Clinical symptoms and videourodynamic findings of detrusor overactivity in women

Abstract

ObjectiveDetrusor overactivity (DO) is a urodynamic term for uninhibited detrusor contractions, which occur in the bladder-filling phase. Women with urodynamic DO might have different clinical presentations and pathophysiology involving the bladder, urethra, and pelvic floor. This retrospective study used videourodynamic study (VUDS) to analyze the correlation between clinical symptoms and DO subtypes in women. Materials and MethodsThe records of 526 consecutive women with urodynamic DO who underwent VUDS for lower urinary tract symptoms (LUTS) from 1996 to 2009 were included. LUTS were classified as storage, emptying, pain, and postmicturition symptoms. A final diagnosis was made based on VUDS findings. Patients were stratified into the categories idiopathic DO only, DO with inadequate contractility (DHIC), and DO with bladder outlet obstruction (BOO). The main symptoms and associated symptoms were used to analyze the correlation with DO subgroups. A group of 272 women with LUTS who were urodynamically normal served as the symptomatic controls. ResultsAmong women with DO, 308 (58.6%) had idiopathic DO only, 69 (13.1%) had DHIC, and 149 (28.3%) had BOO. All of the women in the DO subgroups had storage symptoms as the main or associated symptoms. A combination of storage and emptying symptoms were more common in patients with DHIC [49 (71%)] and BOO [77 (51.7%)]. According to the reported storage symptoms in all women, urodynamic DO was detected in 504 (65.5%) of 770 with frequency symptoms, 467 (73.3%) of 637 with urgency symptoms, and 293 (87.5%) of 335 with urgency urinary incontinence. ConclusionStorage and emptying symptoms are common in women with different DO subtypes. Differential diagnosis of the DO subtype in women should not be based on LUTS alone.