Journal of Ayub Medical College, Abbottabad : JAMC · 2009
Urodynamic findings in female patients reporting with lower urinary tract symptoms.
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Hameed Nazli, Ali M Asghar, Azim Waqar
Аннотация
OBJECTIVE: The study has been undertaken to determine the reproducibility of lower urinary tract symptoms in female patients after urodynamic investigations.
DESIGN: A Descriptive study with retrospective analysis of data.
SETTING: Combined Military Hospital Rawalpindi and Armed Forces Institute of Urology, Rawalpindi.
METHODS: Fifty consecutive women with a primary history of urinary incontinence were interviewed on a standard urinary incontinence questionnaire. They underwent structured clinical pelvic examination, along with cough stress test. Post void residual urine was measured. This was followed by a urine routine examination to exclude any urinary infection. Later these patients underwent a combination of urodynamic tests to predict their final diagnosis. The tests performed were filling cystometry and leak point pressures.
RESULTS: The clinical diagnosis was found to have a variable reproducibility on urodynamic investigations. Clinical stress incontinence translated as genuine stress incontinence in 61.5% of the cases. Patients with isolated symptoms of stress incontinence had an incidence of detrusor instability up to 33.3%. For the symptoms of urgency and urge incontinence, the diagnosis was reproducible in up to 50% of the cases. In cases of mixed symptoms, 20% patients were found to have stress incontinence and 33.3% cases were found to have an unstable bladder, whereas in 46.6% of the cases no objective abnormality was found on urodynamic investigations.
CONCLUSION: Urodynamic investigations should be performed in female patients with lower urinary tract symptoms, especially if irreversible procedure, e.g., surgery is being contemplated.
DESIGN: A Descriptive study with retrospective analysis of data.
SETTING: Combined Military Hospital Rawalpindi and Armed Forces Institute of Urology, Rawalpindi.
METHODS: Fifty consecutive women with a primary history of urinary incontinence were interviewed on a standard urinary incontinence questionnaire. They underwent structured clinical pelvic examination, along with cough stress test. Post void residual urine was measured. This was followed by a urine routine examination to exclude any urinary infection. Later these patients underwent a combination of urodynamic tests to predict their final diagnosis. The tests performed were filling cystometry and leak point pressures.
RESULTS: The clinical diagnosis was found to have a variable reproducibility on urodynamic investigations. Clinical stress incontinence translated as genuine stress incontinence in 61.5% of the cases. Patients with isolated symptoms of stress incontinence had an incidence of detrusor instability up to 33.3%. For the symptoms of urgency and urge incontinence, the diagnosis was reproducible in up to 50% of the cases. In cases of mixed symptoms, 20% patients were found to have stress incontinence and 33.3% cases were found to have an unstable bladder, whereas in 46.6% of the cases no objective abnormality was found on urodynamic investigations.
CONCLUSION: Urodynamic investigations should be performed in female patients with lower urinary tract symptoms, especially if irreversible procedure, e.g., surgery is being contemplated.