Urodynamic classification of female patients with symptoms of overactive bladder and the outcome analysis

Abstract

Objective To introduce a urodynamic classification of female patients with symptoms of overactive bladder(OAB) and discuss its clinical significance. Methods From January 2015 to January 2017, 62 female patients from Peking University People's Hospital who diagnosed clinically with OAB and underwent preoperative urodynamic test were involved in this study. Female OAB patients can be stratified into four groups based on the chief complaints and the urodynamic test, including typeⅠ-no evidence of detrusor overactivity(DO) on urodynamic test, patients can feel urgency and have no urinary incontinence, typeⅡ-involuntary detrusor contraction present, patients aware and able to abort them and have no urinary incontinence, type Ⅲ-involuntary detrusor contraction present, patients aware and able to contract the sphincter but can not abort contractions and have urinary incontinence and type Ⅳ-contractions present, and patients unaware and unable to contract the sphincter or abort contractions and have urinary incontinence.According to the classification, the amount of the four types of OAB patients were 8, 22, 25 and 7, respectively.The data of height, age, weight showed no statistical significance (P>0.05) .The amount of the concomitant diseases of the type Ⅰ, Ⅱ and Ⅲ showed no obviously difference(P>0.05), but the type Ⅳ was higher than the other three types(P 0.05)and AUASS scores(16.38±5.26 vs. 16.59±5.11, P>0.05)of the typeⅠandⅡhave shown no obviously difference. The preoperative OABSS(9.00±2.35 vs.9.71±3.04, P>0.05)and AUASS(20.59±3.95 vs. 22.00±4.97, P>0.05)scores of the type Ⅲ and Ⅳ have shown no obviously difference.The preoperative scores of the OABSS scores and AUASS scores of the type Ⅲ and the type Ⅳ were obviously higher than that of the typeⅠand the typeⅡ(P<0.05 ). In this study, 16 of the 62 patients were treated with tolterodine, 46 patients were treated with solifenacin, with the average duration of drug therapy of 3.4 months (0.5-20.0 months). The postoperative scores of the OABSS and AUASS were followed up. The treatment outcomes among different OAB types were compared. Results The 62 patients were followed up from 6 to 20 months, with an average of 11.2 months.The improvement of the OABSS scores of the typeⅠandⅡ(3.63±0.74 vs.3.86±0.89, P>0.05) have shown no obviously difference. The improvement of the OABSS scores of the type Ⅲ( 6.40±1.17)were obviously higher than the typeⅠ, Ⅱ and Ⅳ( 1.71±1.38)(P 0.05)have shown no obviously difference. The improvement of the AUASS scores of the type Ⅲ(15.28±4.32)were obviously higher than the typeⅠ, Ⅱ and Ⅳ(8.14±4.34)(P<0.05). The improvement of the AUASS scores of the type IV were obviously inferior to the typeⅠ, Ⅱ and Ⅲ(P<0.05). Conclusions The type Ⅳ OAB presented with the worst outcome and the type Ⅲ OAB presented with the best among the four types of OAB.The classification system will have a suggestive significance to predict the prognosis and the therapeutic effect of the patients with OAB. Key words: Overactive bladder; Woman; Clissification; Urodynamic test