Abstract
Introduction and hypothesisVoiding dysfunction has gained interest due to its high prevalence in the elderly. This study characterized bladder dysfunction in women with voiding dysfunction using video urodynamic studies (VUDS) focused on detrusor underactivity (DU).MethodsWe studied 1914 women in which first-line medical treatment failed. Age, comorbidities, and urodynamic parameters were analyzed to determine the association between bladder sensation and contractility.ResultsVUDS were normal in 2.9% (n = 56) of patients and showed DU in 23.1% (n = 443), detrusor hyperactivity and impaired contractility (DHIC) in 12.0% (n = 231), hypersensitive bladder in 17.0% (n = 325), detrusor overactivity (DO) in 2.6% (n = 49) and bladder outlet obstruction in 42.3% (n = 810). The mean age of patients in the DU and DHIC groups was significantly older than in women with normal VUDS and those with hypersensitive bladders (p<0.01). Decreased bladder sensation and larger cystometric bladder capacity were noted in the DU group compared to the DHIC, HSB, and DO groups. Bladder sensation was negatively associated with the bladder contractility. Bladder contractility index and voiding efficiency were lower in the DU and DHIC groups compared to the normal group.ConclusionsThe bladder conditions of women with voiding dysfunction included DU, DHIC, HSB and DO. Bladder contractility index and voiding efficiency were significantly lowest in DU and DHIC groups and lower in HSB and DO groups than normal tracing group. Reduced bladder sensation was noted in DU and negatively associated with detrusor contractility.
Highlights
Introduction and hypothesisVoiding dysfunction has gained interest due to its high prevalence in the elderly
video urodynamic studies (VUDS) were normal in 2.9% (n = 56) of patients and showed detrusor underactivity (DU) in 23.1% (n = 443), detrusor hyperactivity and impaired contractility (DHIC) in 12.0% (n = 231), hypersensitive bladder in 17.0% (n = 325), detrusor overactivity (DO) in 2.6% (n = 49) and bladder outlet obstruction in 42.3% (n = 810)
Decreased bladder sensation and larger cystometric bladder capacity were noted in the DU group compared to the DHIC, hypersensitive bladder (HSB), and DO groups
Summary
Voiding dysfunction has gained interest due to its high prevalence in the elderly. Voiding dysfunction has been extensively studied in men, probably due to the significant prevalence of prostate hypertrophy in aged men causing bladder outlet obstruction (BOO). The prevalence of voiding dysfunction in women varies widely from 6.8% to 61.7% in selected populations, depending on the diagnostic criteria, and seems to increase with age[2]. One recent study reported voiding dysfunction in 7.2% of women who visited a urology office and in up to 12.8% of women with lower urinary tract symptoms (LUTS)[3]. The combination of pressure flow studies and real-time urine flow and imaging studies of video urodynamic studies (VUDS) provide a comprehensive evaluation of lower urinary tract dysfunction[4]
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