assess anorectal angle (ARA) and levator ani muscle minimal plane distance (LAMD). The measurements were taken in the midsagittal plane, after bladder emptying, at rest ( Figure 1 ) [ 47 ].…”

Flat Magnetic Stimulation for Stress Urinary Incontinence: A Prospective Comparison Study

“…Moreover, this condition negatively affects social, occupational, domestic, and psychophysical well-being [ 14 ]. Diagnostic confirmation may involve urodynamic evaluation due to the well-established poor correlation between clinics and instrumental findings in bladder dysfunctions [ 15 , 16 ]. However, the role of urodynamics is currently under debate due to different definitions and inconstant performance [ 17 , 18 ].…”

Flat Magnetic Stimulation for Stress Urinary Incontinence: A 3-Month Follow-Up Study

“…Urodynamics may be useful to confirm the diagnosis since clinical and instrumental findings poorly agree in the evaluation of bladder dysfunction [ 17 , 18 ]. However, its diagnostic importance in the work-up of urinary incontinence is currently debated due to differences in performance and adopted definitions [ 19 , 20 ].…”