Diagnostic Value of the Maximum Urethral Closing Pressure in Women With Overactive Bladder Symptoms and Functional Bladder Outlet Obstruction
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Purpose: Overactive bladder (OAB) is observed in women with functional bladder outlet obstruction (FBOO), as are lower urinary tract symptoms (LUTS). Therefore, we evaluated the urodynamic characteristics of women with storage LUTS and FBOO diagnosed by urodynamic studies (UDS). Methods: Women (n=108) with storage LUTS and FBOO diagnosed by UDS were included in this study. The urodynamic characteristics of women with FBOO were compared with those of women with OAB (n=34) and stress urinary incontinence (SUI, n=78). FBOO was defined as a maximum flow rate (Qmax) < 15 mL/sec, combined with detrusor pressure at a Qmax (PdetQmax) > 20 cm H2O in a pressure-flow study. The UDS included uroflowmetry, postvoid residual volume determination, a cystometrogram, and a pressure-flow study. Results: Women with FBOO who had storage symptoms showed a higher PdetQmax and maximum urethral closing pressure (MUCP) than women with OAB and SUI. Interstitial cystitis/bladder pain syndrome (IC/BPS) was observed in 17.6% of women with FBOO. MUCP was significantly higher in women with BOO than in women with BOO and IC/BPS (115.6±27.4 and 96.6±14.1 cm H2O, P=0.00). The receiver operating characteristic curve analysis showed that the cutoff values of MUCP in women with FBOO compared to women with OAB and SUI were 87 cm H2O (sensitivity=81.5%, specificity=73.5%) and 36 cm H2O (sensitivity=92.6%, specificity=84.4%), respectively. The cutoff value of MUCP in women with FBOO compared to women with FBOO and IC/BPS was 92 cm H2O (sensitivity=85.4%, specificity=78.9%). Conclusions: MUCP could have predictive value for identifying FBOO in women with complex LUTS.
Abstract
Purpose: Overactive bladder (OAB) is observed in women with functional bladder outlet obstruction (FBOO), as are lower urinary tract symptoms (LUTS). Therefore, we evaluated the urodynamic characteristics of women with storage LUTS and FBOO diagnosed by urodynamic studies (UDS). Methods: Women (n=108) with storage LUTS and FBOO diagnosed by UDS were included in this study. The urodynamic characteristics of women with FBOO were compared with those of women with OAB (n=34) and stress urinary incontinence (SUI, n=78). FBOO was defined as a maximum flow rate (Qmax) < 15 mL/sec, combined with detrusor pressure at a Qmax (PdetQmax) > 20 cm H2O in a pressure-flow study. The UDS included uroflowmetry, postvoid residual volume determination, a cystometrogram, and a pressure-flow study. Results: Women with FBOO who had storage symptoms showed a higher PdetQmax and maximum urethral closing pressure (MUCP) than women with OAB and SUI. Interstitial cystitis/bladder pain syndrome (IC/BPS) was observed in 17.6% of women with FBOO. MUCP was significantly higher in women with BOO than in women with BOO and IC/BPS (115.6±27.4 and 96.6±14.1 cm H2O, P=0.00). The receiver operating characteristic curve analysis showed that the cutoff values of MUCP in women with FBOO compared to women with OAB and SUI were 87 cm H2O (sensitivity=81.5%, specificity=73.5%) and 36 cm H2O (sensitivity=92.6%, specificity=84.4%), respectively. The cutoff value of MUCP in women with FBOO compared to women with FBOO and IC/BPS was 92 cm H2O (sensitivity=85.4%, specificity=78.9%). Conclusions: MUCP could have predictive value for identifying FBOO in women with complex LUTS.
