URODYNAMIC FINDINGS IN FEMALE PATIENTS REPORTING WITH LOWER URINARY TRACT SYMPTOMS
Abstract
Objective: The study has been undertaken to determine the reproducibility of lower urinary tractsymptoms in female patients after urodynamic investigations. Design: A Descriptive study withretrospective analysis of data. Setting: Combined Military Hospital Rawalpindi and Armed ForcesInstitute of Urology, Rawalpindi. Methods: Fifty consecutive women with a primary history ofurinary incontinence were interviewed on a standard urinary incontinence questionnaire. Theyunderwent structured clinical pelvic examination, along with cough stress test. Post void residualurine was measured. This was followed by a urine routine examination to exclude any urinaryinfection. Later these patients underwent a combination of urodynamic tests to predict their finaldiagnosis. The tests performed were filling cystometry and leak point pressures. Results: Theclinical diagnosis was found to have a variable reproducibility on urodynamic investigations.Clinical stress incontinence translated as genuine stress incontinence in 61.5% of the cases.Patients with isolated symptoms of stress incontinence had an incidence of detrusor instability upto 33.3%. For the symptoms of urgency and urge incontinence, the diagnosis was reproducible inup to 50% of the cases. In cases of mixed symptoms, 20% patients were found to have stressincontinence and 33.3% cases were found to have an unstable bladder, whereas in 46.6% of thecases no objective abnormality was found on urodynamic investigations. Conclusion:Urodynamic investigations should be performed in female patients with lower urinary tractsymptoms, especially if irreversible procedure, e.g., surgery is being contemplated.Keywords: Urinary incontinence, stress incontinence, cystometry, leak point pressure, urinary tractReferences
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