[Diagnosis of overactive bladder influenced by methods of clinical assessment--micturition diary vs. urodynamics]

Most characteristic symptom of overactive bladder is urgent, possibly painful, desire to void. This complaint is caused by autonomous bladder contractions. The increased activity of detrusor muscle is not only responsible for the urgency but also is the direct reason for the development of urge urinary incontinence.

The comparison of the subjective (micturition diary) and objective (urodynamic investigation) mode of diagnosis of overactive bladder.

Twenty one women complaining of symptoms of the overactive bladder were included into the study. The infection of lower urinary tract was ruled out based on the results of urinalysis. Each patient reported urinary symptoms (number of urgency episodes and urge urinary leakages) in micturition diary for seven days. Thereafter, all participants underwent the urodynamic investigation that included uroflowmetry and cystometry.

Data obtained from micturition diaries proved that all patients had subjective symptoms of overactive bladder (n = 21). However, only 8 subjects met overactive bladder diagnostic criteria on urodynamic investigation. The data obtained from micturition diaries and urodynamics were compared between group with objectively (urodynamic investigation) and subjectively (micturition diary) diagnosed overactive bladder.

1. There is marked discrepancy between data obtained from micturition diary and the results of urodynamic investigation. 2. It was shown that the diagnosis of overactive bladder cannot be made solely on the basis of maturation diary. 3. Volume of voided urine measured at uroflowmetry and volume of infused fluid causing strong desire to void are best markers of urodynamically proven diagnosis of overactive bladder.