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[Prevalence and clinical-urodynamic characteristics of vesical voiding dysfunction in two urodynamic centres]
Maria Isabel González Ruiz1, Oscar Flores Carreras, Patricia Inés Velázquez Castellanos
1Programa de Especialidad en Uroginecología y Reconstrucción del Piso Pélvico, Clínica de Uroginecología y Reconstrucción del Piso Pélvico, Servicio de ginecología, Hospital Civil Fray Antonio Alcalde.
Background:
It has been estimated in English medical reports, that the frequency of vesical voiding dysfunction in urogynecological patients is around of 22-24%; however in our country it does not have any published epidemiological study about this problem.
Objective:
To detect the prevalence of vesical voiding dysfunction in our urodynamic unities and describe the clinical and urodynamic findings.
Material And Methods:
This is a descriptive and retrospective study in which were revised the clinical reports of 300 female patients, that were sent to some of our urodynamic units because they were suffering of lower urinary tract symptoms. Assessment variables included: Patient clinical history, physical examination, urinalysis, urine culture, urethral calibration, Q tip test, urethrocistoscopy, uroflowmetry, multichannel cystometry, electromyography and pressure voiding study. The diagnosis criterion was based in the concept that Blaivas established for vesical voiding dysfunction in women.
Results:
The diagnosis of vesical voiding dysfunction was established in 72 cases of the total 300 patients analyzed. The most frequent symptom was the irritative vesical type (frequency/urgency), following of weak stream. Some grade of pelvic organ prolapse was detected in 84.8% of cases. Uroflowmetry was normal in 50% of the cases; nevertheless in the morphologic aspect were observed profile signs suggestive of distal vesical obstruction in 75%, and detrusor hypoactivity in 25% of the total of the cases.
Conclusions:
The frequency of obstruction in our casuistic was similar to the other authors. The obtained results permit us to confirm that the vesical voiding dysfunction in the urogynecological Mexican patients is a frequent problem in the urogynecological patient; however the diagnostic is complex and require a carefully correlation as clinical as urodynamical aspects in addition to endoscopic and image studies.
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