Do we understand voiding dysfunction in women? Current understanding and future perspectives: ICI‐RS 2017

Panicker, Jalesh N.; Anding, Ralf; Arlandis, Salvador; Blok, Bertil; Dorrepaal, Caroline; Harding, Chris; Marcelissen, Tom; Rademakers, Kevin; Abrams, Paul; Apostolidis, Apostolos

doi:10.1002/nau.23709

Cited by 28 publications

(28 citation statements)

References 90 publications

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“…The terms and phrases used included 'female' combined with 'voiding dysfunction', 'urinary retention', 'detrusor underactivity', 'Fowler's syndrome', 'high-tone nonrelaxing sphincter', 'urethral stricture', 'bladder neck obstruction', 'dysfunctional voiding' and 'idiopathic chronic urinary retention'. In addition, aspects of the existing guidance from the European Association of Urology [4] and a publication from the relevant International Consultation on Incontinence Research Society 'Think Tanks' (ICI-RS) [5] were used, and further informed by UK best practice, to provide a framework for assessment, investigation and management of these patients.…”

Section: Methodsmentioning

confidence: 99%

British Association of Urological Surgeons (BAUS) consensus document: Management of female voiding dysfunction

et al. 2021

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To report the British Association of Urological Surgeon's (BAUS) guidance on the assessment and management of female voiding dysfunction. MethodsA contemporary literature search was conducted to identify the evidence base. The BAUS Section of Female, Neurological and Urodynamic Urology (FNUU) Executive Committee formed a guideline development group to draw up and review the recommendations. Where there was no supporting evidence, expert opinion of the BAUS FNUU executive committee, FNUU Section and BAUS members, including urology consultants working in units throughout the UK, was used. ResultsFemale patients with voiding dysfunction can present with mixed urinary symptoms or urinary retention in both elective and emergency settings. Voiding dysfunction is caused by a wide range of conditions which can be categorized into bladder outlet obstruction (attributable to functional or anatomical causes) or detrusor underactivity. Guidance on the assessment, investigation and treatment of women with voiding dysfunction and urinary retention, in the absence of a known underlying neurological condition, is provided. ConclusionWa have produced a BAUS approved consensus on the management pathway for female voiding dysfunction with the aim to optimize assessment and treatment pathways for patients.

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Section: Methodsmentioning

confidence: 99%

British Association of Urological Surgeons (BAUS) consensus document: Management of female voiding dysfunction

et al. 2021

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“…According to the International Continence Society (ICS) recommendations [ 15 ], a bladder outflow obstruction due to overactive urethral function during voiding (dysfunctional voiding) is considered when all the following parameters are observed: a maximum flow rate < 15 ml/s; a maintained detrusor contraction (> 25 cmH 2 O) in the presence of incomplete bladder emptying (post-voided volume > 100 ml and voided volume > 200 ml); an increase in EUS EMG activity during micturition [ 16 ]. Bladder acontractility was diagnosed when a complete absence of detrusor pressure waves was observed on pressure-flow studies (PFS), regardless of the post-voided residual and maximum flow rate.…”

Section: Methodsmentioning

confidence: 99%

Sacral neuromodulation to treat voiding dysfunction in patients with previous pelvic surgery for deep infiltrating endometriosis: our centre's experience

2020

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Introduction and hypothesis Voiding symptoms/dysfunctions (VS/Ds) after surgery for deep-infiltrating endometriosis (DIE) are frequent (20% of patients) and, together with bowel dysfunctions, may represent a de novo disorder due to surgical damage of the pelvic plexus or a worsening of pre-existent functional damage. Sacral neuromodulation (SNM) might improve voiding symptoms by treating dysfunctional voiding. The aim of this study is to report our experience with SNM in patients treated with surgery for DIE. Methods We retrospectively enrolled 13 patients with VS/Ds after surgery for DIE. All patients were investigated with urodynamic studies (UDS) and agreed to undergo SNM. Pre-existing VS/Ds, bowel disorders and pelvic pain, DIE surgical procedures, UDS and SNM test results were recorded. Results After surgery for DIE, functional bladder outflow obstruction and detrusor acontractility were observed in nine and four patients, respectively. Chronic pelvic pain was present in seven cases. Twelve patients developed constipation, whilst one patient had de novo faecal incontinence. After the SNM testing period, nine patients (69.2%) experienced a significant improvement of symptoms that led to definitive implant. Four patients (30.8%) had no symptom relief and the system was removed. Conclusions Functional bladder outflow obstruction and urinary retention are the most common VS/Ds after surgery for DIE. SNM may be an effective option for these patients, probably due to its action in improving the dysfunctional voiding, which was likely to be already present as part of the "endometriotic syndrome" and got worse after pelvic surgery. Results for pelvic pain control and gastrointestinal disorders should not be underestimated.

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“…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 . In a comprehensive review, Fusco et al reported that DO during the lling phase is the compensation phase of BOO-induced bladder remodeling 11 .…”

Section: Introductionmentioning

confidence: 99%

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

Fang

Yen

et al. 2020

Preprint

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Pregnancy and childbirth are frequently associated with overactive bladder syndrome (OAB). However, the role of parous effects in OAB among nulliparous (NP) women remains controversial. This study investigated abnormal voiding patterns and DO among NP woman with OAB in comparison with parous women. From August 2011 to December 2018, 906 patients met the inclusion criteria for participation and were divided into three groups: 221 patients in the NP group, 571 patients in the normal spontaneous delivery (NSD) group, and 114 patients in the cesarean section (CS) group. Urodynamic study (UDS) examinations were performed, and the presence of DO, abnormal voiding patterns, and maximum urethral closure pressure (MUCP) were recorded. Data were analyzed using analysis of variance, χ2 tests, and independent t tests. Compared with parous women in the NSD and CS groups, patients in the NP group had a significantly higher prevalence of abnormal voiding patterns, DO and MUCP. Furthermore, abnormal voiding patterns were significantly associated with DO and MUCP respectively, especially in the NP group. We hypothesized that hypertonicity or poor relaxation of the pelvic muscle in NP women may cause functional BOO, which is related to their OAB.

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Do we understand voiding dysfunction in women? Current understanding and future perspectives: ICI‐RS 2017

Abstract: In the future, recommendations for research should lead to a better understanding of urinary retention in women and its treatment.

Cited by 28 publications

References 90 publications

British Association of Urological Surgeons (BAUS) consensus document: Management of female voiding dysfunction

British Association of Urological Surgeons (BAUS) consensus document: Management of female voiding dysfunction

Sacral neuromodulation to treat voiding dysfunction in patients with previous pelvic surgery for deep infiltrating endometriosis: our centre's experience

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

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