Age-specific prevalence, clinical and urodynamic findings of detrusor underactivity and bladder outlet obstruction in female voiding dysfunction.

Autor: Wu PC; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan., Hsiao SM; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.; Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan City, Taiwan., Lin HH; Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, Taipei City, Taiwan.; Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2024 Nov; Vol. 167 (2), pp. 797-803. Date of Electronic Publication: 2024 May 27.
DOI: 10.1002/ijgo.15705
Abstrakt: Objective: Female voiding dysfunction with cystocele have been widely studied, but there are no data regarding women without cystoceles. The present study aimed to evaluate the prevalence of detrusor underactivity (DU) and bladder outlet obstruction (BOO) without cystoceles in a large sample size.
Methods: This was a retrospective cohort study. Between April 1996 and September 2018, 602 neurologically intact women with voiding dysfunction without cystoceles were enrolled. Detrusor pressure (DU) at the maximum flow rate (PdetQmax) <20 cmH 2 O, maximum flow rate (Qmax) <15 mL/s, and a bladder voiding efficiency <90% and BOO (PdetQmax ≥40 cmH 2 O and Qmax <12 mL/s) were diagnosed by urodynamic study. Otherwise, a non-DU/BOO diagnosis was made. The prevalence of DU and BOO was the primary outcome. The secondary outcomes were the analyses of the differences between these three groups in objective UDS parameters and subjective questionnaires and bladder diary parameters.
Results: This study included 100 (17%) women with DU, 60 (10%) with BOO, and 442 (73%) with a non-DU/BOO diagnosis. DU increased with age, but BOO decreased as age increased. The women in the DU group were older, had higher parity and pad weights, and lower PdetQmax, maximum urethral closure pressure, and functional profile length than the BOO group. The urodynamic findings did not correlate well to subjective questionnaire parameters. None of the symptoms revealed a significant difference between the groups. The retrospective design was the limitation of the study.
Conclusion: The prevalence of DU increased with age in women with voiding dysfunction without advanced cystoceles. Conversely, BOO decreased with age. Prevalence intersected in the fourth decade. Diagnosis requires urodynamic evaluation, as subjective symptoms are inconclusive.
(© 2024 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)
Databáze: MEDLINE
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