INTRODUCTION: The purposes of the present study were to: (1) compare the findings from videocystourethrography (VCU) with those from ambulatory urodynamic monitoring (AUM) to determine their level of agreement in identifying the causes of overactive bladder (OAB) symptoms; (2) examine changes in the diagnoses that were made following the first test (VCU) after the patient had the second test (AUM).
METHODS: This was a retrospective analysis of our AUM database during 2007 and 2008. The inclusion criteria were: (1) female patients over the age of 18 years with OAB symptoms; (2) complete documentation of all OAB symptoms; (3) results from both VCU and AUM. Patients were referred for AUM because the findings following VCU did not explain the presenting symptoms. The frequency and type of OAB symptoms and the results from the tests were recorded and compared.
RESULTS: A total of 100 women fulfilled the inclusion criteria. The mean age was 56 years (range, 19-87 years). The cause of the OAB symptoms was defined in 55% of the patients following VCU and 64% of the patients following AUM. Detrusor overactivity (DO) was not identified for any patients following VCU; it was found in 32 patients following AUM. Urgency with or without urge urinary incontinence was the symptom most frequently associated with DO. Of the 100 patients, 45 women had normal results from the VCU. Nine of these women also had normal results following AUM. For the remaining 36 women, the results from AUM identified abnormalities that could explain their symptoms. The most common findings were DO (58%) and urodynamic stress incontinence (16%).
CONCLUSION: Results from VCU for patients with symptoms of OAB should be interpreted with caution. AUM appears to be a more discerning tool in identifying DO. Clinicians should interpret urodynamic results in conjunction with clinical symptoms, particularly if a continence surgery is contemplated. AUM is particularly recommended for complex cases.
Ismaiel A Mahfouz, Angie Rantell, Linda Cardozo, Dudley Robinson, Sushma Srikrishna
Submitted September 22, 2010 - Accepted for Publication October 27, 2010
KEYWORDS: Overactive bladder; Detrusor overactivity; Urodynamics; Ambulatory urodynamic monitoring.
CORRESPONDENCE: Ismaiel Mahfouz, MSc, MRCOG, Obstetrics and Gynaecology, North Hampshire Hospital, Basingstoke, RG24 9NA, United Kingdom ( ).
CITATION: UroToday Int J. 2010 Dec;3(6).