Urodynamic findings in women with refractory overactive bladder symptoms

• Published in: International journal of urology Vol. 23; no. 1; pp. 75 - 79
• Main Authors: Al-Zahrani, Ali A, Gajewski, Jerzy
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.01.2016
• Subjects: Adult; Aged; Aged, 80 and over; bladder outlet obstruction; detrusor overactivity; Female; Humans; lower urinary tract symptoms; Middle Aged; Nocturia - etiology; overactive bladder; Retrospective Studies; Severity of Illness Index; Urinary Bladder Neck Obstruction - complications; Urinary Bladder, Overactive - complications; Urinary Bladder, Overactive - physiopathology; Urinary Incontinence, Stress - etiology; Urinary Incontinence, Urge - etiology; urodynamic study; Urodynamics; urodynamic study; bladder outlet obstruction; lower urinary tract symptoms; overactive bladder; detrusor overactivity
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.12954

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.