Impaired bladder emptying in women

Area of Science:

• Urology
• Gynecology
• Nephrology

Background:

• Urinary incontinence and lower urinary tract symptoms are common in women.
• Urodynamic assessment is key to diagnosing bladder dysfunction.
• Voiding dysfunction often coexists with other lower urinary tract disorders.

Purpose of the Study:

• To review clinical and urodynamic findings in women investigated for urinary symptoms.
• To determine the prevalence and characteristics of voiding dysfunction.
• To identify causes and associations of voiding dysfunction.

Main Methods:

• Retrospective review of clinical and urodynamic data from 1,193 women.
• Definition of impaired bladder emptying: max flow rate <15 ml/s or residual volume >=150 ml.
• Analysis of voiding dysfunction prevalence, associated conditions, and contributing factors.

Main Results:

• 165 women (13.8%) were diagnosed with voiding dysfunction.
• 34% of women with voiding dysfunction had a residual urine volume >=150 ml.
• Voiding dysfunction was associated with genuine stress incontinence, detrusor instability, or bladder hypersensitivity in 138 patients.
• Symptoms of impaired bladder emptying were not always present in women with voiding dysfunction.
• Neurological disease, pelvic surgery, and psychological factors were identified as causes.

Conclusions:

• Voiding dysfunction is a common cause of lower urinary tract dysfunction in women.
• It frequently coexists with other urinary symptoms and urodynamic abnormalities.
• Clinical suspicion and urodynamic evaluation are essential for diagnosis and management.
• Causes are multifactorial, including neurological, surgical, and psychological elements.