Abstract

ABSTRACTObjectives To determine the differences between voiding symptoms obtained by open anamnesis (VS-Open) versus voiding symptoms obtained by directed anamnesis (VS-Directed) to predict voiding dysfunction in women.Materials and Methods Retrospective study of women with prior anti-incontinence surgery evaluated during 5 years. In a standardized clinical history taking, each patient was asked to answer question number five of the UDI-6 questionnaire (“Do you experience any difficulty emptying your bladder?”). If the answer was positive, the following voiding symptoms spontaneously described by the patient were documented: slow urine stream, straining to void, intermittent stream and feeling of incomplete bladder emptying, which were considered VS-Open. If the answer to this question was negative or if the patient had not reported the four voiding symptoms, she was asked in a directed manner about the presence of each o Ninety-one women are analyzed. Eighteen patients presented voiding dysfunction (19.8%), There was a statistical association between voiding dysfunction and the presence of any VS-Open (p = 0.037) and straining to void obtained by open anamnesis (p = 0.013). Sensitivity, specificity, PPV, NPV, positive likelihood ratio and negative likelihood ratio, respectively, were 44.4% and 27.8%, 80.8% and 94.5%, 36.3% and 55.6%, 85.5% and 84.1%, 2.324 and 5.129, and 0.686 and 0.764. There was no statistical association between voiding dysfunction and VS-Directed.ConclusionsVS-Open may predict better voiding dysfunction than VS-Directed in women.

Highlights

  • Large epidemiologic studies have demonstrated that the prevalence of voiding symptoms in women ranges between 14.9 and 19.5%, and that these are generally related to storage symptoms [1, 2]

  • The purpose of the present exploratory work is to study whether the voiding symptoms are predictive for voiding dysfunction in women in accordance with the definition of the main international societies, and to define whether there are differences between voiding symptoms obtained by open anamnesis (VS-Open) versus voiding symptoms obtained by directed anamnesis (VS-Directed)

  • A = Insensible urinary incontinence, nocturnal enuresis; b = VS-Open: voiding symptoms obtained by open anamnesis; c = A post micturition symptom according to International Continence Society (ICS); d = VS-Directed: voiding symptoms obtained by directed anamnesis

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Summary

Introduction

Large epidemiologic studies have demonstrated that the prevalence of voiding symptoms in women ranges between 14.9 and 19.5%, and that these are generally related to storage symptoms [1, 2]. Symptoms may be retrieved either through a medical interview [5, 6, 9,10,11] or through the implementation of standardized questionnaires [1, 2, 7, 12], generating variations in their value to predict voiding dysfunction In their most recent terminology report, the International Urogynecological Association (IUGA) and the International Continence Society (ICS) define voiding dysfunction as an abnormally slow and/ or incomplete voiding and recommend it is studied with the use of uroflowmetry and PVR measurement, there is still no consensus on the values that are considered as abnormal [13]

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