Prevalence of Detrusor Underactivity and Bladder Outlet Obstruction in Female Without Cystocele
Condition: Voiding Disorders
MeSH terms: Hypokinesia; Cystocele; Urinary Bladder Neck Obstruction; Urinary Bladder, Underactive
Study type: Observational

Summary: 
      Women with symptoms of voiding dysfunction may be associated with detrusor underactivity (DU)
      or bladder outlet obstruction (BOO). The treatment strategies are different between DU and
      BOO. In general, urodynamic/videourodynamic studies are important for differential diagnosis.
      However, urodynamic/videourodynamic studies are invasive. The investigators are interested in
      whether there were specific symptoms or measurements that can be used for initial
      differential diagnosis between DU and BOO. Thus, the aim of this study was to elucidate the
      prevalence of DU and BOO in each age group and elucidate the clinical and urodynamic
      differences between the DU, BOO and non-DU/BOO groups.
    

Detailed description: 
      Between April 1996 and September 2018, all women with symptoms of voiding dysfunction who
      visited the urogynecological department of a medical center for urodynamic evaluation were
      reviewed. Those women who have no complete data of maximum flow rate (Qmax), voided volume,
      post-void residual volume (PVR) and detrusor pressure at a maximum flow rate (PdetQmax) were
      excluded from this study. Besides, women with cystocele were also excluded. The DU was
      defined when the PdetQmax was less than 20 cmH2O, the Qmax was less than 15 mL/s, and the
      bladder voiding efficiency (BVE) was less than 90 %. The BOO was defined when the PdetQmax
      was not less than 40 cmH2O, and the Qmax was less than 12 mL/s. BVE = voided volume / (voided
      volume+ PVR) x 100%. Those women without DU or BOO were allocated to the non-DU/BOO group.

      STATA software was used for statistical analysis. ANOVA test with Bonferroni correction or
      chi-square test was used for statistical analysis as appropriate. Linear regression analysis
      with age adjustment was used to assess the adjusted effect of variables. P < 0.05 was
      considered as statistical significant.
    

Intervention name(s): Urodynamic study
Intervention type(s): Diagnostic Test
Intervention description(s): The urodynamic assessment included uroflowmetry, filling cystometry with 35°C distilled water at a rate of 60 mL/sec, a pressure flow study, and a stress urethral pressure profile with patient in sitting position [14]. A 20-minute pad test for each woman was also performed [15, 16]. Multichannel urodynamic equipment (Life-Tech, Houston, TX, USA) with computer analysis and Urovision (Urolab Janus System V, Houston) was used. All terminology conformed to the standards recommended by the ICS [3]. All procedures were performed by an experienced technician, and the data were interpreted by a single observer to avoid interobserver variability.
Other intervention name(s): Pad test
Observational model: Case-Only
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        All women with symptoms of voiding dysfunction and without cystocele who visited the
        urogynecological department of a medical center for urodynamic evaluation were reviewed.
      
Keywords: Bladder outlet obstruction; Detrusor underactivity; Voiding dysfunction