Is urodynamic study is a necessity for evaluation of lower urinary tract symptoms in postmenopausal female patients? Result of a prospective observational study

The aim of this study is to evaluate the causes of lower urinary tract symptoms (LUTS) in postmenopausal female patients (PMFP) and correlate their symptoms with their urodynamic study (UDS) findings.

A prospective observational study analyzing the clinical and UDS findings of PMFP presenting with LUTS. A detailed history including history of diabetes, neurological disease, drug history, and pelvic surgeries was taken, followed by physical examination and urodynamic assessment.

A total of 100 patients were classified according to their predominant symptoms into three categories: (1) voiding dysfunction (45 patients), (2) storage symptoms (30 patients), and (3) urinary incontinence (25 patients). The patients with voiding LUTS could be categorized urodynamically into three grades of bladder outlet obstruction (BOO): (a) early (37.8%) (maximal flow [Qmax] >15 mL/s and detrusor pressure at maximal flow [PdetQmax] >30 cm of water), (b) compensated (31.1%) (Qmax <15 mL/s and PdetQmax >30 cm of water), and (c) late (31.1%) (Qmax <15 mL/s and PdetQmax <30 cm of water). The patients with storage symptoms could be categorized into two with either the presence of demonstrable idiopathic detrusor contractions (53.3%) or not (46.7%). The patients with incontinence were of three types: (a) stress incontinence (44%), (b) urge incontinence (28%), and (c) mixed incontinence (28%). UDS showed no demonstrable leak in nine patients (36%) and the rest had UDS findings corroborative to their symptoms.

Thus, the major LUTS in PMFP were BOO, storage symptoms, and incontinence. Proper evaluation of LUTS necessitates UDS and along with good physical examination can help us in reaching a correct diagnosis and plan respective treatment.

Urology annals. 0000 Jan [Epub]

Sunirmal Choudhury, Susanta Kumar Das, Debarshi Jana, Dilip Kumar Pal

Department of Urology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.