Antocholinergics in patients with overactive bladder: Assessment of ambulatory urodynamics and patient perception

Abstract

The aim of this study was to evaluate whether ambulatory urodynamic monitoring (AUM) may reflect patient perception of bladder condition and treatment benefit in patients with overactive bladder (OAB). A total of 33 women and 7 men 23 to 72 years old who were undergoing AUM were included in this study. At baseline, patients were asked to complete the following information in the micturition chart for 3 consecutive days. Patients were given anticholinergics once daily for the 2 weeks. Two weeks after the treatment, all patients received an identical repeat study. Most parameters of AUM, micturition chart and patient perception were improved 2 weeks after treatment. However, when Spearman correlation coefficients were performed, all AUM parameters did not correlate with patient perception of bladder condition after treatment although some AUM parameters regarding incontinence were associated with patient perception of bladder condition at baseline. In addition, when patients were divided as the 'no or some benefit' group (n = 25) and the 'much benefit' group (n = 15), all AUM parameters except total voided volume (P = 0.004) were not significantly different in the two groups. Because patients with pelvic floor dysfunction have widely varying expectations from treatment, the patient's goal for treatment is highly subjective. Our findings suggest that AUM does not take into account the patient perception of disease severity, and correlations between the patient view of treatment outcome and objective measures are poor. Therefore, strategies for assessing OAB should incorporate self-perceived disease condition.