참고문헌 (26)
- Irwin DE, "Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries:results of the EPIC study", Eur Urol, 50, pp.1306~1314 (2006)
- 박정옥, "Sex Differences in Lower Urinary Tract Symptoms in Older Korean Adults Living in Rural Areas: Prevalence, Quality of Life, and Associated Factors", International Neurourology Journal, 22(3), pp.212~219 (2018), 대한배뇨장애요실금학회
- Robinson D, "Defining female voiding dysfunction : ICI-RS 2011", Neurourol Urodyn, 31, pp.313~316 (2012)
- Konstantinos-Vaios Mytilekas, "Defining Voiding Dysfunction in Women: Bladder Outflow Obstruction Versus Detrusor Underactivity", International Neurourology Journal, 25(3), pp.244~251 (2021), 대한배뇨장애요실금학회[DOI]
- Coyne KS, "The prevalence of lower urinary tract symptoms (LUTS)in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study", BJU Int, 104, pp.352~360 (2009)
- Al-Zahrani AA, "Urodynamic findings in women with refractory overactive bladder symptoms", Int J Urol, 23, pp.75~79 (2016)
- Scarpero H, "Urodynamics in the evaluation of female LUTS : when are they helpful and how do we use them", Urol Clin North Am, 41, pp.429~438 (2014)
- Verghese TS, "The impact of urodynamics on treatment and outcomes in women with an overactive bladder : a longitudinal prospective follow-up study", Int Urogynecol J, 29, pp.513~519 (2018)
- Abrams P, "The standardisation of terminology of lower urinary tract function : report from the Standardisation Sub-committee of the International Continence Society", Am J Obstet Gynecol, 187, pp.116~126 (2002)
- Blaivas JG, "Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology", Neurourol Urodyn, 19, pp.553~564 (2000)
- 김도경, "Alpha-1 Adrenergic Receptor Blockers for the Treatment of Lower Urinary Tract Symptoms in Women: A Systematic Review and Meta-Analysis", International Neurourology Journal, 23(1), pp.56~68 (2019), 대한배뇨장애요실금학회[DOI]
- Chassagne S, "Proposed cutoffvalues to define bladder outlet obstruction in women", Urology, 51, pp.408~411 (1998)
- Nitti VW, "Diagnosing bladder outlet obstruction in women", J Urol, 161, pp.1535~1540 (1999)
- Choi YS, "Analysis of female voiding dysfunction: a prospective, multicenter study", Int Urol Nephrol, 45, pp.989~994 (2013)
- Cho KJ, "Evaluation of female overactive bladder using urodynamics : relationship with female voiding dysfunction", Int Braz J Urol, 41, pp.722~728 (2015)
- Kuo HC, "Clinical symptoms are not reliable in the diagnosis of lower urinary tract dysfunction in women", J Formos Med Assoc, 111, pp.386~391 (2012)
- Daan NM, "Associations between subjective overactive bladder symptoms and objective parameters on bladder diary and filling cystometry", Int Urogynecol J, 23, pp.1619~1624 (2012)
- Sheng-Mou Hsiao, "Urodynamic and Bladder Diary Factors Predict Overactive Bladderwet in Women: A Comparison With Overactive Bladder-dry", International Neurourology Journal, 23(1), pp.69~74 (2019), 대한배뇨장애요실금학회[DOI]
- FitzGerald MP, "Bother arising from urinary frequency in women", Neurourol Urodyn, 21, pp.36~40 (2002)
- Sekido N, "How many uncomplicated male and female overactive bladder patients reveal detrusor overactivity during urodynamic study", Int J Urol, 13, pp.1276~1279 (2006)
- Weber AM, "Is urethral pressure profilometry a useful diagnostic test for stress urinary incontinence?", Obstet Gynecol Surv, 56, pp.720~735 (2001)
- Suskind AM, "Patient perceptions of physical and emotional discomfort related to urodynamic testing : a questionnaire-based study in men and women with and without neurologic conditions", Urology, 85, pp.547~551 (2015)
- Cameron AP, "Bladder outlet obstruction in painful bladder syndrome", interstitial cystitis, 2009, pp.28, 944~948
- Kuo YC, "Videourodynamic characteristics of interstitial cystitis", bladder pain syndrome-The role of bladder outlet dysfunction in the pathophysiology, 2018, pp.37, 1971~1977
- Deindl FM, "Dysfunctional voiding in women : which muscles are responsible", Br J Urol, 82, pp.814~819 (1998)
- Butrick CW, "Chronic pelvic pain syndromes: clinical, urodynamic, and urothelial observations", Int Urogynecol J Pelvic Floor Dysfunct, 20, pp.1047~1053 (2009)