Voiding symptoms obtained by open versus directed anamnesis as predictors of voiding dysfunction in women

Abstract

Aims To describe the voiding pattern (VP) of women with urinary incontinence but without voiding symptoms and compare their clinical and urodynamic features between those voiding with and without a measurable detrusor contraction (DET-cont). Methods Retrospective analysis of a prospectively built database of female urodynamic studies (UDS). Women with voiding symptoms and having medical history of different factors that could alter the lower urinary tract function were excluded. All UDS were performed following the ICS guidelines. DET-cont and abdominal straining (ABD-strain) were defined as an increase >= 10 cm H2O over the baseline forp(det)andp(abd)atQ(max), respectively. Results A total of 186 women were included in the analysis. Mean age was 58 +/- 10.7 years (24-83). Most women showed a VP with DET-cont (77.4%), with or without ABD-strain. When compared to women voiding without DET-cont, those with DET-cont were younger (P = .004), more likely to have detrusor overactivity (P = .035) and better urinary sphincter competency in the UDS (P = .018). On multivariate analysis, the presence of DET-cont was associated with age <= 50 years (P = .004) and the absence of urodynamic stress urinary incontinence (SUI) or SUI with abdominal leak point pressure >= 100 cm H2O (P = .008). Conclusions Most women without voiding symptoms show a VP characterized by a measurable detrusor contraction, with or without ABD-strain. The results suggest that the VP may vary independently with aging and with changes in the state of the urinary sphincter, emphasizing that for the interpretation of micturition in women different aspects must be considered.