How frequent are overactive bladder symptoms in women with urodynamic verification of an overactive bladder? (original) (raw)
Related papers
Overactive bladder symptoms: Do we need urodynamics
Neurourology and Urodynamics, 2003
AimsThe aim of our study was to determine whether the urodynamic diagnosis is useful in the management of women with symptoms of an overactive bladder (OAB).The aim of our study was to determine whether the urodynamic diagnosis is useful in the management of women with symptoms of an overactive bladder (OAB).MethodsWomen with lower urinary tract symptoms, attending a tertiary referral urogynaecology clinic were studied. All women were fully evaluated, with history, urinary symptoms questionnaire, frequency-volume chart, vaginal examination, and videocystourethrography. Women with symptoms consistent with an overactive bladder (urinary frequency, urgency, and/or urge incontinence) were selected. Women with neurological disorders were excluded. Finally, urinary symptoms and urodynamic diagnosis were correlated. All terms and definitions are in accordance with the International Continence Society [Abrams et al., 1988, Scand J Urol Nephrol 114(Suppl):5–19.].Women with lower urinary tract symptoms, attending a tertiary referral urogynaecology clinic were studied. All women were fully evaluated, with history, urinary symptoms questionnaire, frequency-volume chart, vaginal examination, and videocystourethrography. Women with symptoms consistent with an overactive bladder (urinary frequency, urgency, and/or urge incontinence) were selected. Women with neurological disorders were excluded. Finally, urinary symptoms and urodynamic diagnosis were correlated. All terms and definitions are in accordance with the International Continence Society [Abrams et al., 1988, Scand J Urol Nephrol 114(Suppl):5–19.].ResultsA total of 4,500 women 22–73 years of age were studied. Only 843 women (18.7%) could be classified as having an OAB. Of these, 457 women (54.2%) had urodynamically proven detrusor instability, whereas 386 women (45.8%) had a stable urodynamic trace. Sixty-eight (8.1%) of the women studied had postvoid residual greater than 100 mL. Of the 4,500 women studied, 1,641 (36.5%) had detrusor instability on laboratory urodynamics. Only 27.5% of these women (457 of 1,641) had OAB symptoms.A total of 4,500 women 22–73 years of age were studied. Only 843 women (18.7%) could be classified as having an OAB. Of these, 457 women (54.2%) had urodynamically proven detrusor instability, whereas 386 women (45.8%) had a stable urodynamic trace. Sixty-eight (8.1%) of the women studied had postvoid residual greater than 100 mL. Of the 4,500 women studied, 1,641 (36.5%) had detrusor instability on laboratory urodynamics. Only 27.5% of these women (457 of 1,641) had OAB symptoms.ConclusionsSymptomatic diagnosis of OAB does not correlate with a urodynamic diagnosis of detrusor instability. The diagnosis of overactive bladder based on urinary symptoms underdiagnoses the condition of detrusor instability in a population of women suffering from lower urinary tract symptoms. Therefore, symptomatic diagnosis of OAB alone is not recommended. Our study suggested that urodynamic evaluation is mandatory in the management of the women with symptoms of an overactive bladder. Neurourol. Urodynam. 22:105–108, 2003. © 2003 Wiley-Liss, Inc.Symptomatic diagnosis of OAB does not correlate with a urodynamic diagnosis of detrusor instability. The diagnosis of overactive bladder based on urinary symptoms underdiagnoses the condition of detrusor instability in a population of women suffering from lower urinary tract symptoms. Therefore, symptomatic diagnosis of OAB alone is not recommended. Our study suggested that urodynamic evaluation is mandatory in the management of the women with symptoms of an overactive bladder. Neurourol. Urodynam. 22:105–108, 2003. © 2003 Wiley-Liss, Inc.
Urodynamic Detrusor Overactivity in Patients with Overactive Bladder Symptoms
International Neurourology Journal, 2011
Purpose: To evaluate the relationship between urodynamic detrusor overactivity (DO) and overactive bladder (OAB) symptoms in men and women. Methods: We reviewed the records of adult males and females who attended a tertiary referral center for urodynamic evaluation of OAB syndrome symptoms with the presence or absence of DO. DO was calculated for symptoms alone or in combination.
Urotoday international journal, 2010
The purposes of the present study were to: (1) compare the findings from videocystourethrography (VCU) with those from ambulatory urodynamic monitoring (AUM) to determine their level of agreement in identifying the causes of overactive bladder (OAB) symptoms; (2) examine changes in the diagnoses that were made following the first test (VCU) after the patient had the second test (AUM). METHODS: This was a retrospective analysis of our AUM database during 2007 and 2008. The inclusion criteria were: (1) female patients over the age of 18 years with OAB symptoms; (2) complete documentation of all OAB symptoms; (3) results from both VCU and AUM. Patients were referred for AUM because the findings following VCU did not explain the presenting symptoms. The frequency and type of OAB symptoms and the results from the tests were recorded and compared. RESULTS: A total of 100 women fulfilled the inclusion criteria. The mean age was 56 years (range, 19-87 years). The cause of the OAB symptoms was defined in 55% of the patients following VCU and 64% of the patients following AUM. Detrusor overactivity (DO) was not identified for any patients following VCU; it was found in 32 patients following AUM. Urgency with or without urge urinary incontinence was the symptom most frequently associated with DO. Of the 100 patients, 45 women had normal results from the VCU. Nine of these women also had normal results following AUM. For the remaining 36 women, the results from AUM identified abnormalities that could explain their symptoms. The most common findings were DO (58%) and urodynamic stress incontinence (16%). CONCLUSION: Results from VCU for patients with symptoms of OAB should be interpreted with caution. AUM appears to be a more discerning tool in identifying DO. Clinicians should interpret urodynamic results in conjunction with clinical symptoms, particularly if a continence surgery is contemplated. AUM is particularly recommended for complex cases.
