BERKELEY, CA (UroToday Inc.) - The purpose of this study from London was to assess urinary symptoms in adult women with congenital adrenal hyperplasia (CAH). Feminizing surgery in infancy is current standard practice for CAH with one of the indications for surgery being the reduction of urinary symptoms via the correction of the urogenital sinus.

It was a case-controlled study of 19 women with CAH, of whom 16 had had childhood feminizing genital surgery. They were age-matched with women without a history of CAH. Subjects and controls completed the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaire. The study reported urge incontinence in 13 (68%) patients and three (16%) controls (P = 0.003) and stress incontinence was present in 47% and 26%, respectively (P = 0.31). Results from the controls were comparable with those documented in larger studies on normal populations. Nine of the CAH patients felt that their urinary symptoms had an adverse effect on their lives, compared with only one of the controls (P = 0.008).

The authors concluded that patients with a diagnosis of CAH are more likely to have significant urinary symptoms than normal controls. Currently it is not clear whether this is a result of surgery or an effect of CAH. In at least two-thirds of patients surgery did not achieve the objective of reducing urinary symptoms. The impact of voiding dysfunction and constipation need to be further investigated, as these may in fact be confounding factors.

BJU Int. 2005 Jun;95(9):1263-6