Relationship between urodynamic patterns and lower urinary tract symptoms in Chinese women with a non-neurogenic bladder

doi:10.1016/j.ajur.2015.11.004

Asian Journal of Urology, 2016, 3 (1): 10-19 doi: 10.1016/j.ajur.2015.11.004

Asian Focus

Relationship between urodynamic patterns and lower urinary tract symptoms in Chinese women with a non-neurogenic bladder

Linhui Wang, Cunzhou Wang, Chuangyu Qu, Lei Yin, Danfeng Xu, Xingang Cui, Bing Liu

Department of Urology, Changzheng Hospital, Second Military Medical University, Shanghai, China

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Abstract Objective: To investigate the urodynamic study (UDS) patterns, obstruction status, continence status, and their correlations among neurologically intact women with lower urinary tract symptoms (LUTS) through an epidemiological and logistic regression analyses.
Methods: We retrospectively analyzed the UDS data of 3265 neurologically intact women with LUTS (2002-2014). Five UDS patterns were identified: normo-active detrusor/sphincter (NA, or DSI, detrusor/sphincter intact), idiopathic detrusor overactivity (IDO), idiopathic sphincter overactivity (ISO), IDO + ISO, and detrusor underactivity (DUA). Analyses of UDS pattern distribution and stratification were performed (based on a modification of the European Urological Association-Madersbacher classification system), and their correlations with bladder outlet obstruction (BOO) and stress urinary incontinence (SUI) status were evaluated via logistic regression analysis.
Results: NA, IDO, IDO + ISO, ISO, and DUA were noted in 927 (28.4%), 678 (20.8%), 320 (9.8%), 689 (21.1%), and 651 (19.9%) cases, respectively. Moreover, storage, storage + voiding, and voiding symptoms were noted in 62.4%, 21.1%, and 16.5% cases, respectively, whereas BOO and SUI were observed in 12.1% and 29.0% cases, respectively. The risk factors for BOO included NA, IDO, ISO, and IDO + ISO, whereas the protective factors against BOO included storage symptoms, SUI, storage + voiding symptoms, and complaint duration within 1-12 months. NA was the only risk factor for SUI, whereas BOO, storage + voiding symptoms, IDO, and storage symptoms were protective factors for SUI.
Conclusion: Five UDS patterns were identified among neurologically intact women with LUTS. Functional abnormalities of the detrusor and/or sphincter were the main causes of LUTS, and were correlated with the BOO or SUI status. Thus, the UDS pattern can provide additional information regarding the risk factors for BOO or SUI status, as compared to symptomatic typing.

Key words： Bladder outlet obstruction Detrusor underactivity Idiopathic detrusor overactivity Idiopathic sphincter overactivity Urodynamics

Received: 18 August 2015 Published: 29 January 2016

Fund:The authors would like to thank Zhilian Min, Youhua Zhu, Yacheng Yao, Jizhong Ren, Yushan Liu, and Yi Gao for their outstanding efforts in data management; Zixing Zhang for the development of decoction of Chinese medicinal herbs; Xingyi Zhang for the help with image creation; Wei Qian and Jin Wang for help with statistical analysis; and Cheng Zhong, Yana Liu and Xingwei Liu for their constant technical support.

Corresponding Authors: Chuangyu Qu, Lei Yin E-mail: qu_cy@sohu.com;yin202@163.com

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Cite this article:

Linhui Wang,Cunzhou Wang,Chuangyu Qu, et al. Relationship between urodynamic patterns and lower urinary tract symptoms in Chinese women with a non-neurogenic bladder[J]. Asian Journal of Urology, 2016, 3(1): 10-19.

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http://www.ajurology.com/EN/10.1016/j.ajur.2015.11.004 OR http://www.ajurology.com/EN/Y2016/V3/I1/10

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