Urology
To explain what role urinary urgency has on urinary frequency in patients with overactive bladder (OAB). We prospectively enrolled 102 patients with OAB over a 6-week period. Patients were assessed with the OAB-q and a pilot questionnaire to identify which urinary symptoms were most bothersome and what underlying cause subjects attributed urinary frequency to. Associations between epidemiologic characteristics, OAB-q scores, and subject responses to the pilot questionnaire, were examined for statistical significance with the Pearson chi square test. The study population comprised 85% women and 15% men, with mean age 67.4 years and mean OAB-q score 54. Subjects reported their most bothersome symptom was: frequency 24.5%, urgency or urgency incontinence 48.0%, nocturia 27.5%. Of the patients most bothered by frequency, 64% identified the International Continence Society definition of urgency or "fear of leakage" as the underlying reason for their frequency. Overall, 82.4% an...
International Urogynecology Journal, 2010
Introduction and hypothesis This paper aims to determine if there are differences between female overactive bladder (OAB) patients with and without urodynamic detrusor overactivity (DO). Methods A retrospective chart review was performed on 146 women with OAB. All patients completed an American Urological Association symptom score, 48-h bladder diary (documenting voided volumes, incontinent episodes, and degree of urgency to void), and urodynamic testing (UDS). Patients with urodynamic DO were then compared to patients without DO. Results There were no differences in symptom scores. Patients with DO (54.1%) were older (61.8 vs. 50.8 years) and had smaller maximum voided volumes per void (377 mL vs. 476 mL), average 24-h urine output (1,975 mL vs. 2,320 mL), and significantly more incontinent episodes. On UDS, patients with DO were more likely to have abnormal sensation, with strong desire and urgency occurring at significantly lower bladder volumes.
BJU International, 2014
The term lower urinary tract symptoms (LUTS) encompasses a range of urinary symptoms, including storage symptoms (e.g. overactive bladder [OAB]) as well as voiding and post-micturition symptoms. Although treatment of male LUTS tends to focus on voiding symptoms, patients typically find storage symptoms the most bothersome. The core storage symptom is urgency, which drives the other main storage symptoms of increased daytime frequency, nocturia and incontinence. Although several validated questionnaires have been widely used to study urgency, few measure the two important storage parameters, urgency and frequency, in a single assessment. The total urgency and frequency score (TUFS) is a new validated tool that captures both variables and is derived from the Patient Perception of Intensity of Urgency Scale, which has been validated in patients with OAB and LUTS. The TUFS was first validated in OAB in the phase IIa BLOSSOM study, which was designed to assess the efficacy and safety of mirabegron, a β3-adrenoceptor agonist, in 260 patients. The responsiveness of the TUFS to treatment has been confirmed in a further three large-scale randomized controlled trials of solifenacin in patients with OAB or LUTS. Changes in TUFS from baseline to end of treatment were consistent with changes in micturition diary variables in all four studies. Furthermore, the TUFS was significantly correlated with several health-related quality-of-life variables in the phase III NEPTUNE study. Thus, the TUFS appears to be useful for assessing improvements in major storage symptoms (urgency and frequency) in clinical trials.
The role of urodynamics in the treatment of lower urinary tract symptoms in women
Current Opinion in Urology, 2005
Purpose of review Urodynamic investigation was developed as an extension of patient history and physical examination in order to reveal the pathology of a patient's complaints. Much progress in standardizing definitions and procedures has been made in recent years. In particular, stress urinary incontinence and overactive bladder can be differentiated with urodynamics. The developed parameters, however, cannot distinguish the various types of stress urinary incontinence. Moreover the definition and diagnosis of voiding dysfunction is not clear. Finally our understanding of bladder sensations and the impact on voiding behaviour has only started to emerge. This review is about last year's publications that focus on urodynamics and lower urinary tract symptoms in women. Recent findings Defining bladder outlet obstruction is based on voiding pressure, urinary flow speed and residual urine but standardization is lacking. Urodynamics to reveal occult stress urinary incontinence in patients with pelvic organ prolapse needs standardization of the reducing manoeuvres. The quest for urodynamic tools for distinguishing intrinsic sphincter deficiency from urethral hypermobility continues. Urodynamics are still not good enough to discriminate between treatment options for stress urinary incontinence. The use of urodynamics in overactive bladder is developing and has elicited new findings. Voiding habit seems to be independent from bladder sensations. Also bladder sensations appear to be imperfectly correlated with bladder filling. Even bladder volumes do not predict entirely bladder fullness sensations. Summary In order to use urodynamics as a proper clinical tool, defining subtypes of stress urinary incontinence and standardization of urodynamics in pelvic organ prolapse and bladder outlet obstruction in women is needed.