Urodynamic findings in women with refractory overactive bladder symptoms

Abstract

Abbreviations & Acronyms BOO = bladder outlet obstruction DO = detrusor overactivity MCC = maximum cystometric capacity MFR = maximum flow rate OAB = overactive bladder PdetQ max = detrusor pressure at maximum flow PFS = pressure flow study Q max = maximum flow SUI = stress urinary incontinence UD = urodynamic UUI = urgency urinary incontinence Objectives: To assess: (i) the correlation between overactive bladder symptoms and urodynamic findings in female patients; and (ii) the association of urinary symptoms with the presence of detrusor overactivity and/or bladder outlet obstruction. Methods: The present retrospective study included female patients with overactive bladder symptoms who underwent urodynamic evaluation by a single physician. Patients with previous anti-incontinence surgery or neurogenic bladder were excluded. Spearman's correlation coefficients were calculated to correlate overactive bladder symptoms with the urodynamic findings. Univariate and multivariate logistic regression analyses were used to determine the independent factors for detrusor overactivity and bladder outlet obstruction. Results: Overall, 1737 reports were analyzed. All patients had urgency with or without urgency urinary incontinence. Urgency, urgency urinary incontinence and nocturia correlated with detrusor overactivity. The severity of frequency, nocturia and slow stream correlated with bladder outlet obstruction. In contrast, stress urinary incontinence showed an inverse, but weak, correlation with bladder outlet obstruction. Stress urinary incontinence correlated moderately with urine leak. Storage symptoms showed an inverse, but weak, correlation with maximum cystometric capacity. Multivariate analysis data showed that age, urgency, urgency urinary incontinence and nocturia were independent predictors of detrusor overactivity, whereas the severity of frequency was a predictor of bladder outlet obstruction. Conclusion: As overactive bladder symptoms increase in severity, female patients tend to have a smaller bladder capacity and a higher incidence of detrusor overactivity. A significant number of these patients have bladder outlet obstruction.

Cough associated detrusor overactivity in women with urinary incontinence

“…The authors did not comment on CADO but it was unclear whether an effort was made to identify the entity. 17 The same is true for a study of 537 adults (171 males) with urinary frequency or urinary incontinence who underwent urodynamics evaluation. 18 In another study of 1626 women with mixed urinary incontinence, the authors did not report CADO in any patient.…”

“…A study of urodynamics in 1737 women with refractory overactive bladder found positive stress test in 34.3% and detrusor overactivity in 38.7%. The authors did not comment on CADO but it was unclear whether an effort was made to identify the entity . The same is true for a study of 537 adults (171 males) with urinary frequency or urinary incontinence who underwent urodynamics evaluation .…”

Modified posterior intravaginal slingplasty: does the additional bilateral tape attachment to the sacrospinous ligament improve the results?

“…Meanwhile, there are many publications about the positive effects of POP surgery on OAB [ 22 , 23 ]. On the other hand, Zahravi et al still support the general view of International Continence Society (ICS) and they believe that patients with OAB symptoms tend to have a smaller bladder capacity and a higher incidence of detrusor overactivity [ 24 ].…”

Prevention of genital prolapse recurrence in elderly women after surgery

“…Цей органозберігаючий метод забезпечує високу анатомічну ефективність, нормалізує гемодинаміку, сприяє покращенню якості життя. Водночас використання синтетичних сітчастих матеріалів ускладнює післяопераційний період через часті запалення, відторгнення штучного матеріалу та подальше рецидивування ГП у 8-10% пацієнток, а також спричиняє стресове нетримання сечі після операції [10][11][12][13]. Все це подовжує час, необхідний для лікування пацієнток із ГП; до того ж, згадані матеріали дорого коштують.…”