Urodynamic (UDS) studies are used for a more detailed evaluation of the bladder when empiric therapy for OAB has failed. Our study explores whether urodynamic study parameters in patients with refractory OAB symptoms differ by race and ethnicity. We performed a 5-year retrospective chart review of women 18 years and older who endorsed OAB symptoms and underwent urodynamics at a racially and ethnically diverse academic urban medical center. About half of the patients in the study had detrusor overactivity. Compared with white women, black women were 3.4-fold more likely to have detrusor overactivity and had lower volumes (102.6mL less) at the point in which they felt a "strong desire” to void. Hispanics had on average 75.88 mL less volume at sensation of "strong desire" to void, than did whites. These differences remained significant even after controlling for other risk factors for OAB, including age, body mass index, parity, diabetes, history of anti-incontinence surgery, and history of smoking.
Our study suggests that minority race and ethnicity may be associated with worse performance on certain UDS parameters. These differences could be due to genetic, disease-related, behavioral, and/or socioeconomic factors. Further exploration of what is contributing to differences in UDS parameters may aid in individualizing and optimizing care in these populations.
Written by: Nitya Abraham, MD, Assistant Professor, Department of Urology, Montefiore Medical Center, New York, New York, Twitter: @nityaabraham and Stephanie Zuo, MD, Resident, Montefiore Medical Center, New York, New York, Twitter: @StephanieWZuo
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