Bladder diary volume per void measurements in detrusor overactivity.

Area of Science:

• Urology
• Clinical diagnostics
• Bladder function studies

Background:

• Volume per void measurements can increase with 24-hour urine volume in asymptomatic individuals.
• This tendency may affect the diagnostic accuracy of volume per void in identifying bladder conditions like detrusor overactivity.
• A need exists to refine reference values for volume per void to enhance clinical utility.

Purpose of the Study:

• To assess the clinical usefulness of adjusting volume per void (VPV) reference values based on 24-hour urine volume.
• To determine if this adjustment improves the separation between patients with detrusor overactivity and asymptomatic individuals.
• To compare VPV versus 24-hour volume relationships in patients and controls using regression analysis.

Main Methods:

• Analysis of 3-day bladder diaries from 29 patients with detrusor overactivity and 29 age-matched asymptomatic controls.
• Inclusion of a reference population of 161 asymptomatic women for comparison.
• Calculation of minimum, maximum, and average VPV; use of incidence below the 10th reference percentile as a separation measure.

Main Results:

• A significant positive relationship was observed between VPV and 24-hour volume in detrusor overactivity patients (p <0.0005).
• Adjusting for 24-hour volume significantly increased the incidence of VPV measurements below the 10th percentile in detrusor overactivity patients (p <0.01).
• Patient data points tended to lie below and parallel to control data points, indicating a potential for misclassification without adjustment.

Conclusions:

• Adjusting VPV for 24-hour urine volume enhances the separation of detrusor overactivity patients from the reference population.
• This adjustment reduces false-negative VPV percentiles in patients and false-positive percentiles in asymptomatic volunteers.
• The findings support the clinical utility of incorporating 24-hour volume adjustments for more accurate VPV interpretation in bladder dysfunction assessment.