Factors affecting voiding function in urogynecology patients

Our objective was to assess the impacts of menopause, age and parity on voiding function in urogynecology patients.

The medical records of 4,470 patients with urodynamic studies were reviewed at our center between January 1999 and May 2003. Patients with conditions including a prior continence procedure, advanced pelvic prolapse, hysterectomy or neurologic deficits were excluded from our study. Comprehensive medical histories, physical examinations, bladder diaries and results of multi-channel urodynamic testing were analyzed.

The mean age of the 3,161 women enrolled was 50 years, and the mean parity was three. Four urodynamic variables served as voiding parameters: maximum flow rate (Qmax) and post-void residual (PVR) from uroflowmetry, and maximum flow rate (Qmax.p) and detrusor pressure at maximum flow (PdetQmax) from pressure-flow studies. Of the three factors studied (menopause, age, and parity), only parity had a significant impact on uroflowmetry and pressure-flow study results (Qmax, p=0.007; PVR, p<0.001; Qmax.p, p=0.002; PdetQmax, p<0.001). Twenty-five percent of the patients in our study were diagnosed with voiding dysfunction.

Our results indicated that parity had a significant impact on voiding function in urogynecology patients. Twenty-five percent of patients in our study were diagnosed with voiding dysfunction. The bladder behavior in women after childbirth may be more complex than previously thought, and special attention should be paid to women who suffer from bladder symptoms after childbirth.