Bladder outlet obstruction is associated with bladder oversensitivity in women

Area of Science:

• Urology
• Female Lower Urinary Tract Symptoms
• Urodynamics

Background:

• Bladder outlet obstruction (BOO) in women can cause storage symptoms like frequency, urgency, and incontinence.
• Understanding the objective association between BOO and urodynamic parameters is crucial for diagnosis and management.

Purpose of the Study:

• To prospectively assess the objective association between bladder outlet obstruction (BOO) and abnormal parameters during filling cystometry in women.
• To identify specific urodynamic parameters that may predict BOO in the female population.

Main Methods:

• 169 women underwent urodynamic investigation, including pressure-flow studies to define obstruction (Qmax <12 ml/s and Pdet @ Qmax >25 cmH2O).
• Data collected included medical history, physical examination, ultrasound, and the International Prostate Symptom Score (IPSS).
• Statistical analyses, including logistic regression, were used to compare obstructed and non-obstructed groups.

Main Results:

• No significant difference in detrusor overactivity was observed between obstructed and non-obstructed groups (37% vs 32%).
• Significantly lower bladder sensation volumes, particularly first desire to void (FDV), were found in obstructed women.
• FDV <105 ml demonstrated a strong association with BOO (OR=9.84), with high predictive value (AUC=0.75).

Conclusions:

• A strong association exists between bladder oversensitivity and bladder outlet obstruction (BOO) in women.
• Reduced sensation volumes, especially FDV, may serve as objective indicators for BOO.
• Findings suggest a pathophysiological link between obstruction and heightened afferent bladder signaling.