Urodynamic and clinical features in women with overactive bladder: When to suspect concomitant voiding dysfunction?

Area of Science:

• Urology
• Female Pelvic Medicine

Background:

• Overactive bladder (OAB) syndrome is a common condition affecting many women.
• Female voiding dysfunction (FVD) can coexist with OAB, impacting diagnosis and treatment.
• Urodynamics (UDS) is crucial for evaluating lower urinary tract symptoms.

Purpose of the Study:

• To determine the prevalence and types of FVD in female patients diagnosed with OAB via urodynamics.
• To investigate the relationship between FVD subtypes and specific voiding symptoms in OAB patients.

Main Methods:

• A cross-sectional study analyzed urodynamic data from 299 adult female patients with OAB syndrome.
• Female voiding dysfunction was categorized as bladder outlet obstruction (BOO) or detrusor underactivity (DU) based on established urodynamic criteria.
• Clinical features and urodynamic parameters were compared between patients with and without FVD, and between BOO and DU subgroups.

Main Results:

• Female voiding dysfunction was diagnosed in 23% of the studied OAB patients.
• Bladder outlet obstruction (BOO) was diagnosed in 19.7% of patients, while detrusor underactivity (DU) was found in 3.3%.
• Independent predictors for BOO included nighttime frequency, detrusor overactivity, and high postvoid residual (PVR). A smaller voided volume predicted DU.

Conclusions:

• Female voiding dysfunction is present in a significant minority of OAB patients.
• BOO is more prevalent than DU in this population.
• Specific clinical and urodynamic parameters can help predict the presence of BOO or DU in women with OAB, aiding clinical suspicion and diagnosis.