A comparison of urodynamic diagnoses and detrusor muscle function in white and South Indian Asian women.

PURPOSE: We compared urodynamic data and the final diagnosis after testing between white and Asian women investigated for urinary incontinence.

MATERIALS AND

METHODS

Urodynamic traces of consecutive women investigated between January 2002 and December 2003 were reviewed. Urodynamic diagnoses were classified as normal, urodynamic stress incontinence, detrusor overactivity (DOA) or mixed incontinence. In DOA cases the amplitude and number of detrusor contractions, and the volume at which the first involuntary contraction occurred were recorded. Data were compared by ethnic group.

RESULTS

The distribution of diagnoses was significantly different between Asian and white women (p <0.0001). In Asian and white women we noted urodynamic stress incontinence in 22% and 53% (OR 0.24, 95% CI 0.13 to 0.48), DOA in 28% and 17% (OR 1.88, 95% CI 0.98 to 3.60) and mixed incontinence in 22% and 7% (OR 3.74, 95% CI 1.70 to 8.22), respectively. Post-void residual volume (p = 0.02), volume at strong desire to void (p = 0.03) and cystometric capacity (p = 0.0002) were lower in Asian women. In those with DOA the first contraction occurred at a lower volume in Asian woman (57 vs 179 ml, p = 0.002). Asian women had more contractions (5 vs 3, p = 0.009) with higher maximum (50 vs 32 cm H2O, p = 0.004) and average (34.4 vs 25.3 cm H2O, p = 0.03) detrusor pressure.

CONCLUSIONS

In women who undergo urodynamics a greater proportion of Asian women have DOA and mixed incontinence compared with white women. Functional differences in detrusor contraction pressures exist, which may suggest a fundamental difference in bladder function or disease etiology. Exploration of this theory requires further study.